code_type,code,description,gross_charge,discounted_cash,min_negotiated,max_negotiated,payer_entries
,,Bilateral Procedure,,,,,0
APR-DRG,0011,LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT,,,51493.23,54067.89,14
APR-DRG,0012,LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT,,,59222.75,62183.89,14
APR-DRG,0013,LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT,,,73721.62,77407.7,14
APR-DRG,0014,LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT,,,157591.25,165470.81,14
APR-DRG,0021,HEART AND/OR LUNG TRANSPLANT,,,97800.81,102690.85,14
APR-DRG,0022,HEART AND/OR LUNG TRANSPLANT,,,106346.23,111663.54,14
APR-DRG,0023,HEART AND/OR LUNG TRANSPLANT,,,146130.09,153436.59,14
APR-DRG,0024,HEART AND/OR LUNG TRANSPLANT,,,260252.21,273264.82,14
APR-DRG,0041,TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE,,,53742.52,56429.65,14
APR-DRG,0042,TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE,,,60560.82,63588.86,14
APR-DRG,0043,TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE,,,98142.63,103049.76,14
APR-DRG,0044,TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE,,,156510.84,164336.38,14
APR-DRG,0051,TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE,,,36152.7,37960.34,14
APR-DRG,0052,TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE,,,46562.65,48890.78,14
APR-DRG,0053,TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE,,,70519.02,74044.97,14
APR-DRG,0054,TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE,,,102088.12,107192.53,14
APR-DRG,0061,PANCREAS TRANSPLANT,,,48226.22,50637.53,14
APR-DRG,0062,PANCREAS TRANSPLANT,,,64485.7,67709.99,14
APR-DRG,0063,PANCREAS TRANSPLANT,,,80537.35,84564.22,14
APR-DRG,0064,PANCREAS TRANSPLANT,,,113366.35,119034.67,14
APR-DRG,0071,ALLOGENEIC BONE MARROW TRANSPLANT,,,65975.78,69274.57,14
APR-DRG,0072,ALLOGENEIC BONE MARROW TRANSPLANT,,,69448.06,72920.46,14
APR-DRG,0073,ALLOGENEIC BONE MARROW TRANSPLANT,,,86605.88,90936.17,14
APR-DRG,0074,ALLOGENEIC BONE MARROW TRANSPLANT,,,177203.63,186063.81,14
APR-DRG,0081,AUTOLOGOUS BONE MARROW TRANSPLANT,,,26483.07,27807.22,14
APR-DRG,0082,AUTOLOGOUS BONE MARROW TRANSPLANT,,,37753.57,39641.25,14
APR-DRG,0083,AUTOLOGOUS BONE MARROW TRANSPLANT,,,44813.2,47053.86,14
APR-DRG,0084,AUTOLOGOUS BONE MARROW TRANSPLANT,,,87829.72,92221.21,14
APR-DRG,0091,EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO),,,43550.71,45728.25,14
APR-DRG,0092,EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO),,,45842.09,48134.19,14
APR-DRG,0093,EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO),,,75986.37,79785.69,14
APR-DRG,0094,EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO),,,176315.6,185131.38,14
APR-DRG,0111,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,52254.16,54866.87,14
APR-DRG,0112,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,114592.77,120322.41,14
APR-DRG,0113,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,133459.68,140132.66,14
APR-DRG,0114,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,228840.29,240282.3,14
APR-DRG,0201,OPEN CRANIOTOMY FOR TRAUMA,,,19692.25,20676.86,14
APR-DRG,0202,OPEN CRANIOTOMY FOR TRAUMA,,,22748.85,23886.29,14
APR-DRG,0203,OPEN CRANIOTOMY FOR TRAUMA,,,32542.15,34169.26,14
APR-DRG,0204,OPEN CRANIOTOMY FOR TRAUMA,,,52241.28,54853.34,14
APR-DRG,0211,OPEN CRANIOTOMY EXCEPT TRAUMA,,,18495.89,19420.68,14
APR-DRG,0212,OPEN CRANIOTOMY EXCEPT TRAUMA,,,23861.9,25055.0,14
APR-DRG,0213,OPEN CRANIOTOMY EXCEPT TRAUMA,,,36032.46,37834.08,14
APR-DRG,0214,OPEN CRANIOTOMY EXCEPT TRAUMA,,,58310.67,61226.2,14
APR-DRG,0221,VENTRICULAR SHUNT PROCEDURES,,,12180.01,12789.01,14
APR-DRG,0222,VENTRICULAR SHUNT PROCEDURES,,,14907.68,15653.06,14
APR-DRG,0223,VENTRICULAR SHUNT PROCEDURES,,,23002.2,24152.31,14
APR-DRG,0224,VENTRICULAR SHUNT PROCEDURES,,,45185.94,47445.24,14
APR-DRG,0231,SPINAL PROCEDURES,,,15894.48,16689.2,14
APR-DRG,0232,SPINAL PROCEDURES,,,20442.87,21465.01,14
APR-DRG,0233,SPINAL PROCEDURES,,,33909.42,35604.89,14
APR-DRG,0234,SPINAL PROCEDURES,,,53535.54,56212.32,14
APR-DRG,0241,OPEN EXTRACRANIAL VASCULAR PROCEDURES,,,8616.7,9047.54,14
APR-DRG,0242,OPEN EXTRACRANIAL VASCULAR PROCEDURES,,,11589.99,12169.49,14
APR-DRG,0243,OPEN EXTRACRANIAL VASCULAR PROCEDURES,,,20878.3,21922.22,14
APR-DRG,0244,OPEN EXTRACRANIAL VASCULAR PROCEDURES,,,38018.09,39918.99,14
APR-DRG,0261,OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,,,12441.1,13063.16,14
APR-DRG,0262,OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,,,15925.4,16721.67,14
APR-DRG,0263,OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,,,23751.11,24938.67,14
APR-DRG,0264,OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,,,44354.59,46572.32,14
APR-DRG,0271,OTHER OPEN CRANIOTOMY,,,16684.61,17518.84,14
APR-DRG,0272,OTHER OPEN CRANIOTOMY,,,18871.2,19814.76,14
APR-DRG,0273,OTHER OPEN CRANIOTOMY,,,31276.23,32840.04,14
APR-DRG,0274,OTHER OPEN CRANIOTOMY,,,54658.04,57390.94,14
APR-DRG,0291,OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES,,,19739.49,20726.46,14
APR-DRG,0292,OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES,,,22294.52,23409.25,14
APR-DRG,0293,OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES,,,25082.31,26336.43,14
APR-DRG,0294,OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES,,,38360.77,40278.81,14
APR-DRG,0301,PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,,,17080.53,17934.56,14
APR-DRG,0302,PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,,,23580.2,24759.21,14
APR-DRG,0303,PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,,,32020.84,33621.88,14
APR-DRG,0304,PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,,,42999.34,45149.31,14
APR-DRG,0401,SPINAL DISORDERS AND INJURIES,,,9411.98,9882.58,14
APR-DRG,0402,SPINAL DISORDERS AND INJURIES,,,12670.41,13303.93,14
APR-DRG,0403,SPINAL DISORDERS AND INJURIES,,,17961.7,18859.79,14
APR-DRG,0404,SPINAL DISORDERS AND INJURIES,,,25449.03,26721.48,14
APR-DRG,0411,NERVOUS SYSTEM MALIGNANCY,,,7840.31,8232.33,14
APR-DRG,0412,NERVOUS SYSTEM MALIGNANCY,,,8048.15,8450.56,14
APR-DRG,0413,NERVOUS SYSTEM MALIGNANCY,,,11016.29,11567.1,14
APR-DRG,0414,NERVOUS SYSTEM MALIGNANCY,,,17040.17,17892.18,14
APR-DRG,0421,DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS,,,6363.97,6682.17,14
APR-DRG,0422,DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS,,,8023.25,8424.41,14
APR-DRG,0423,DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS,,,11898.31,12493.23,14
APR-DRG,0424,DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS,,,22643.21,23775.37,14
APR-DRG,0431,"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES",,,8242.25,8654.36,14
APR-DRG,0432,"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES",,,11413.07,11983.72,14
APR-DRG,0433,"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES",,,16842.63,17684.76,14
APR-DRG,0434,"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES",,,32091.27,33695.83,14
APR-DRG,0441,INTRACRANIAL HEMORRHAGE,,,7817.98,8208.88,14
APR-DRG,0442,INTRACRANIAL HEMORRHAGE,,,10482.09,11006.19,14
APR-DRG,0443,INTRACRANIAL HEMORRHAGE,,,14889.64,15634.12,14
APR-DRG,0444,INTRACRANIAL HEMORRHAGE,,,18964.82,19913.06,14
APR-DRG,0451,CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION,,,6829.46,7170.93,14
APR-DRG,0452,CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION,,,8798.77,9238.71,14
APR-DRG,0453,CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION,,,12466.0,13089.3,14
APR-DRG,0454,CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION,,,20810.46,21850.98,14
APR-DRG,0461,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION,,,6979.76,7328.75,14
APR-DRG,0462,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION,,,8011.22,8411.78,14
APR-DRG,0463,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION,,,10395.35,10915.12,14
APR-DRG,0464,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION,,,20688.5,21722.93,14
APR-DRG,0471,TRANSIENT ISCHEMIA,,,6405.2,6725.46,14
APR-DRG,0472,TRANSIENT ISCHEMIA,,,7176.43,7535.25,14
APR-DRG,0473,TRANSIENT ISCHEMIA,,,9064.16,9517.37,14
APR-DRG,0474,TRANSIENT ISCHEMIA,,,16473.33,17297.0,14
APR-DRG,0481,"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS",,,6296.99,6611.84,14
APR-DRG,0482,"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS",,,7087.11,7441.47,14
APR-DRG,0483,"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS",,,9854.28,10346.99,14
APR-DRG,0484,"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS",,,19413.13,20383.79,14
APR-DRG,0491,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,,,8736.08,9172.88,14
APR-DRG,0492,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,,,18260.57,19173.6,14
APR-DRG,0493,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,,,20799.29,21839.25,14
APR-DRG,0494,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,,,33852.74,35545.38,14
APR-DRG,0501,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,,,6456.73,6779.57,14
APR-DRG,0502,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,,,12313.99,12929.69,14
APR-DRG,0503,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,,,19709.43,20694.9,14
APR-DRG,0504,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,,,38345.31,40262.58,14
APR-DRG,0511,VIRAL MENINGITIS,,,4674.64,4908.37,14
APR-DRG,0512,VIRAL MENINGITIS,,,6581.26,6910.32,14
APR-DRG,0513,VIRAL MENINGITIS,,,11740.29,12327.3,14
APR-DRG,0514,VIRAL MENINGITIS,,,22596.83,23726.67,14
APR-DRG,0521,ALTERATION IN CONSCIOUSNESS,,,5658.01,5940.91,14
APR-DRG,0522,ALTERATION IN CONSCIOUSNESS,,,6329.62,6646.1,14
APR-DRG,0523,ALTERATION IN CONSCIOUSNESS,,,8636.45,9068.27,14
APR-DRG,0524,ALTERATION IN CONSCIOUSNESS,,,18793.91,19733.61,14
APR-DRG,0531,SEIZURE,,,5082.59,5336.72,14
APR-DRG,0532,SEIZURE,,,6335.63,6652.41,14
APR-DRG,0533,SEIZURE,,,9071.03,9524.58,14
APR-DRG,0534,SEIZURE,,,20270.25,21283.76,14
APR-DRG,0541,MIGRAINE AND OTHER HEADACHES,,,5806.59,6096.92,14
APR-DRG,0542,MIGRAINE AND OTHER HEADACHES,,,6834.62,7176.35,14
APR-DRG,0543,MIGRAINE AND OTHER HEADACHES,,,8943.06,9390.21,14
APR-DRG,0544,MIGRAINE AND OTHER HEADACHES,,,14772.84,15511.48,14
APR-DRG,0551,HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE,,,6534.88,6861.62,14
APR-DRG,0552,HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE,,,9180.1,9639.11,14
APR-DRG,0553,HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE,,,14102.09,14807.19,14
APR-DRG,0554,HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE,,,25949.73,27247.22,14
APR-DRG,0561,"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR NO COMA",,,6589.85,6919.34,14
APR-DRG,0562,"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR NO COMA",,,8047.29,8449.65,14
APR-DRG,0563,"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR NO COMA",,,12879.96,13523.96,14
APR-DRG,0564,"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR NO COMA",,,20868.86,21912.3,14
APR-DRG,0571,"CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA",,,6129.51,6435.99,14
APR-DRG,0572,"CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA",,,8531.68,8958.26,14
APR-DRG,0573,"CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA",,,12591.39,13220.96,14
APR-DRG,0574,"CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA",,,20049.53,21052.01,14
APR-DRG,0581,OTHER DISORDERS OF NERVOUS SYSTEM,,,7939.94,8336.94,14
APR-DRG,0582,OTHER DISORDERS OF NERVOUS SYSTEM,,,10636.68,11168.51,14
APR-DRG,0583,OTHER DISORDERS OF NERVOUS SYSTEM,,,13676.96,14360.81,14
APR-DRG,0584,OTHER DISORDERS OF NERVOUS SYSTEM,,,19599.5,20579.48,14
APR-DRG,0591,ANOXIC AND OTHER SEVERE BRAIN DAMAGE,,,6576.11,6904.92,14
APR-DRG,0592,ANOXIC AND OTHER SEVERE BRAIN DAMAGE,,,9648.16,10130.57,14
APR-DRG,0593,ANOXIC AND OTHER SEVERE BRAIN DAMAGE,,,14790.87,15530.41,14
APR-DRG,0594,ANOXIC AND OTHER SEVERE BRAIN DAMAGE,,,19994.56,20994.29,14
APR-DRG,0731,ORBIT AND EYE PROCEDURES,,,9424.87,9896.11,14
APR-DRG,0732,ORBIT AND EYE PROCEDURES,,,11896.6,12491.43,14
APR-DRG,0733,ORBIT AND EYE PROCEDURES,,,18451.23,19373.79,14
APR-DRG,0734,ORBIT AND EYE PROCEDURES,,,33202.6,34862.73,14
APR-DRG,0821,EYE INFECTIONS AND OTHER EYE DISORDERS,,,5562.68,5840.81,14
APR-DRG,0822,EYE INFECTIONS AND OTHER EYE DISORDERS,,,6833.76,7175.45,14
APR-DRG,0823,EYE INFECTIONS AND OTHER EYE DISORDERS,,,10388.48,10907.9,14
APR-DRG,0824,EYE INFECTIONS AND OTHER EYE DISORDERS,,,20838.8,21880.74,14
APR-DRG,0891,MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,15781.97,16571.07,14
APR-DRG,0892,MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,20217.0,21227.85,14
APR-DRG,0893,MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,36509.98,38335.48,14
APR-DRG,0894,MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,48552.58,50980.21,14
APR-DRG,0911,OTHER MAJOR HEAD AND NECK PROCEDURES,,,13926.88,14623.22,14
APR-DRG,0912,OTHER MAJOR HEAD AND NECK PROCEDURES,,,21506.11,22581.42,14
APR-DRG,0913,OTHER MAJOR HEAD AND NECK PROCEDURES,,,37075.09,38928.84,14
APR-DRG,0914,OTHER MAJOR HEAD AND NECK PROCEDURES,,,59278.58,62242.51,14
APR-DRG,0921,FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,12897.14,13542.0,14
APR-DRG,0922,FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,16937.96,17784.86,14
APR-DRG,0923,FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,26296.7,27611.54,14
APR-DRG,0924,FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,50280.55,52794.58,14
APR-DRG,0951,CLEFT LIP AND PALATE REPAIR,,,7861.78,8254.87,14
APR-DRG,0952,CLEFT LIP AND PALATE REPAIR,,,8858.89,9301.83,14
APR-DRG,0953,CLEFT LIP AND PALATE REPAIR,,,14837.25,15579.11,14
APR-DRG,0954,CLEFT LIP AND PALATE REPAIR,,,27705.19,29090.45,14
APR-DRG,0971,TONSIL AND ADENOID PROCEDURES,,,5671.75,5955.34,14
APR-DRG,0972,TONSIL AND ADENOID PROCEDURES,,,8384.82,8804.06,14
APR-DRG,0973,TONSIL AND ADENOID PROCEDURES,,,13690.7,14375.24,14
APR-DRG,0974,TONSIL AND ADENOID PROCEDURES,,,24352.29,25569.9,14
APR-DRG,0981,"OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES",,,8335.0,8751.75,14
APR-DRG,0982,"OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES",,,11697.35,12282.22,14
APR-DRG,0983,"OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES",,,19572.01,20550.61,14
APR-DRG,0984,"OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES",,,35837.51,37629.39,14
APR-DRG,1101,"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES",,,7709.77,8095.26,14
APR-DRG,1102,"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES",,,8881.22,9325.28,14
APR-DRG,1103,"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES",,,12934.93,13581.68,14
APR-DRG,1104,"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES",,,22332.31,23448.93,14
APR-DRG,1111,VERTIGO AND OTHER LABYRINTH DISORDERS,,,5599.61,5879.59,14
APR-DRG,1112,VERTIGO AND OTHER LABYRINTH DISORDERS,,,6211.1,6521.66,14
APR-DRG,1113,VERTIGO AND OTHER LABYRINTH DISORDERS,,,7641.92,8024.02,14
APR-DRG,1114,VERTIGO AND OTHER LABYRINTH DISORDERS,,,16498.24,17323.15,14
APR-DRG,1131,INFECTIONS OF UPPER RESPIRATORY TRACT,,,3327.13,3493.49,14
APR-DRG,1132,INFECTIONS OF UPPER RESPIRATORY TRACT,,,4628.27,4859.68,14
APR-DRG,1133,INFECTIONS OF UPPER RESPIRATORY TRACT,,,6811.43,7152.0,14
APR-DRG,1134,INFECTIONS OF UPPER RESPIRATORY TRACT,,,14498.87,15223.81,14
APR-DRG,1141,DENTAL DISEASES AND DISORDERS,,,3897.4,4092.27,14
APR-DRG,1142,DENTAL DISEASES AND DISORDERS,,,5512.01,5787.61,14
APR-DRG,1143,DENTAL DISEASES AND DISORDERS,,,8254.27,8666.98,14
APR-DRG,1144,DENTAL DISEASES AND DISORDERS,,,16948.27,17795.68,14
APR-DRG,1151,"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES",,,4835.25,5077.01,14
APR-DRG,1152,"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES",,,6609.6,6940.08,14
APR-DRG,1153,"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES",,,10358.42,10876.34,14
APR-DRG,1154,"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES",,,18334.43,19251.15,14
APR-DRG,1201,MAJOR RESPIRATORY AND CHEST PROCEDURES,,,15703.82,16489.01,14
APR-DRG,1202,MAJOR RESPIRATORY AND CHEST PROCEDURES,,,19626.98,20608.33,14
APR-DRG,1203,MAJOR RESPIRATORY AND CHEST PROCEDURES,,,29575.74,31054.53,14
APR-DRG,1204,MAJOR RESPIRATORY AND CHEST PROCEDURES,,,55938.57,58735.5,14
APR-DRG,1211,OTHER RESPIRATORY AND CHEST PROCEDURES,,,12180.87,12789.91,14
APR-DRG,1212,OTHER RESPIRATORY AND CHEST PROCEDURES,,,15893.62,16688.3,14
APR-DRG,1213,OTHER RESPIRATORY AND CHEST PROCEDURES,,,25266.1,26529.41,14
APR-DRG,1214,OTHER RESPIRATORY AND CHEST PROCEDURES,,,44336.55,46553.38,14
APR-DRG,1301,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS,,,26635.08,27966.83,14
APR-DRG,1302,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS,,,29643.58,31125.76,14
APR-DRG,1303,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS,,,35954.31,37752.03,14
APR-DRG,1304,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS,,,47129.48,49485.95,14
APR-DRG,1311,CYSTIC FIBROSIS - PULMONARY DISEASE,,,11680.17,12264.18,14
APR-DRG,1312,CYSTIC FIBROSIS - PULMONARY DISEASE,,,15105.21,15860.47,14
APR-DRG,1313,CYSTIC FIBROSIS - PULMONARY DISEASE,,,20478.09,21501.99,14
APR-DRG,1314,CYSTIC FIBROSIS - PULMONARY DISEASE,,,26856.66,28199.49,14
APR-DRG,1321,BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,,,3615.7,3796.49,14
APR-DRG,1322,BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,,,5574.7,5853.44,14
APR-DRG,1323,BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,,,10484.67,11008.9,14
APR-DRG,1324,BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,,,15555.24,16333.0,14
APR-DRG,1331,RESPIRATORY FAILURE,,,3712.75,3898.39,14
APR-DRG,1332,RESPIRATORY FAILURE,,,6400.9,6720.95,14
APR-DRG,1333,RESPIRATORY FAILURE,,,9868.03,10361.43,14
APR-DRG,1334,RESPIRATORY FAILURE,,,16959.43,17807.4,14
APR-DRG,1341,PULMONARY EMBOLISM,,,4990.7,5240.24,14
APR-DRG,1342,PULMONARY EMBOLISM,,,6547.77,6875.16,14
APR-DRG,1343,PULMONARY EMBOLISM,,,10106.78,10612.12,14
APR-DRG,1344,PULMONARY EMBOLISM,,,16980.91,17829.96,14
APR-DRG,1351,MAJOR CHEST AND RESPIRATORY TRAUMA,,,6802.84,7142.98,14
APR-DRG,1352,MAJOR CHEST AND RESPIRATORY TRAUMA,,,7825.71,8217.0,14
APR-DRG,1353,MAJOR CHEST AND RESPIRATORY TRAUMA,,,11236.15,11797.96,14
APR-DRG,1354,MAJOR CHEST AND RESPIRATORY TRAUMA,,,19637.29,20619.15,14
APR-DRG,1361,RESPIRATORY MALIGNANCY,,,6662.85,6995.99,14
APR-DRG,1362,RESPIRATORY MALIGNANCY,,,8481.86,8905.95,14
APR-DRG,1363,RESPIRATORY MALIGNANCY,,,12121.61,12727.69,14
APR-DRG,1364,RESPIRATORY MALIGNANCY,,,18556.01,19483.81,14
APR-DRG,1371,MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS,,,5330.8,5597.34,14
APR-DRG,1372,MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS,,,6824.31,7165.53,14
APR-DRG,1373,MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS,,,9115.69,9571.47,14
APR-DRG,1374,MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS,,,17182.73,18041.87,14
APR-DRG,1381,BRONCHIOLITIS AND RSV PNEUMONIA,,,2984.46,3133.68,14
APR-DRG,1382,BRONCHIOLITIS AND RSV PNEUMONIA,,,4335.4,4552.17,14
APR-DRG,1383,BRONCHIOLITIS AND RSV PNEUMONIA,,,7190.17,7549.68,14
APR-DRG,1384,BRONCHIOLITIS AND RSV PNEUMONIA,,,17712.63,18598.26,14
APR-DRG,1391,OTHER PNEUMONIA,,,4074.32,4278.04,14
APR-DRG,1392,OTHER PNEUMONIA,,,5344.54,5611.77,14
APR-DRG,1393,OTHER PNEUMONIA,,,8036.99,8438.84,14
APR-DRG,1394,OTHER PNEUMONIA,,,14602.79,15332.93,14
APR-DRG,1401,CHRONIC OBSTRUCTIVE PULMONARY DISEASE,,,4532.94,4759.59,14
APR-DRG,1402,CHRONIC OBSTRUCTIVE PULMONARY DISEASE,,,5700.09,5985.09,14
APR-DRG,1403,CHRONIC OBSTRUCTIVE PULMONARY DISEASE,,,7157.54,7515.42,14
APR-DRG,1404,CHRONIC OBSTRUCTIVE PULMONARY DISEASE,,,13914.86,14610.6,14
APR-DRG,1411,ASTHMA,,,3960.95,4159.0,14
APR-DRG,1412,ASTHMA,,,5675.19,5958.95,14
APR-DRG,1413,ASTHMA,,,6545.19,6872.45,14
APR-DRG,1414,ASTHMA,,,13275.89,13939.68,14
APR-DRG,1421,INTERSTITIAL AND ALVEOLAR LUNG DISEASES,,,5901.06,6196.11,14
APR-DRG,1422,INTERSTITIAL AND ALVEOLAR LUNG DISEASES,,,6997.8,7347.69,14
APR-DRG,1423,INTERSTITIAL AND ALVEOLAR LUNG DISEASES,,,10621.22,11152.28,14
APR-DRG,1424,INTERSTITIAL AND ALVEOLAR LUNG DISEASES,,,18975.98,19924.78,14
APR-DRG,1431,"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,4893.65,5138.33,14
APR-DRG,1432,"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,6986.63,7335.96,14
APR-DRG,1433,"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,10830.78,11372.32,14
APR-DRG,1434,"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,18097.39,19002.26,14
APR-DRG,1441,"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,4977.81,5226.7,14
APR-DRG,1442,"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,6496.24,6821.05,14
APR-DRG,1443,"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,9842.26,10334.37,14
APR-DRG,1444,"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,17869.8,18763.29,14
APR-DRG,1451,ACUTE BRONCHITIS AND RELATED SYMPTOMS,,,4639.43,4871.4,14
APR-DRG,1452,ACUTE BRONCHITIS AND RELATED SYMPTOMS,,,5764.51,6052.74,14
APR-DRG,1453,ACUTE BRONCHITIS AND RELATED SYMPTOMS,,,7513.96,7889.66,14
APR-DRG,1454,ACUTE BRONCHITIS AND RELATED SYMPTOMS,,,13524.09,14200.29,14
APR-DRG,1601,MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY,,,25922.25,27218.36,14
APR-DRG,1602,MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY,,,32964.7,34612.94,14
APR-DRG,1603,MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY,,,52702.47,55337.59,14
APR-DRG,1604,MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY,,,130125.68,136631.96,14
APR-DRG,1611,IMPLANTABLE HEART ASSIST SYSTEMS,,,115416.39,121187.21,14
APR-DRG,1612,IMPLANTABLE HEART ASSIST SYSTEMS,,,121138.82,127195.76,14
APR-DRG,1613,IMPLANTABLE HEART ASSIST SYSTEMS,,,150911.23,158456.79,14
APR-DRG,1614,IMPLANTABLE HEART ASSIST SYSTEMS,,,223034.56,234186.29,14
APR-DRG,1621,CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,36309.01,38124.46,14
APR-DRG,1622,CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,42211.79,44322.38,14
APR-DRG,1623,CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,56751.02,59588.57,14
APR-DRG,1624,CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,88834.56,93276.29,14
APR-DRG,1631,CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,31110.48,32666.0,14
APR-DRG,1632,CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,35458.76,37231.7,14
APR-DRG,1633,CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,47223.1,49584.26,14
APR-DRG,1634,CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,73998.17,77698.08,14
APR-DRG,1651,CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,32225.24,33836.5,14
APR-DRG,1652,CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,36161.29,37969.35,14
APR-DRG,1653,CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,46249.18,48561.64,14
APR-DRG,1654,CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,69107.1,72562.46,14
APR-DRG,1661,CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,26761.33,28099.4,14
APR-DRG,1662,CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,30879.45,32423.42,14
APR-DRG,1663,CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,38876.07,40819.87,14
APR-DRG,1664,CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,60517.88,63543.77,14
APR-DRG,1671,OTHER CARDIOTHORACIC AND THORACIC VASCULAR PROCEDURES,,,26752.74,28090.38,14
APR-DRG,1672,OTHER CARDIOTHORACIC AND THORACIC VASCULAR PROCEDURES,,,27700.9,29085.95,14
APR-DRG,1673,OTHER CARDIOTHORACIC AND THORACIC VASCULAR PROCEDURES,,,42810.4,44950.92,14
APR-DRG,1674,OTHER CARDIOTHORACIC AND THORACIC VASCULAR PROCEDURES,,,74501.45,78226.52,14
APR-DRG,1691,MAJOR ABDOMINAL VASCULAR PROCEDURES,,,24380.64,25599.67,14
APR-DRG,1692,MAJOR ABDOMINAL VASCULAR PROCEDURES,,,24811.77,26052.36,14
APR-DRG,1693,MAJOR ABDOMINAL VASCULAR PROCEDURES,,,33681.83,35365.92,14
APR-DRG,1694,MAJOR ABDOMINAL VASCULAR PROCEDURES,,,53332.86,55999.5,14
APR-DRG,1701,"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK",,,18017.52,18918.4,14
APR-DRG,1702,"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK",,,19011.19,19961.75,14
APR-DRG,1703,"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK",,,27517.11,28892.97,14
APR-DRG,1704,"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK",,,39115.69,41071.47,14
APR-DRG,1711,"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK",,,13646.05,14328.35,14
APR-DRG,1712,"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK",,,15669.46,16452.93,14
APR-DRG,1713,"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK",,,21035.47,22087.24,14
APR-DRG,1714,"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK",,,33727.35,35413.72,14
APR-DRG,1741,PERCUTANEOUS CARDIAC INTERVENTION WITH AMI,,,16044.77,16847.01,14
APR-DRG,1742,PERCUTANEOUS CARDIAC INTERVENTION WITH AMI,,,17781.34,18670.41,14
APR-DRG,1743,PERCUTANEOUS CARDIAC INTERVENTION WITH AMI,,,22969.57,24118.05,14
APR-DRG,1744,PERCUTANEOUS CARDIAC INTERVENTION WITH AMI,,,34244.37,35956.59,14
APR-DRG,1751,PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI,,,18823.97,19765.17,14
APR-DRG,1752,PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI,,,20727.15,21763.51,14
APR-DRG,1753,PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI,,,26013.28,27313.94,14
APR-DRG,1754,PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI,,,38556.58,40484.41,14
APR-DRG,1761,"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES",,,14758.24,15496.15,14
APR-DRG,1762,"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES",,,18380.81,19299.85,14
APR-DRG,1763,"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES",,,27799.66,29189.64,14
APR-DRG,1764,"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES",,,47742.69,50129.82,14
APR-DRG,1771,CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT,,,11863.96,12457.16,14
APR-DRG,1772,CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT,,,15994.1,16793.81,14
APR-DRG,1773,CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT,,,23741.66,24928.74,14
APR-DRG,1774,CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT,,,30619.22,32150.18,14
APR-DRG,1781,EXTERNAL HEART ASSIST SYSTEMS,,,42599.12,44729.08,14
APR-DRG,1782,EXTERNAL HEART ASSIST SYSTEMS,,,50212.71,52723.35,14
APR-DRG,1783,EXTERNAL HEART ASSIST SYSTEMS,,,52234.41,54846.13,14
APR-DRG,1784,EXTERNAL HEART ASSIST SYSTEMS,,,70913.23,74458.89,14
APR-DRG,1791,DEFIBRILLATOR IMPLANTS,,,29791.3,31280.87,14
APR-DRG,1792,DEFIBRILLATOR IMPLANTS,,,33901.69,35596.77,14
APR-DRG,1793,DEFIBRILLATOR IMPLANTS,,,41594.29,43674.0,14
APR-DRG,1794,DEFIBRILLATOR IMPLANTS,,,57469.87,60343.36,14
APR-DRG,1801,OTHER CIRCULATORY SYSTEM PROCEDURES,,,11101.31,11656.38,14
APR-DRG,1802,OTHER CIRCULATORY SYSTEM PROCEDURES,,,14133.01,14839.66,14
APR-DRG,1803,OTHER CIRCULATORY SYSTEM PROCEDURES,,,19815.06,20805.81,14
APR-DRG,1804,OTHER CIRCULATORY SYSTEM PROCEDURES,,,34412.7,36133.34,14
APR-DRG,1811,LOWER EXTREMITY ARTERIAL PROCEDURES,,,12947.81,13595.2,14
APR-DRG,1812,LOWER EXTREMITY ARTERIAL PROCEDURES,,,18811.08,19751.63,14
APR-DRG,1813,LOWER EXTREMITY ARTERIAL PROCEDURES,,,29690.82,31175.36,14
APR-DRG,1814,LOWER EXTREMITY ARTERIAL PROCEDURES,,,46426.96,48748.31,14
APR-DRG,1821,OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES,,,17361.37,18229.44,14
APR-DRG,1822,OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES,,,19478.4,20452.32,14
APR-DRG,1823,OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES,,,23860.18,25053.19,14
APR-DRG,1824,OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES,,,42382.7,44501.84,14
APR-DRG,1831,PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES,,,32494.06,34118.76,14
APR-DRG,1832,PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES,,,34075.18,35778.94,14
APR-DRG,1833,PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES,,,41388.17,43457.58,14
APR-DRG,1834,PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES,,,61799.26,64889.22,14
APR-DRG,1901,ACUTE MYOCARDIAL INFARCTION,,,7021.84,7372.93,14
APR-DRG,1902,ACUTE MYOCARDIAL INFARCTION,,,7787.07,8176.42,14
APR-DRG,1903,ACUTE MYOCARDIAL INFARCTION,,,10595.46,11125.23,14
APR-DRG,1904,ACUTE MYOCARDIAL INFARCTION,,,17999.48,18899.45,14
APR-DRG,1911,CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE,,,8499.04,8923.99,14
APR-DRG,1912,CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE,,,9678.22,10162.13,14
APR-DRG,1913,CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE,,,13290.49,13955.01,14
APR-DRG,1914,CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE,,,24076.61,25280.44,14
APR-DRG,1921,CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS,,,9000.6,9450.63,14
APR-DRG,1922,CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS,,,10971.63,11520.21,14
APR-DRG,1923,CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS,,,16150.41,16957.93,14
APR-DRG,1924,CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS,,,28789.9,30229.4,14
APR-DRG,1931,ACUTE AND SUBACUTE ENDOCARDITIS,,,8231.08,8642.63,14
APR-DRG,1932,ACUTE AND SUBACUTE ENDOCARDITIS,,,9761.53,10249.61,14
APR-DRG,1933,ACUTE AND SUBACUTE ENDOCARDITIS,,,13755.98,14443.78,14
APR-DRG,1934,ACUTE AND SUBACUTE ENDOCARDITIS,,,21596.29,22676.1,14
APR-DRG,1941,HEART FAILURE,,,4514.04,4739.74,14
APR-DRG,1942,HEART FAILURE,,,6030.75,6332.29,14
APR-DRG,1943,HEART FAILURE,,,8944.78,9392.02,14
APR-DRG,1944,HEART FAILURE,,,16773.07,17611.72,14
APR-DRG,1961,CARDIAC ARREST AND SHOCK,,,3973.83,4172.52,14
APR-DRG,1962,CARDIAC ARREST AND SHOCK,,,5105.78,5361.07,14
APR-DRG,1963,CARDIAC ARREST AND SHOCK,,,8659.64,9092.62,14
APR-DRG,1964,CARDIAC ARREST AND SHOCK,,,17254.02,18116.72,14
APR-DRG,1971,PERIPHERAL AND OTHER VASCULAR DISORDERS,,,5116.09,5371.89,14
APR-DRG,1972,PERIPHERAL AND OTHER VASCULAR DISORDERS,,,6467.89,6791.28,14
APR-DRG,1973,PERIPHERAL AND OTHER VASCULAR DISORDERS,,,9273.71,9737.4,14
APR-DRG,1974,PERIPHERAL AND OTHER VASCULAR DISORDERS,,,17544.3,18421.52,14
APR-DRG,1981,ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,,,4864.45,5107.67,14
APR-DRG,1982,ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,,,5585.01,5864.26,14
APR-DRG,1983,ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,,,7442.67,7814.8,14
APR-DRG,1984,ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,,,14927.43,15673.8,14
APR-DRG,1991,HYPERTENSION,,,4930.58,5177.11,14
APR-DRG,1992,HYPERTENSION,,,5797.14,6087.0,14
APR-DRG,1993,HYPERTENSION,,,8203.6,8613.78,14
APR-DRG,1994,HYPERTENSION,,,14942.89,15690.03,14
APR-DRG,2001,CARDIAC STRUCTURAL AND VALVULAR DISORDERS,,,5485.39,5759.66,14
APR-DRG,2002,CARDIAC STRUCTURAL AND VALVULAR DISORDERS,,,7139.5,7496.48,14
APR-DRG,2003,CARDIAC STRUCTURAL AND VALVULAR DISORDERS,,,10377.32,10896.19,14
APR-DRG,2004,CARDIAC STRUCTURAL AND VALVULAR DISORDERS,,,18659.93,19592.93,14
APR-DRG,2011,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS,,,4035.67,4237.45,14
APR-DRG,2012,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS,,,5194.24,5453.95,14
APR-DRG,2013,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS,,,8028.4,8429.82,14
APR-DRG,2014,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS,,,15560.39,16338.41,14
APR-DRG,2031,CHEST PAIN,,,5170.19,5428.7,14
APR-DRG,2032,CHEST PAIN,,,5766.22,6054.53,14
APR-DRG,2033,CHEST PAIN,,,7175.57,7534.35,14
APR-DRG,2034,CHEST PAIN,,,12370.67,12989.2,14
APR-DRG,2041,SYNCOPE AND COLLAPSE,,,5740.46,6027.48,14
APR-DRG,2042,SYNCOPE AND COLLAPSE,,,6324.47,6640.69,14
APR-DRG,2043,SYNCOPE AND COLLAPSE,,,7972.57,8371.2,14
APR-DRG,2044,SYNCOPE AND COLLAPSE,,,14455.07,15177.82,14
APR-DRG,2051,CARDIOMYOPATHY,,,5377.17,5646.03,14
APR-DRG,2052,CARDIOMYOPATHY,,,5683.78,5967.97,14
APR-DRG,2053,CARDIOMYOPATHY,,,9448.05,9920.45,14
APR-DRG,2054,CARDIOMYOPATHY,,,20416.25,21437.06,14
APR-DRG,2061,"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE",,,6783.09,7122.24,14
APR-DRG,2062,"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE",,,7140.36,7497.38,14
APR-DRG,2063,"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE",,,10352.41,10870.03,14
APR-DRG,2064,"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE",,,19870.03,20863.53,14
APR-DRG,2071,OTHER CIRCULATORY SYSTEM DIAGNOSES,,,5011.31,5261.88,14
APR-DRG,2072,OTHER CIRCULATORY SYSTEM DIAGNOSES,,,6427.53,6748.91,14
APR-DRG,2073,OTHER CIRCULATORY SYSTEM DIAGNOSES,,,9374.19,9842.9,14
APR-DRG,2074,OTHER CIRCULATORY SYSTEM DIAGNOSES,,,17436.09,18307.89,14
APR-DRG,2201,"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,13159.09,13817.04,14
APR-DRG,2202,"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,18461.54,19384.62,14
APR-DRG,2203,"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,28370.79,29789.33,14
APR-DRG,2204,"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,53683.26,56367.42,14
APR-DRG,2221,"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,7165.27,7523.53,14
APR-DRG,2222,"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,12566.49,13194.81,14
APR-DRG,2223,"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,19030.95,19982.5,14
APR-DRG,2224,"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,36831.18,38672.74,14
APR-DRG,2231,OTHER SMALL AND LARGE BOWEL PROCEDURES,,,10047.52,10549.9,14
APR-DRG,2232,OTHER SMALL AND LARGE BOWEL PROCEDURES,,,12819.84,13460.83,14
APR-DRG,2233,OTHER SMALL AND LARGE BOWEL PROCEDURES,,,18136.9,19043.75,14
APR-DRG,2234,OTHER SMALL AND LARGE BOWEL PROCEDURES,,,36530.59,38357.12,14
APR-DRG,2241,PERITONEAL ADHESIOLYSIS,,,11940.4,12537.42,14
APR-DRG,2242,PERITONEAL ADHESIOLYSIS,,,13914.0,14609.7,14
APR-DRG,2243,PERITONEAL ADHESIOLYSIS,,,20215.28,21226.04,14
APR-DRG,2244,PERITONEAL ADHESIOLYSIS,,,35335.95,37102.75,14
APR-DRG,2261,ANAL AND PERINEAL PROCEDURES,,,7337.04,7703.89,14
APR-DRG,2262,ANAL AND PERINEAL PROCEDURES,,,9252.24,9714.85,14
APR-DRG,2263,ANAL AND PERINEAL PROCEDURES,,,14154.48,14862.2,14
APR-DRG,2264,ANAL AND PERINEAL PROCEDURES,,,26909.05,28254.5,14
APR-DRG,2271,"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL",,,10267.38,10780.75,14
APR-DRG,2272,"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL",,,12538.15,13165.06,14
APR-DRG,2273,"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL",,,18373.94,19292.64,14
APR-DRG,2274,"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL",,,35888.18,37682.59,14
APR-DRG,2281,"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES",,,8622.71,9053.85,14
APR-DRG,2282,"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES",,,10732.01,11268.61,14
APR-DRG,2283,"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES",,,14960.92,15708.97,14
APR-DRG,2284,"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES",,,28731.5,30168.08,14
APR-DRG,2291,OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES,,,10341.24,10858.3,14
APR-DRG,2292,OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES,,,14347.71,15065.1,14
APR-DRG,2293,OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES,,,21494.09,22568.79,14
APR-DRG,2294,OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES,,,37420.34,39291.36,14
APR-DRG,2301,MAJOR SMALL BOWEL PROCEDURES,,,11697.35,12282.22,14
APR-DRG,2302,MAJOR SMALL BOWEL PROCEDURES,,,16266.35,17079.67,14
APR-DRG,2303,MAJOR SMALL BOWEL PROCEDURES,,,24024.22,25225.43,14
APR-DRG,2304,MAJOR SMALL BOWEL PROCEDURES,,,44256.68,46469.51,14
APR-DRG,2311,MAJOR LARGE BOWEL PROCEDURES,,,12663.54,13296.72,14
APR-DRG,2312,MAJOR LARGE BOWEL PROCEDURES,,,16027.6,16828.98,14
APR-DRG,2313,MAJOR LARGE BOWEL PROCEDURES,,,23287.34,24451.71,14
APR-DRG,2314,MAJOR LARGE BOWEL PROCEDURES,,,38170.97,40079.52,14
APR-DRG,2321,GASTRIC FUNDOPLICATION,,,9874.04,10367.74,14
APR-DRG,2322,GASTRIC FUNDOPLICATION,,,12134.49,12741.21,14
APR-DRG,2323,GASTRIC FUNDOPLICATION,,,18261.43,19174.5,14
APR-DRG,2324,GASTRIC FUNDOPLICATION,,,54287.02,57001.37,14
APR-DRG,2331,APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS,,,9162.06,9620.16,14
APR-DRG,2332,APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS,,,11675.88,12259.67,14
APR-DRG,2333,APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS,,,16352.24,17169.85,14
APR-DRG,2334,APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS,,,25638.83,26920.77,14
APR-DRG,2341,APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS,,,8400.27,8820.28,14
APR-DRG,2342,APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS,,,10173.77,10682.46,14
APR-DRG,2343,APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS,,,15302.74,16067.88,14
APR-DRG,2344,APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS,,,27061.06,28414.11,14
APR-DRG,2401,DIGESTIVE MALIGNANCY,,,7311.27,7676.83,14
APR-DRG,2402,DIGESTIVE MALIGNANCY,,,8345.31,8762.58,14
APR-DRG,2403,DIGESTIVE MALIGNANCY,,,11824.45,12415.67,14
APR-DRG,2404,DIGESTIVE MALIGNANCY,,,20268.53,21281.96,14
APR-DRG,2411,PEPTIC ULCER AND GASTRITIS,,,5680.34,5964.36,14
APR-DRG,2412,PEPTIC ULCER AND GASTRITIS,,,6762.47,7100.59,14
APR-DRG,2413,PEPTIC ULCER AND GASTRITIS,,,10227.02,10738.37,14
APR-DRG,2414,PEPTIC ULCER AND GASTRITIS,,,20843.09,21885.24,14
APR-DRG,2421,MAJOR ESOPHAGEAL DISORDERS,,,5103.2,5358.36,14
APR-DRG,2422,MAJOR ESOPHAGEAL DISORDERS,,,6569.24,6897.7,14
APR-DRG,2423,MAJOR ESOPHAGEAL DISORDERS,,,9588.05,10067.45,14
APR-DRG,2424,MAJOR ESOPHAGEAL DISORDERS,,,20816.47,21857.29,14
APR-DRG,2431,OTHER ESOPHAGEAL DISORDERS,,,5548.08,5825.48,14
APR-DRG,2432,OTHER ESOPHAGEAL DISORDERS,,,6603.59,6933.77,14
APR-DRG,2433,OTHER ESOPHAGEAL DISORDERS,,,9642.15,10124.26,14
APR-DRG,2434,OTHER ESOPHAGEAL DISORDERS,,,18194.44,19104.16,14
APR-DRG,2441,DIVERTICULITIS AND DIVERTICULOSIS,,,4545.82,4773.11,14
APR-DRG,2442,DIVERTICULITIS AND DIVERTICULOSIS,,,6130.37,6436.89,14
APR-DRG,2443,DIVERTICULITIS AND DIVERTICULOSIS,,,9653.32,10135.99,14
APR-DRG,2444,DIVERTICULITIS AND DIVERTICULOSIS,,,18078.5,18982.43,14
APR-DRG,2451,INFLAMMATORY BOWEL DISEASE,,,5099.77,5354.76,14
APR-DRG,2452,INFLAMMATORY BOWEL DISEASE,,,6742.72,7079.86,14
APR-DRG,2453,INFLAMMATORY BOWEL DISEASE,,,10370.44,10888.96,14
APR-DRG,2454,INFLAMMATORY BOWEL DISEASE,,,18170.39,19078.91,14
APR-DRG,2461,GASTROINTESTINAL VASCULAR INSUFFICIENCY,,,5261.23,5524.29,14
APR-DRG,2462,GASTROINTESTINAL VASCULAR INSUFFICIENCY,,,6645.67,6977.95,14
APR-DRG,2463,GASTROINTESTINAL VASCULAR INSUFFICIENCY,,,9868.03,10361.43,14
APR-DRG,2464,GASTROINTESTINAL VASCULAR INSUFFICIENCY,,,16286.97,17101.32,14
APR-DRG,2471,INTESTINAL OBSTRUCTION,,,4156.77,4364.61,14
APR-DRG,2472,INTESTINAL OBSTRUCTION,,,5463.91,5737.11,14
APR-DRG,2473,INTESTINAL OBSTRUCTION,,,8754.12,9191.83,14
APR-DRG,2474,INTESTINAL OBSTRUCTION,,,17294.38,18159.1,14
APR-DRG,2481,MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS,,,4688.39,4922.81,14
APR-DRG,2482,MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS,,,6310.73,6626.27,14
APR-DRG,2483,MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS,,,9689.39,10173.86,14
APR-DRG,2484,MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS,,,18728.64,19665.07,14
APR-DRG,2491,"OTHER GASTROENTERITIS, NAUSEA AND VOMITING",,,4407.55,4627.93,14
APR-DRG,2492,"OTHER GASTROENTERITIS, NAUSEA AND VOMITING",,,5329.94,5596.44,14
APR-DRG,2493,"OTHER GASTROENTERITIS, NAUSEA AND VOMITING",,,7955.4,8353.17,14
APR-DRG,2494,"OTHER GASTROENTERITIS, NAUSEA AND VOMITING",,,16361.68,17179.76,14
APR-DRG,2511,ABDOMINAL PAIN,,,4908.25,5153.66,14
APR-DRG,2512,ABDOMINAL PAIN,,,5977.5,6276.38,14
APR-DRG,2513,ABDOMINAL PAIN,,,8063.61,8466.79,14
APR-DRG,2514,ABDOMINAL PAIN,,,13782.6,14471.73,14
APR-DRG,2521,"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE",,,5573.85,5852.54,14
APR-DRG,2522,"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE",,,6935.1,7281.86,14
APR-DRG,2523,"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE",,,10539.64,11066.62,14
APR-DRG,2524,"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE",,,21179.75,22238.74,14
APR-DRG,2531,OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE,,,5166.76,5425.1,14
APR-DRG,2532,OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE,,,6563.22,6891.38,14
APR-DRG,2533,OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE,,,9828.52,10319.95,14
APR-DRG,2534,OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE,,,17990.04,18889.54,14
APR-DRG,2541,OTHER DIGESTIVE SYSTEM DIAGNOSES,,,5041.37,5293.44,14
APR-DRG,2542,OTHER DIGESTIVE SYSTEM DIAGNOSES,,,6443.85,6766.04,14
APR-DRG,2543,OTHER DIGESTIVE SYSTEM DIAGNOSES,,,9658.47,10141.39,14
APR-DRG,2544,OTHER DIGESTIVE SYSTEM DIAGNOSES,,,17591.54,18471.12,14
APR-DRG,2601,"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES",,,16852.94,17695.59,14
APR-DRG,2602,"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES",,,20666.17,21699.48,14
APR-DRG,2603,"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES",,,28600.1,30030.11,14
APR-DRG,2604,"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES",,,55489.39,58263.86,14
APR-DRG,2611,MAJOR BILIARY TRACT PROCEDURES,,,13158.23,13816.14,14
APR-DRG,2612,MAJOR BILIARY TRACT PROCEDURES,,,17920.47,18816.49,14
APR-DRG,2613,MAJOR BILIARY TRACT PROCEDURES,,,24883.06,26127.21,14
APR-DRG,2614,MAJOR BILIARY TRACT PROCEDURES,,,48098.25,50503.16,14
APR-DRG,2631,CHOLECYSTECTOMY,,,10096.48,10601.3,14
APR-DRG,2632,CHOLECYSTECTOMY,,,12275.34,12889.11,14
APR-DRG,2633,CHOLECYSTECTOMY,,,15526.9,16303.25,14
APR-DRG,2634,CHOLECYSTECTOMY,,,31776.93,33365.78,14
APR-DRG,2641,"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES",,,12354.36,12972.08,14
APR-DRG,2642,"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES",,,13649.48,14331.95,14
APR-DRG,2643,"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES",,,20983.08,22032.23,14
APR-DRG,2644,"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES",,,44645.73,46878.02,14
APR-DRG,2791,HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS,,,4585.33,4814.6,14
APR-DRG,2792,HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS,,,5937.13,6233.99,14
APR-DRG,2793,HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS,,,9547.68,10025.06,14
APR-DRG,2794,HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS,,,21221.84,22282.93,14
APR-DRG,2801,ALCOHOLIC LIVER DISEASE,,,4773.41,5012.08,14
APR-DRG,2802,ALCOHOLIC LIVER DISEASE,,,6253.18,6565.84,14
APR-DRG,2803,ALCOHOLIC LIVER DISEASE,,,9925.57,10421.85,14
APR-DRG,2804,ALCOHOLIC LIVER DISEASE,,,21867.68,22961.06,14
APR-DRG,2811,MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,,,6680.03,7014.03,14
APR-DRG,2812,MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,,,8418.31,8839.23,14
APR-DRG,2813,MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,,,11182.04,11741.14,14
APR-DRG,2814,MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,,,17266.04,18129.34,14
APR-DRG,2821,DISORDERS OF PANCREAS EXCEPT MALIGNANCY,,,4666.06,4899.36,14
APR-DRG,2822,DISORDERS OF PANCREAS EXCEPT MALIGNANCY,,,6164.72,6472.96,14
APR-DRG,2823,DISORDERS OF PANCREAS EXCEPT MALIGNANCY,,,10121.38,10627.45,14
APR-DRG,2824,DISORDERS OF PANCREAS EXCEPT MALIGNANCY,,,23245.26,24407.52,14
APR-DRG,2831,OTHER DISORDERS OF THE LIVER,,,4818.07,5058.97,14
APR-DRG,2832,OTHER DISORDERS OF THE LIVER,,,6116.63,6422.46,14
APR-DRG,2833,OTHER DISORDERS OF THE LIVER,,,9308.92,9774.37,14
APR-DRG,2834,OTHER DISORDERS OF THE LIVER,,,18689.13,19623.59,14
APR-DRG,2841,DISORDERS OF GALLBLADDER AND BILIARY TRACT,,,6284.1,6598.31,14
APR-DRG,2842,DISORDERS OF GALLBLADDER AND BILIARY TRACT,,,7968.28,8366.69,14
APR-DRG,2843,DISORDERS OF GALLBLADDER AND BILIARY TRACT,,,11381.29,11950.35,14
APR-DRG,2844,DISORDERS OF GALLBLADDER AND BILIARY TRACT,,,20326.07,21342.37,14
APR-DRG,3031,DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK,,,35580.72,37359.76,14
APR-DRG,3032,DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK,,,44691.25,46925.81,14
APR-DRG,3033,DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK,,,63689.56,66874.04,14
APR-DRG,3034,DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK,,,93459.39,98132.36,14
APR-DRG,3041,DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK,,,23350.89,24518.43,14
APR-DRG,3042,DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK,,,28795.05,30234.8,14
APR-DRG,3043,DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK,,,42146.52,44253.85,14
APR-DRG,3044,DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK,,,65527.47,68803.84,14
APR-DRG,3051,AMPUTATION OF LOWER LIMB EXCEPT TOES,,,8818.53,9259.46,14
APR-DRG,3052,AMPUTATION OF LOWER LIMB EXCEPT TOES,,,12095.85,12700.64,14
APR-DRG,3053,AMPUTATION OF LOWER LIMB EXCEPT TOES,,,19115.11,20070.87,14
APR-DRG,3054,AMPUTATION OF LOWER LIMB EXCEPT TOES,,,35914.8,37710.54,14
APR-DRG,3081,HIP AND FEMUR FRACTURE REPAIR,,,11751.45,12339.02,14
APR-DRG,3082,HIP AND FEMUR FRACTURE REPAIR,,,13828.12,14519.53,14
APR-DRG,3083,HIP AND FEMUR FRACTURE REPAIR,,,18361.91,19280.01,14
APR-DRG,3084,HIP AND FEMUR FRACTURE REPAIR,,,28220.49,29631.51,14
APR-DRG,3091,OTHER SIGNIFICANT HIP AND FEMUR SURGERY,,,13000.2,13650.21,14
APR-DRG,3092,OTHER SIGNIFICANT HIP AND FEMUR SURGERY,,,16821.16,17662.22,14
APR-DRG,3093,OTHER SIGNIFICANT HIP AND FEMUR SURGERY,,,24432.17,25653.78,14
APR-DRG,3094,OTHER SIGNIFICANT HIP AND FEMUR SURGERY,,,37172.14,39030.75,14
APR-DRG,3101,VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES,,,10714.84,11250.58,14
APR-DRG,3102,VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES,,,14381.21,15100.27,14
APR-DRG,3103,VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES,,,19836.54,20828.37,14
APR-DRG,3104,VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES,,,37952.82,39850.46,14
APR-DRG,3121,"SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES",,,12827.57,13468.95,14
APR-DRG,3122,"SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES",,,19737.77,20724.66,14
APR-DRG,3123,"SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES",,,32492.34,34116.96,14
APR-DRG,3124,"SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES",,,61365.55,64433.83,14
APR-DRG,3131,KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT,,,12161.12,12769.18,14
APR-DRG,3132,KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT,,,15605.91,16386.21,14
APR-DRG,3133,KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT,,,23184.28,24343.49,14
APR-DRG,3134,KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT,,,37255.45,39118.22,14
APR-DRG,3141,FOOT AND TOE PROCEDURES,,,10436.58,10958.41,14
APR-DRG,3142,FOOT AND TOE PROCEDURES,,,10539.64,11066.62,14
APR-DRG,3143,FOOT AND TOE PROCEDURES,,,14314.22,15029.93,14
APR-DRG,3144,FOOT AND TOE PROCEDURES,,,25966.05,27264.35,14
APR-DRG,3151,"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT",,,10068.13,10571.54,14
APR-DRG,3152,"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT",,,14710.14,15445.65,14
APR-DRG,3153,"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT",,,21874.55,22968.28,14
APR-DRG,3154,"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT",,,38383.96,40303.16,14
APR-DRG,3161,HAND AND WRIST PROCEDURES,,,8454.38,8877.1,14
APR-DRG,3162,HAND AND WRIST PROCEDURES,,,10955.31,11503.08,14
APR-DRG,3163,HAND AND WRIST PROCEDURES,,,16732.7,17569.34,14
APR-DRG,3164,HAND AND WRIST PROCEDURES,,,31849.07,33441.52,14
APR-DRG,3171,"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES",,,9102.8,9557.94,14
APR-DRG,3172,"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES",,,11869.97,12463.47,14
APR-DRG,3173,"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES",,,18382.53,19301.66,14
APR-DRG,3174,"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES",,,34148.18,35855.59,14
APR-DRG,3201,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES,,,9968.51,10466.94,14
APR-DRG,3202,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES,,,14019.64,14720.62,14
APR-DRG,3203,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES,,,20475.51,21499.29,14
APR-DRG,3204,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES,,,37460.71,39333.75,14
APR-DRG,3211,SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES,,,15806.02,16596.32,14
APR-DRG,3212,SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES,,,19469.81,20443.3,14
APR-DRG,3213,SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES,,,27444.96,28817.21,14
APR-DRG,3214,SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES,,,44266.13,46479.44,14
APR-DRG,3221,SHOULDER AND ELBOW JOINT REPLACEMENT,,,13626.29,14307.6,14
APR-DRG,3222,SHOULDER AND ELBOW JOINT REPLACEMENT,,,15204.83,15965.07,14
APR-DRG,3223,SHOULDER AND ELBOW JOINT REPLACEMENT,,,21944.12,23041.33,14
APR-DRG,3224,SHOULDER AND ELBOW JOINT REPLACEMENT,,,30848.53,32390.96,14
APR-DRG,3231,NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT,,,13453.67,14126.35,14
APR-DRG,3232,NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT,,,15428.13,16199.54,14
APR-DRG,3233,NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT,,,21343.79,22410.98,14
APR-DRG,3234,NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT,,,30845.09,32387.34,14
APR-DRG,3241,ELECTIVE HIP JOINT REPLACEMENT,,,11291.98,11856.58,14
APR-DRG,3242,ELECTIVE HIP JOINT REPLACEMENT,,,12898.0,13542.9,14
APR-DRG,3243,ELECTIVE HIP JOINT REPLACEMENT,,,19255.96,20218.76,14
APR-DRG,3244,ELECTIVE HIP JOINT REPLACEMENT,,,32459.71,34082.7,14
APR-DRG,3251,NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,,,17684.29,18568.5,14
APR-DRG,3252,NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,,,20594.03,21623.73,14
APR-DRG,3253,NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,,,27358.22,28726.13,14
APR-DRG,3254,NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,,,40045.81,42048.1,14
APR-DRG,3261,ELECTIVE KNEE JOINT REPLACEMENT,,,11124.5,11680.73,14
APR-DRG,3262,ELECTIVE KNEE JOINT REPLACEMENT,,,12396.44,13016.26,14
APR-DRG,3263,ELECTIVE KNEE JOINT REPLACEMENT,,,17708.34,18593.76,14
APR-DRG,3264,ELECTIVE KNEE JOINT REPLACEMENT,,,27023.27,28374.43,14
APR-DRG,3401,FRACTURE OF FEMUR,,,4278.72,4492.66,14
APR-DRG,3402,FRACTURE OF FEMUR,,,5426.98,5698.33,14
APR-DRG,3403,FRACTURE OF FEMUR,,,8034.41,8436.13,14
APR-DRG,3404,FRACTURE OF FEMUR,,,13402.14,14072.25,14
APR-DRG,3411,FRACTURE OF PELVIS OR DISLOCATION OF HIP,,,4711.57,4947.15,14
APR-DRG,3412,FRACTURE OF PELVIS OR DISLOCATION OF HIP,,,5650.28,5932.79,14
APR-DRG,3413,FRACTURE OF PELVIS OR DISLOCATION OF HIP,,,7661.68,8044.76,14
APR-DRG,3414,FRACTURE OF PELVIS OR DISLOCATION OF HIP,,,14007.62,14708.0,14
APR-DRG,3421,"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK",,,5303.31,5568.48,14
APR-DRG,3422,"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK",,,6508.26,6833.67,14
APR-DRG,3423,"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK",,,9336.41,9803.23,14
APR-DRG,3424,"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK",,,16747.3,17584.67,14
APR-DRG,3431,MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY,,,7684.01,8068.21,14
APR-DRG,3432,MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY,,,8962.81,9410.95,14
APR-DRG,3433,MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY,,,13769.72,14458.21,14
APR-DRG,3434,MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY,,,23257.28,24420.14,14
APR-DRG,3441,"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",,,6475.62,6799.4,14
APR-DRG,3442,"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",,,8115.14,8520.9,14
APR-DRG,3443,"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",,,11915.49,12511.26,14
APR-DRG,3444,"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",,,19429.45,20400.92,14
APR-DRG,3461,CONNECTIVE TISSUE DISORDERS,,,6479.06,6803.01,14
APR-DRG,3462,CONNECTIVE TISSUE DISORDERS,,,8625.29,9056.55,14
APR-DRG,3463,CONNECTIVE TISSUE DISORDERS,,,13404.71,14074.95,14
APR-DRG,3464,CONNECTIVE TISSUE DISORDERS,,,28359.62,29777.6,14
APR-DRG,3471,"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES",,,6200.8,6510.84,14
APR-DRG,3472,"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES",,,7494.2,7868.91,14
APR-DRG,3473,"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES",,,10336.09,10852.89,14
APR-DRG,3474,"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES",,,19000.03,19950.03,14
APR-DRG,3491,"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE",,,5495.69,5770.47,14
APR-DRG,3492,"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE",,,7455.56,7828.34,14
APR-DRG,3493,"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE",,,10731.16,11267.72,14
APR-DRG,3494,"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE",,,18650.48,19583.0,14
APR-DRG,3511,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,,,5327.36,5593.73,14
APR-DRG,3512,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,,,5842.66,6134.79,14
APR-DRG,3513,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,,,9125.99,9582.29,14
APR-DRG,3514,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,,,17314.13,18179.84,14
APR-DRG,3611,SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES,,,14296.18,15010.99,14
APR-DRG,3612,SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES,,,17715.21,18600.97,14
APR-DRG,3613,SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES,,,27633.05,29014.7,14
APR-DRG,3614,SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES,,,59456.36,62429.18,14
APR-DRG,3621,MASTECTOMY PROCEDURES,,,12966.71,13615.05,14
APR-DRG,3622,MASTECTOMY PROCEDURES,,,19570.3,20548.82,14
APR-DRG,3623,MASTECTOMY PROCEDURES,,,21291.4,22355.97,14
APR-DRG,3624,MASTECTOMY PROCEDURES,,,28944.49,30391.71,14
APR-DRG,3631,BREAST PROCEDURES EXCEPT MASTECTOMY,,,11298.85,11863.79,14
APR-DRG,3632,BREAST PROCEDURES EXCEPT MASTECTOMY,,,18795.63,19735.41,14
APR-DRG,3633,BREAST PROCEDURES EXCEPT MASTECTOMY,,,23372.36,24540.98,14
APR-DRG,3634,BREAST PROCEDURES EXCEPT MASTECTOMY,,,44478.26,46702.17,14
APR-DRG,3641,"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES",,,7283.79,7647.98,14
APR-DRG,3642,"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES",,,9787.3,10276.67,14
APR-DRG,3643,"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES",,,16000.11,16800.12,14
APR-DRG,3644,"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES",,,30120.24,31626.25,14
APR-DRG,3801,SKIN ULCERS,,,4952.91,5200.56,14
APR-DRG,3802,SKIN ULCERS,,,6302.14,6617.25,14
APR-DRG,3803,SKIN ULCERS,,,9842.26,10334.37,14
APR-DRG,3804,SKIN ULCERS,,,18087.09,18991.44,14
APR-DRG,3811,MAJOR SKIN DISORDERS,,,3857.03,4049.88,14
APR-DRG,3812,MAJOR SKIN DISORDERS,,,6642.24,6974.35,14
APR-DRG,3813,MAJOR SKIN DISORDERS,,,13226.93,13888.28,14
APR-DRG,3814,MAJOR SKIN DISORDERS,,,27421.77,28792.86,14
APR-DRG,3821,MALIGNANT BREAST DISORDERS,,,6503.11,6828.27,14
APR-DRG,3822,MALIGNANT BREAST DISORDERS,,,7513.1,7888.76,14
APR-DRG,3823,MALIGNANT BREAST DISORDERS,,,10766.37,11304.69,14
APR-DRG,3824,MALIGNANT BREAST DISORDERS,,,16145.26,16952.52,14
APR-DRG,3831,CELLULITIS AND OTHER SKIN INFECTIONS,,,4118.98,4324.93,14
APR-DRG,3832,CELLULITIS AND OTHER SKIN INFECTIONS,,,5396.93,5666.78,14
APR-DRG,3833,CELLULITIS AND OTHER SKIN INFECTIONS,,,8446.65,8868.98,14
APR-DRG,3834,CELLULITIS AND OTHER SKIN INFECTIONS,,,17061.64,17914.72,14
APR-DRG,3841,"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE",,,6136.38,6443.2,14
APR-DRG,3842,"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE",,,7048.47,7400.89,14
APR-DRG,3843,"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE",,,10219.29,10730.25,14
APR-DRG,3844,"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE",,,17053.05,17905.7,14
APR-DRG,3851,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS",,,4589.62,4819.1,14
APR-DRG,3852,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS",,,5767.94,6056.34,14
APR-DRG,3853,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS",,,9250.52,9713.05,14
APR-DRG,3854,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS",,,18026.97,18928.32,14
APR-DRG,4011,ADRENAL PROCEDURES,,,11916.35,12512.17,14
APR-DRG,4012,ADRENAL PROCEDURES,,,20959.89,22007.88,14
APR-DRG,4013,ADRENAL PROCEDURES,,,29978.53,31477.46,14
APR-DRG,4014,ADRENAL PROCEDURES,,,42001.37,44101.44,14
APR-DRG,4031,PROCEDURES FOR OBESITY,,,10119.66,10625.64,14
APR-DRG,4032,PROCEDURES FOR OBESITY,,,11554.78,12132.52,14
APR-DRG,4033,PROCEDURES FOR OBESITY,,,18887.52,19831.9,14
APR-DRG,4034,PROCEDURES FOR OBESITY,,,41907.76,44003.15,14
APR-DRG,4041,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES",,,9491.0,9965.55,14
APR-DRG,4042,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES",,,13283.62,13947.8,14
APR-DRG,4043,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES",,,22492.91,23617.56,14
APR-DRG,4044,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES",,,44301.34,46516.41,14
APR-DRG,4051,"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS",,,12830.15,13471.66,14
APR-DRG,4052,"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS",,,13798.06,14487.96,14
APR-DRG,4053,"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS",,,21129.08,22185.53,14
APR-DRG,4054,"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS",,,42601.7,44731.79,14
APR-DRG,4201,DIABETES,,,4332.83,4549.47,14
APR-DRG,4202,DIABETES,,,5034.5,5286.23,14
APR-DRG,4203,DIABETES,,,7853.2,8245.86,14
APR-DRG,4204,DIABETES,,,17064.21,17917.42,14
APR-DRG,4211,"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS",,,4608.51,4838.94,14
APR-DRG,4212,"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS",,,6231.71,6543.3,14
APR-DRG,4213,"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS",,,9852.57,10345.2,14
APR-DRG,4214,"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS",,,19649.31,20631.78,14
APR-DRG,4221,HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS,,,3571.9,3750.5,14
APR-DRG,4222,HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS,,,4767.4,5005.77,14
APR-DRG,4223,HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS,,,7051.9,7404.5,14
APR-DRG,4224,HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS,,,12566.49,13194.81,14
APR-DRG,4231,INBORN ERRORS OF METABOLISM,,,6530.59,6857.12,14
APR-DRG,4232,INBORN ERRORS OF METABOLISM,,,7218.52,7579.45,14
APR-DRG,4233,INBORN ERRORS OF METABOLISM,,,12429.07,13050.52,14
APR-DRG,4234,INBORN ERRORS OF METABOLISM,,,35882.17,37676.28,14
APR-DRG,4241,OTHER ENDOCRINE DISORDERS,,,5094.62,5349.35,14
APR-DRG,4242,OTHER ENDOCRINE DISORDERS,,,7142.94,7500.09,14
APR-DRG,4243,OTHER ENDOCRINE DISORDERS,,,10648.71,11181.15,14
APR-DRG,4244,OTHER ENDOCRINE DISORDERS,,,19155.48,20113.25,14
APR-DRG,4251,OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS,,,3999.6,4199.58,14
APR-DRG,4252,OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS,,,5067.13,5320.49,14
APR-DRG,4253,OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS,,,7525.12,7901.38,14
APR-DRG,4254,OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS,,,16574.68,17403.41,14
APR-DRG,4261,NON-HYPOVOLEMIC SODIUM DISORDERS,,,4222.9,4434.05,14
APR-DRG,4262,NON-HYPOVOLEMIC SODIUM DISORDERS,,,5614.21,5894.92,14
APR-DRG,4263,NON-HYPOVOLEMIC SODIUM DISORDERS,,,8706.88,9142.22,14
APR-DRG,4264,NON-HYPOVOLEMIC SODIUM DISORDERS,,,16204.52,17014.75,14
APR-DRG,4271,THYROID DISORDERS,,,4794.02,5033.72,14
APR-DRG,4272,THYROID DISORDERS,,,6164.72,6472.96,14
APR-DRG,4273,THYROID DISORDERS,,,9652.46,10135.08,14
APR-DRG,4274,THYROID DISORDERS,,,20059.83,21062.82,14
APR-DRG,4401,KIDNEY TRANSPLANT,,,40567.98,42596.38,14
APR-DRG,4402,KIDNEY TRANSPLANT,,,43974.98,46173.73,14
APR-DRG,4403,KIDNEY TRANSPLANT,,,50311.47,52827.04,14
APR-DRG,4404,KIDNEY TRANSPLANT,,,83017.66,87168.54,14
APR-DRG,4411,MAJOR BLADDER PROCEDURES,,,12179.15,12788.11,14
APR-DRG,4412,MAJOR BLADDER PROCEDURES,,,19762.68,20750.81,14
APR-DRG,4413,MAJOR BLADDER PROCEDURES,,,26468.47,27791.89,14
APR-DRG,4414,MAJOR BLADDER PROCEDURES,,,49024.94,51476.19,14
APR-DRG,4421,KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY,,,12121.61,12727.69,14
APR-DRG,4422,KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY,,,14071.17,14774.73,14
APR-DRG,4423,KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY,,,21474.34,22548.06,14
APR-DRG,4424,KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY,,,39242.79,41204.93,14
APR-DRG,4431,KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY,,,11060.09,11613.09,14
APR-DRG,4432,KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY,,,12822.42,13463.54,14
APR-DRG,4433,KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY,,,18862.62,19805.75,14
APR-DRG,4434,KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY,,,34893.65,36638.33,14
APR-DRG,4441,RENAL DIALYSIS ACCESS DEVICE PROCEDURES,,,9359.59,9827.57,14
APR-DRG,4442,RENAL DIALYSIS ACCESS DEVICE PROCEDURES,,,13707.02,14392.37,14
APR-DRG,4443,RENAL DIALYSIS ACCESS DEVICE PROCEDURES,,,20329.51,21345.99,14
APR-DRG,4444,RENAL DIALYSIS ACCESS DEVICE PROCEDURES,,,36309.01,38124.46,14
APR-DRG,4451,OTHER BLADDER PROCEDURES,,,9167.22,9625.58,14
APR-DRG,4452,OTHER BLADDER PROCEDURES,,,11321.18,11887.24,14
APR-DRG,4453,OTHER BLADDER PROCEDURES,,,16433.83,17255.52,14
APR-DRG,4454,OTHER BLADDER PROCEDURES,,,30979.93,32528.93,14
APR-DRG,4461,URETHRAL AND TRANSURETHRAL PROCEDURES,,,7925.34,8321.61,14
APR-DRG,4462,URETHRAL AND TRANSURETHRAL PROCEDURES,,,9413.7,9884.39,14
APR-DRG,4463,URETHRAL AND TRANSURETHRAL PROCEDURES,,,15249.49,16011.96,14
APR-DRG,4464,URETHRAL AND TRANSURETHRAL PROCEDURES,,,27938.79,29335.73,14
APR-DRG,4471,"OTHER KIDNEY, URINARY TRACT AND RELATED PROCEDURES",,,11548.77,12126.21,14
APR-DRG,4472,"OTHER KIDNEY, URINARY TRACT AND RELATED PROCEDURES",,,13883.08,14577.23,14
APR-DRG,4473,"OTHER KIDNEY, URINARY TRACT AND RELATED PROCEDURES",,,20083.88,21088.07,14
APR-DRG,4474,"OTHER KIDNEY, URINARY TRACT AND RELATED PROCEDURES",,,39695.4,41680.17,14
APR-DRG,4611,KIDNEY AND URINARY TRACT MALIGNANCY,,,6575.25,6904.01,14
APR-DRG,4612,KIDNEY AND URINARY TRACT MALIGNANCY,,,7536.29,7913.1,14
APR-DRG,4613,KIDNEY AND URINARY TRACT MALIGNANCY,,,11437.98,12009.88,14
APR-DRG,4614,KIDNEY AND URINARY TRACT MALIGNANCY,,,18171.25,19079.81,14
APR-DRG,4621,NEPHRITIS AND NEPHROSIS,,,4796.6,5036.43,14
APR-DRG,4622,NEPHRITIS AND NEPHROSIS,,,6619.91,6950.91,14
APR-DRG,4623,NEPHRITIS AND NEPHROSIS,,,12316.57,12932.4,14
APR-DRG,4624,NEPHRITIS AND NEPHROSIS,,,22604.56,23734.79,14
APR-DRG,4631,KIDNEY AND URINARY TRACT INFECTIONS,,,4536.37,4763.19,14
APR-DRG,4632,KIDNEY AND URINARY TRACT INFECTIONS,,,5360.85,5628.89,14
APR-DRG,4633,KIDNEY AND URINARY TRACT INFECTIONS,,,7446.97,7819.32,14
APR-DRG,4634,KIDNEY AND URINARY TRACT INFECTIONS,,,13187.43,13846.8,14
APR-DRG,4651,URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,,,5002.72,5252.86,14
APR-DRG,4652,URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,,,5928.54,6224.97,14
APR-DRG,4653,URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,,,9526.21,10002.52,14
APR-DRG,4654,URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,,,16621.91,17453.01,14
APR-DRG,4661,"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE",,,4446.19,4668.5,14
APR-DRG,4662,"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE",,,5755.06,6042.81,14
APR-DRG,4663,"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE",,,8663.08,9096.23,14
APR-DRG,4664,"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE",,,14230.05,14941.55,14
APR-DRG,4681,"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",,,4728.75,4965.19,14
APR-DRG,4682,"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",,,6211.1,6521.66,14
APR-DRG,4683,"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",,,9134.58,9591.31,14
APR-DRG,4684,"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",,,17172.43,18031.05,14
APR-DRG,4691,ACUTE KIDNEY INJURY,,,4138.73,4345.67,14
APR-DRG,4692,ACUTE KIDNEY INJURY,,,5608.2,5888.61,14
APR-DRG,4693,ACUTE KIDNEY INJURY,,,9417.14,9888.0,14
APR-DRG,4694,ACUTE KIDNEY INJURY,,,19427.73,20399.12,14
APR-DRG,4701,CHRONIC KIDNEY DISEASE,,,4205.72,4416.01,14
APR-DRG,4702,CHRONIC KIDNEY DISEASE,,,5521.46,5797.53,14
APR-DRG,4703,CHRONIC KIDNEY DISEASE,,,8996.31,9446.13,14
APR-DRG,4704,CHRONIC KIDNEY DISEASE,,,18612.69,19543.32,14
APR-DRG,4801,MAJOR MALE PELVIC PROCEDURES,,,11594.29,12174.0,14
APR-DRG,4802,MAJOR MALE PELVIC PROCEDURES,,,13050.01,13702.51,14
APR-DRG,4803,MAJOR MALE PELVIC PROCEDURES,,,22829.58,23971.06,14
APR-DRG,4804,MAJOR MALE PELVIC PROCEDURES,,,38015.52,39916.3,14
APR-DRG,4821,TRANSURETHRAL PROSTATECTOMY,,,7079.39,7433.36,14
APR-DRG,4822,TRANSURETHRAL PROSTATECTOMY,,,8719.76,9155.75,14
APR-DRG,4823,TRANSURETHRAL PROSTATECTOMY,,,15839.51,16631.49,14
APR-DRG,4824,TRANSURETHRAL PROSTATECTOMY,,,27534.28,28910.99,14
APR-DRG,4831,"PENIS, TESTES AND SCROTAL PROCEDURES",,,9662.76,10145.9,14
APR-DRG,4832,"PENIS, TESTES AND SCROTAL PROCEDURES",,,12280.5,12894.53,14
APR-DRG,4833,"PENIS, TESTES AND SCROTAL PROCEDURES",,,18427.19,19348.55,14
APR-DRG,4834,"PENIS, TESTES AND SCROTAL PROCEDURES",,,33893.1,35587.76,14
APR-DRG,4841,OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,10999.11,11549.07,14
APR-DRG,4842,OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,12792.36,13431.98,14
APR-DRG,4843,OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,15774.24,16562.95,14
APR-DRG,4844,OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,34924.57,36670.8,14
APR-DRG,5001,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",,,6779.65,7118.63,14
APR-DRG,5002,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",,,7103.43,7458.6,14
APR-DRG,5003,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",,,10682.2,11216.31,14
APR-DRG,5004,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",,,21398.76,22468.7,14
APR-DRG,5011,MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,,,4593.91,4823.61,14
APR-DRG,5012,MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,,,5959.46,6257.43,14
APR-DRG,5013,MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,,,8951.65,9399.23,14
APR-DRG,5014,MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,,,17822.56,18713.69,14
APR-DRG,5101,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND OTHER RADICAL GYNECOLOGICAL PROCEDURES",,,11904.33,12499.55,14
APR-DRG,5102,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND OTHER RADICAL GYNECOLOGICAL PROCEDURES",,,14109.82,14815.31,14
APR-DRG,5103,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND OTHER RADICAL GYNECOLOGICAL PROCEDURES",,,24789.44,26028.91,14
APR-DRG,5104,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND OTHER RADICAL GYNECOLOGICAL PROCEDURES",,,46591.85,48921.44,14
APR-DRG,5111,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY,,,12347.49,12964.86,14
APR-DRG,5112,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY,,,15035.64,15787.42,14
APR-DRG,5113,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY,,,22409.61,23530.09,14
APR-DRG,5114,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY,,,44394.95,46614.7,14
APR-DRG,5121,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY,,,11904.33,12499.55,14
APR-DRG,5122,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY,,,13402.14,14072.25,14
APR-DRG,5123,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY,,,22461.14,23584.2,14
APR-DRG,5124,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY,,,39270.28,41233.79,14
APR-DRG,5131,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA,,,8865.76,9309.05,14
APR-DRG,5132,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA,,,10537.06,11063.91,14
APR-DRG,5133,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA,,,17215.37,18076.14,14
APR-DRG,5134,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA,,,30255.93,31768.73,14
APR-DRG,5141,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,,7440.1,7812.11,14
APR-DRG,5142,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,,11358.11,11926.02,14
APR-DRG,5143,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,,17567.49,18445.86,14
APR-DRG,5144,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,,46778.22,49117.13,14
APR-DRG,5171,DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES,,,6883.57,7227.75,14
APR-DRG,5172,DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES,,,8445.79,8868.08,14
APR-DRG,5173,DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES,,,13412.44,14083.06,14
APR-DRG,5174,DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES,,,23635.17,24816.93,14
APR-DRG,5181,OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,8204.46,8614.68,14
APR-DRG,5182,OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,11704.22,12289.43,14
APR-DRG,5183,OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,20557.1,21584.96,14
APR-DRG,5184,OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,43404.71,45574.95,14
APR-DRG,5191,UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA,,,8435.49,8857.26,14
APR-DRG,5192,UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA,,,11015.43,11566.2,14
APR-DRG,5193,UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA,,,18903.84,19849.03,14
APR-DRG,5194,UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA,,,36761.62,38599.7,14
APR-DRG,5301,FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,,,6133.81,6440.5,14
APR-DRG,5302,FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,,,7459.85,7832.84,14
APR-DRG,5303,FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,,,11363.26,11931.42,14
APR-DRG,5304,FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,,,20242.76,21254.9,14
APR-DRG,5311,FEMALE REPRODUCTIVE SYSTEM INFECTIONS,,,4590.48,4820.0,14
APR-DRG,5312,FEMALE REPRODUCTIVE SYSTEM INFECTIONS,,,5968.05,6266.45,14
APR-DRG,5313,FEMALE REPRODUCTIVE SYSTEM INFECTIONS,,,9929.0,10425.45,14
APR-DRG,5314,FEMALE REPRODUCTIVE SYSTEM INFECTIONS,,,17417.19,18288.05,14
APR-DRG,5321,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,,,4432.45,4654.07,14
APR-DRG,5322,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,,,5316.19,5582.0,14
APR-DRG,5323,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,,,7981.16,8380.22,14
APR-DRG,5324,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,,,16327.33,17143.7,14
APR-DRG,5391,CESAREAN SECTION WITH STERILIZATION,,,5068.85,5322.29,14
APR-DRG,5392,CESAREAN SECTION WITH STERILIZATION,,,6078.84,6382.78,14
APR-DRG,5393,CESAREAN SECTION WITH STERILIZATION,,,9763.25,10251.41,14
APR-DRG,5394,CESAREAN SECTION WITH STERILIZATION,,,24667.49,25900.86,14
APR-DRG,5401,CESAREAN SECTION WITHOUT STERILIZATION,,,5003.58,5253.76,14
APR-DRG,5402,CESAREAN SECTION WITHOUT STERILIZATION,,,6236.87,6548.71,14
APR-DRG,5403,CESAREAN SECTION WITHOUT STERILIZATION,,,8562.59,8990.72,14
APR-DRG,5404,CESAREAN SECTION WITHOUT STERILIZATION,,,17892.99,18787.64,14
APR-DRG,5411,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C,,,5010.45,5260.97,14
APR-DRG,5412,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C,,,5238.04,5499.94,14
APR-DRG,5413,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C,,,7148.09,7505.49,14
APR-DRG,5414,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C,,,12010.82,12611.36,14
APR-DRG,5421,VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C,,,3368.35,3536.77,14
APR-DRG,5422,VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C,,,4027.08,4228.43,14
APR-DRG,5423,VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C,,,6808.85,7149.29,14
APR-DRG,5424,VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C,,,20979.65,22028.63,14
APR-DRG,5431,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,4730.47,4966.99,14
APR-DRG,5432,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,5974.06,6272.76,14
APR-DRG,5433,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,9020.35,9471.37,14
APR-DRG,5434,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,22084.97,23189.22,14
APR-DRG,5471,ANTEPARTUM WITH O.R. PROCEDURE,,,6279.81,6593.8,14
APR-DRG,5472,ANTEPARTUM WITH O.R. PROCEDURE,,,8580.63,9009.66,14
APR-DRG,5473,ANTEPARTUM WITH O.R. PROCEDURE,,,14038.53,14740.46,14
APR-DRG,5474,ANTEPARTUM WITH O.R. PROCEDURE,,,24956.92,26204.77,14
APR-DRG,5481,POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE,,,4295.9,4510.7,14
APR-DRG,5482,POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE,,,8328.13,8744.54,14
APR-DRG,5483,POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE,,,14141.59,14848.67,14
APR-DRG,5484,POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE,,,31866.25,33459.56,14
APR-DRG,5601,VAGINAL DELIVERY,,,2973.29,3121.95,14
APR-DRG,5602,VAGINAL DELIVERY,,,3371.79,3540.38,14
APR-DRG,5603,VAGINAL DELIVERY,,,4805.19,5045.45,14
APR-DRG,5604,VAGINAL DELIVERY,,,9198.13,9658.04,14
APR-DRG,5611,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE,,,2332.6,2449.23,14
APR-DRG,5612,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE,,,3663.79,3846.98,14
APR-DRG,5613,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE,,,6102.89,6408.03,14
APR-DRG,5614,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE,,,14571.87,15300.46,14
APR-DRG,5641,"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,2851.34,2993.91,14
APR-DRG,5642,"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,3929.17,4125.63,14
APR-DRG,5643,"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,6313.3,6628.97,14
APR-DRG,5644,"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,21270.79,22334.33,14
APR-DRG,5661,ANTEPARTUM WITHOUT O.R. PROCEDURE,,,2520.68,2646.71,14
APR-DRG,5662,ANTEPARTUM WITHOUT O.R. PROCEDURE,,,3382.1,3551.21,14
APR-DRG,5663,ANTEPARTUM WITHOUT O.R. PROCEDURE,,,5353.12,5620.78,14
APR-DRG,5664,ANTEPARTUM WITHOUT O.R. PROCEDURE,,,11099.6,11654.58,14
APR-DRG,5801,"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE",,,2682.14,2816.25,14
APR-DRG,5802,"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE",,,3968.68,4167.11,14
APR-DRG,5803,"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE",,,6440.41,6762.43,14
APR-DRG,5804,"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE",,,10109.36,10614.83,14
APR-DRG,5811,"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE",,,901.78,946.87,14
APR-DRG,5812,"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE",,,1459.16,1532.12,14
APR-DRG,5813,"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE",,,2500.93,2625.98,14
APR-DRG,5814,"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE",,,4624.83,4856.07,14
APR-DRG,5831,NEONATE WITH ECMO,,,162866.22,171009.53,14
APR-DRG,5832,NEONATE WITH ECMO,,,224066.02,235269.32,14
APR-DRG,5833,NEONATE WITH ECMO,,,291822.17,306413.28,14
APR-DRG,5834,NEONATE WITH ECMO,,,450460.34,472983.36,14
APR-DRG,5881,NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE,,,143751.97,150939.57,14
APR-DRG,5882,NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE,,,167710.92,176096.47,14
APR-DRG,5883,NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE,,,191127.94,200684.34,14
APR-DRG,5884,NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE,,,293873.93,308567.63,14
APR-DRG,5891,"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION",,,114798.89,120538.83,14
APR-DRG,5892,"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION",,,111412.5,116983.13,14
APR-DRG,5893,"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION",,,109038.68,114490.61,14
APR-DRG,5894,"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION",,,17024.71,17875.95,14
APR-DRG,5911,NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,,,63164.81,66323.05,14
APR-DRG,5912,NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,,,105077.73,110331.62,14
APR-DRG,5913,NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,,,138566.32,145494.64,14
APR-DRG,5914,NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,,,186687.76,196022.15,14
APR-DRG,5931,NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,,,21279.38,22343.35,14
APR-DRG,5932,NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,,,98331.57,103248.15,14
APR-DRG,5933,NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,,,120055.83,126058.62,14
APR-DRG,5934,NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,,,173106.98,181762.33,14
APR-DRG,6021,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,21643.53,22725.71,14
APR-DRG,6022,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,72918.61,76564.54,14
APR-DRG,6023,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,91181.76,95740.85,14
APR-DRG,6024,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,128545.42,134972.69,14
APR-DRG,6031,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,18178.98,19087.93,14
APR-DRG,6032,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,39435.17,41406.93,14
APR-DRG,6033,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,70726.0,74262.3,14
APR-DRG,6034,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,160117.95,168123.85,14
APR-DRG,6071,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,27923.33,29319.5,14
APR-DRG,6072,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,50367.3,52885.67,14
APR-DRG,6073,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,68195.87,71605.66,14
APR-DRG,6074,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,98514.5,103440.23,14
APR-DRG,6081,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,15970.91,16769.46,14
APR-DRG,6082,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,37117.17,38973.03,14
APR-DRG,6083,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,49559.99,52037.99,14
APR-DRG,6084,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,62242.42,65354.54,14
APR-DRG,6091,NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE,,,37814.55,39705.28,14
APR-DRG,6092,NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE,,,39804.47,41794.69,14
APR-DRG,6093,NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE,,,72145.66,75752.94,14
APR-DRG,6094,NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE,,,193223.5,202884.68,14
APR-DRG,6111,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,,,14090.92,14795.47,14
APR-DRG,6112,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,,,27949.96,29347.46,14
APR-DRG,6113,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,,,49328.96,51795.41,14
APR-DRG,6114,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,,,79844.27,83836.48,14
APR-DRG,6121,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,22535.0,23661.75,14
APR-DRG,6122,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,34642.87,36375.01,14
APR-DRG,6123,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,43839.28,46031.24,14
APR-DRG,6124,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,70368.73,73887.17,14
APR-DRG,6131,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,18636.74,19568.58,14
APR-DRG,6132,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,25516.02,26791.82,14
APR-DRG,6133,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,48686.55,51120.88,14
APR-DRG,6134,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,80219.58,84230.56,14
APR-DRG,6141,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION,,,11563.37,12141.54,14
APR-DRG,6142,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION,,,21916.64,23012.47,14
APR-DRG,6143,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION,,,39439.47,41411.44,14
APR-DRG,6144,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION,,,57450.98,60323.53,14
APR-DRG,6211,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,,,5500.84,5775.88,14
APR-DRG,6212,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,,,16882.14,17726.25,14
APR-DRG,6213,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,,,33314.25,34979.96,14
APR-DRG,6214,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,,,67590.39,70969.91,14
APR-DRG,6221,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,14524.63,15250.86,14
APR-DRG,6222,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,21576.54,22655.37,14
APR-DRG,6223,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,24866.74,26110.08,14
APR-DRG,6224,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,42046.89,44149.23,14
APR-DRG,6231,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,10697.66,11232.54,14
APR-DRG,6232,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,17874.95,18768.7,14
APR-DRG,6233,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,37848.9,39741.35,14
APR-DRG,6234,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,47355.36,49723.13,14
APR-DRG,6251,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,12368.96,12987.41,14
APR-DRG,6252,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,15511.44,16287.01,14
APR-DRG,6253,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,27508.52,28883.95,14
APR-DRG,6254,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,56205.66,59015.94,14
APR-DRG,6261,"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,1576.82,1655.66,14
APR-DRG,6262,"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,2038.88,2140.82,14
APR-DRG,6263,"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,6033.32,6334.99,14
APR-DRG,6264,"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,19483.55,20457.73,14
APR-DRG,6301,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE,,,27949.96,29347.46,14
APR-DRG,6302,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE,,,58576.91,61505.76,14
APR-DRG,6303,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE,,,102362.09,107480.19,14
APR-DRG,6304,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE,,,214370.62,225089.15,14
APR-DRG,6311,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE,,,7280.35,7644.37,14
APR-DRG,6312,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE,,,36991.78,38841.37,14
APR-DRG,6313,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE,,,56961.44,59809.51,14
APR-DRG,6314,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE,,,189697.12,199181.98,14
APR-DRG,6331,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY,,,2117.03,2222.88,14
APR-DRG,6332,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY,,,8122.87,8529.01,14
APR-DRG,6333,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY,,,24719.02,25954.97,14
APR-DRG,6334,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY,,,66909.34,70254.81,14
APR-DRG,6341,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,6157.0,6464.85,14
APR-DRG,6342,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,13026.82,13678.16,14
APR-DRG,6343,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,14872.46,15616.08,14
APR-DRG,6344,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,39789.87,41779.36,14
APR-DRG,6361,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,6691.19,7025.75,14
APR-DRG,6362,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,11218.12,11779.03,14
APR-DRG,6363,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,23071.77,24225.36,14
APR-DRG,6364,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,29915.83,31411.62,14
APR-DRG,6391,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,4164.5,4372.73,14
APR-DRG,6392,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,6636.23,6968.04,14
APR-DRG,6393,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,18672.81,19606.45,14
APR-DRG,6394,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,29351.58,30819.16,14
APR-DRG,6401,"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,959.32,1007.29,14
APR-DRG,6402,"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,1374.14,1442.85,14
APR-DRG,6403,"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,3143.34,3300.51,14
APR-DRG,6404,"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,17825.14,18716.4,14
APR-DRG,6501,SPLENIC PROCEDURES,,,12337.18,12954.04,14
APR-DRG,6502,SPLENIC PROCEDURES,,,16454.44,17277.16,14
APR-DRG,6503,SPLENIC PROCEDURES,,,23222.93,24384.08,14
APR-DRG,6504,SPLENIC PROCEDURES,,,40245.91,42258.21,14
APR-DRG,6511,OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS,,,10329.22,10845.68,14
APR-DRG,6512,OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS,,,14614.81,15345.55,14
APR-DRG,6513,OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS,,,21518.14,22594.05,14
APR-DRG,6514,OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS,,,46199.36,48509.33,14
APR-DRG,6601,MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION,,,6540.04,6867.04,14
APR-DRG,6602,MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION,,,7307.84,7673.23,14
APR-DRG,6603,MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION,,,11529.01,12105.46,14
APR-DRG,6604,MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION,,,28211.9,29622.5,14
APR-DRG,6611,COAGULATION AND PLATELET DISORDERS,,,7452.12,7824.73,14
APR-DRG,6612,COAGULATION AND PLATELET DISORDERS,,,9974.52,10473.25,14
APR-DRG,6613,COAGULATION AND PLATELET DISORDERS,,,12368.1,12986.51,14
APR-DRG,6614,COAGULATION AND PLATELET DISORDERS,,,23696.14,24880.95,14
APR-DRG,6621,SICKLE CELL ANEMIA CRISIS,,,4989.84,5239.33,14
APR-DRG,6622,SICKLE CELL ANEMIA CRISIS,,,6813.15,7153.81,14
APR-DRG,6623,SICKLE CELL ANEMIA CRISIS,,,10428.85,10950.29,14
APR-DRG,6624,SICKLE CELL ANEMIA CRISIS,,,21663.28,22746.44,14
APR-DRG,6631,OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS,,,4718.44,4954.36,14
APR-DRG,6632,OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS,,,6495.38,6820.15,14
APR-DRG,6633,OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS,,,9330.39,9796.91,14
APR-DRG,6634,OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS,,,16781.66,17620.74,14
APR-DRG,6801,"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,14404.4,15124.62,14
APR-DRG,6802,"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,19579.74,20558.73,14
APR-DRG,6803,"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,31495.23,33069.99,14
APR-DRG,6804,"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,67532.85,70909.49,14
APR-DRG,6811,"OTHER  O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,10846.24,11388.55,14
APR-DRG,6812,"OTHER  O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,14670.64,15404.17,14
APR-DRG,6813,"OTHER  O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,24853.0,26095.65,14
APR-DRG,6814,"OTHER  O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,61535.6,64612.38,14
APR-DRG,6901,ACUTE LEUKEMIA,,,11425.95,11997.25,14
APR-DRG,6902,ACUTE LEUKEMIA,,,20355.27,21373.03,14
APR-DRG,6903,ACUTE LEUKEMIA,,,35300.74,37065.78,14
APR-DRG,6904,ACUTE LEUKEMIA,,,60957.6,64005.48,14
APR-DRG,6911,"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",,,9520.2,9996.21,14
APR-DRG,6912,"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",,,12238.41,12850.33,14
APR-DRG,6913,"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",,,18154.93,19062.68,14
APR-DRG,6914,"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",,,35687.21,37471.57,14
APR-DRG,6921,RADIOTHERAPY,,,10288.0,10802.4,14
APR-DRG,6922,RADIOTHERAPY,,,14333.11,15049.77,14
APR-DRG,6923,RADIOTHERAPY,,,21527.58,22603.96,14
APR-DRG,6924,RADIOTHERAPY,,,30643.27,32175.43,14
APR-DRG,6941,LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,,,6528.01,6854.41,14
APR-DRG,6942,LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,,,7952.82,8350.46,14
APR-DRG,6943,LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,,,12077.81,12681.7,14
APR-DRG,6944,LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,,,22262.75,23375.89,14
APR-DRG,6951,CHEMOTHERAPY FOR ACUTE LEUKEMIA,,,4930.58,5177.11,14
APR-DRG,6952,CHEMOTHERAPY FOR ACUTE LEUKEMIA,,,8298.93,8713.88,14
APR-DRG,6953,CHEMOTHERAPY FOR ACUTE LEUKEMIA,,,19746.36,20733.68,14
APR-DRG,6954,CHEMOTHERAPY FOR ACUTE LEUKEMIA,,,54019.93,56720.93,14
APR-DRG,6961,OTHER CHEMOTHERAPY,,,6898.17,7243.08,14
APR-DRG,6962,OTHER CHEMOTHERAPY,,,8420.89,8841.93,14
APR-DRG,6963,OTHER CHEMOTHERAPY,,,13627.15,14308.51,14
APR-DRG,6964,OTHER CHEMOTHERAPY,,,29651.31,31133.88,14
APR-DRG,7101,INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE,,,9826.8,10318.14,14
APR-DRG,7102,INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE,,,13822.11,14513.22,14
APR-DRG,7103,INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE,,,22645.79,23778.08,14
APR-DRG,7104,INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE,,,41600.3,43680.32,14
APR-DRG,7111,"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE",,,9795.02,10284.77,14
APR-DRG,7112,"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE",,,13120.44,13776.46,14
APR-DRG,7113,"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE",,,21903.75,22998.94,14
APR-DRG,7114,"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE",,,39989.12,41988.58,14
APR-DRG,7201,SEPTICEMIA AND DISSEMINATED INFECTIONS,,,5354.84,5622.58,14
APR-DRG,7202,SEPTICEMIA AND DISSEMINATED INFECTIONS,,,6786.52,7125.85,14
APR-DRG,7203,SEPTICEMIA AND DISSEMINATED INFECTIONS,,,10591.17,11120.73,14
APR-DRG,7204,SEPTICEMIA AND DISSEMINATED INFECTIONS,,,20757.21,21795.07,14
APR-DRG,7211,"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS",,,5351.41,5618.98,14
APR-DRG,7212,"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS",,,7262.32,7625.44,14
APR-DRG,7213,"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS",,,11613.18,12193.84,14
APR-DRG,7214,"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS",,,20661.88,21694.97,14
APR-DRG,7221,FEVER AND INFLAMMATORY CONDITIONS,,,3874.21,4067.92,14
APR-DRG,7222,FEVER AND INFLAMMATORY CONDITIONS,,,5388.34,5657.76,14
APR-DRG,7223,FEVER AND INFLAMMATORY CONDITIONS,,,7712.35,8097.97,14
APR-DRG,7224,FEVER AND INFLAMMATORY CONDITIONS,,,12777.76,13416.65,14
APR-DRG,7231,VIRAL ILLNESS,,,3766.0,3954.3,14
APR-DRG,7232,VIRAL ILLNESS,,,5069.71,5323.2,14
APR-DRG,7233,VIRAL ILLNESS,,,8091.95,8496.55,14
APR-DRG,7234,VIRAL ILLNESS,,,20382.75,21401.89,14
APR-DRG,7241,OTHER INFECTIOUS AND PARASITIC DISEASES,,,5505.14,5780.4,14
APR-DRG,7242,OTHER INFECTIOUS AND PARASITIC DISEASES,,,6637.08,6968.93,14
APR-DRG,7243,OTHER INFECTIOUS AND PARASITIC DISEASES,,,10888.32,11432.74,14
APR-DRG,7244,OTHER INFECTIOUS AND PARASITIC DISEASES,,,23122.44,24278.56,14
APR-DRG,7401,MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE,,,9623.26,10104.42,14
APR-DRG,7402,MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE,,,10809.31,11349.78,14
APR-DRG,7403,MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE,,,24488.85,25713.29,14
APR-DRG,7404,MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE,,,61283.96,64348.16,14
APR-DRG,7501,SCHIZOPHRENIA,,,5585.01,5864.26,14
APR-DRG,7502,SCHIZOPHRENIA,,,7172.14,7530.75,14
APR-DRG,7503,SCHIZOPHRENIA,,,11988.49,12587.91,14
APR-DRG,7504,SCHIZOPHRENIA,,,25108.07,26363.47,14
APR-DRG,7511,MAJOR DEPRESSIVE DISORDERS AND OTHER OR UNSPECIFIED PSYCHOSES,,,3278.18,3442.09,14
APR-DRG,7512,MAJOR DEPRESSIVE DISORDERS AND OTHER OR UNSPECIFIED PSYCHOSES,,,4644.59,4876.82,14
APR-DRG,7513,MAJOR DEPRESSIVE DISORDERS AND OTHER OR UNSPECIFIED PSYCHOSES,,,9061.58,9514.66,14
APR-DRG,7514,MAJOR DEPRESSIVE DISORDERS AND OTHER OR UNSPECIFIED PSYCHOSES,,,18714.04,19649.74,14
APR-DRG,7521,DISORDERS OF PERSONALITY AND IMPULSE CONTROL,,,2760.3,2898.32,14
APR-DRG,7522,DISORDERS OF PERSONALITY AND IMPULSE CONTROL,,,4004.75,4204.99,14
APR-DRG,7523,DISORDERS OF PERSONALITY AND IMPULSE CONTROL,,,11440.55,12012.58,14
APR-DRG,7524,DISORDERS OF PERSONALITY AND IMPULSE CONTROL,,,21234.72,22296.46,14
APR-DRG,7531,BIPOLAR DISORDERS,,,3658.64,3841.57,14
APR-DRG,7532,BIPOLAR DISORDERS,,,5120.38,5376.4,14
APR-DRG,7533,BIPOLAR DISORDERS,,,10006.3,10506.62,14
APR-DRG,7534,BIPOLAR DISORDERS,,,17933.35,18830.02,14
APR-DRG,7541,DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER,,,2835.88,2977.67,14
APR-DRG,7542,DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER,,,3988.43,4187.85,14
APR-DRG,7543,DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER,,,7156.68,7514.51,14
APR-DRG,7544,DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER,,,17232.54,18094.17,14
APR-DRG,7551,ADJUSTMENT DISORDERS AND NEUROSES EXCEPT DEPRESSIVE DIAGNOSES,,,2729.38,2865.85,14
APR-DRG,7552,ADJUSTMENT DISORDERS AND NEUROSES EXCEPT DEPRESSIVE DIAGNOSES,,,4093.21,4297.87,14
APR-DRG,7553,ADJUSTMENT DISORDERS AND NEUROSES EXCEPT DEPRESSIVE DIAGNOSES,,,6829.46,7170.93,14
APR-DRG,7554,ADJUSTMENT DISORDERS AND NEUROSES EXCEPT DEPRESSIVE DIAGNOSES,,,10403.94,10924.14,14
APR-DRG,7561,ACUTE ANXIETY AND DELIRIUM STATES,,,4561.28,4789.34,14
APR-DRG,7562,ACUTE ANXIETY AND DELIRIUM STATES,,,5728.44,6014.86,14
APR-DRG,7563,ACUTE ANXIETY AND DELIRIUM STATES,,,6378.57,6697.5,14
APR-DRG,7564,ACUTE ANXIETY AND DELIRIUM STATES,,,15252.93,16015.58,14
APR-DRG,7571,ORGANIC MENTAL HEALTH DISTURBANCES,,,4762.25,5000.36,14
APR-DRG,7572,ORGANIC MENTAL HEALTH DISTURBANCES,,,6852.65,7195.28,14
APR-DRG,7573,ORGANIC MENTAL HEALTH DISTURBANCES,,,11580.54,12159.57,14
APR-DRG,7574,ORGANIC MENTAL HEALTH DISTURBANCES,,,22949.82,24097.31,14
APR-DRG,7581,BEHAVIORAL DISORDERS,,,3575.33,3754.1,14
APR-DRG,7582,BEHAVIORAL DISORDERS,,,4414.42,4635.14,14
APR-DRG,7583,BEHAVIORAL DISORDERS,,,8474.99,8898.74,14
APR-DRG,7584,BEHAVIORAL DISORDERS,,,44822.65,47063.78,14
APR-DRG,7591,EATING DISORDERS,,,8637.31,9069.18,14
APR-DRG,7592,EATING DISORDERS,,,10614.35,11145.07,14
APR-DRG,7593,EATING DISORDERS,,,15549.23,16326.69,14
APR-DRG,7594,EATING DISORDERS,,,57547.17,60424.53,14
APR-DRG,7601,OTHER MENTAL HEALTH DISORDERS,,,4460.79,4683.83,14
APR-DRG,7602,OTHER MENTAL HEALTH DISORDERS,,,6668.0,7001.4,14
APR-DRG,7603,OTHER MENTAL HEALTH DISORDERS,,,10368.73,10887.17,14
APR-DRG,7604,OTHER MENTAL HEALTH DISORDERS,,,21428.82,22500.26,14
APR-DRG,7701,"DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE",,,2493.2,2617.86,14
APR-DRG,7702,"DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE",,,3669.81,3853.3,14
APR-DRG,7703,"DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE",,,6120.07,6426.07,14
APR-DRG,7704,"DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE",,,13076.64,13730.47,14
APR-DRG,7721,ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY,,,4145.6,4352.88,14
APR-DRG,7722,ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY,,,5793.71,6083.4,14
APR-DRG,7723,ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY,,,7381.7,7750.79,14
APR-DRG,7724,ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY,,,18272.59,19186.22,14
APR-DRG,7731,OPIOID ABUSE AND DEPENDENCE,,,2569.64,2698.12,14
APR-DRG,7732,OPIOID ABUSE AND DEPENDENCE,,,3815.81,4006.6,14
APR-DRG,7733,OPIOID ABUSE AND DEPENDENCE,,,7542.3,7919.42,14
APR-DRG,7734,OPIOID ABUSE AND DEPENDENCE,,,17777.05,18665.9,14
APR-DRG,7741,COCAINE ABUSE AND DEPENDENCE,,,3278.18,3442.09,14
APR-DRG,7742,COCAINE ABUSE AND DEPENDENCE,,,3830.41,4021.93,14
APR-DRG,7743,COCAINE ABUSE AND DEPENDENCE,,,7223.67,7584.85,14
APR-DRG,7744,COCAINE ABUSE AND DEPENDENCE,,,17172.43,18031.05,14
APR-DRG,7751,ALCOHOL ABUSE AND DEPENDENCE,,,3571.04,3749.59,14
APR-DRG,7752,ALCOHOL ABUSE AND DEPENDENCE,,,4818.93,5059.88,14
APR-DRG,7753,ALCOHOL ABUSE AND DEPENDENCE,,,8672.53,9106.16,14
APR-DRG,7754,ALCOHOL ABUSE AND DEPENDENCE,,,20381.9,21401.0,14
APR-DRG,7761,OTHER DRUG ABUSE AND DEPENDENCE,,,3912.86,4108.5,14
APR-DRG,7762,OTHER DRUG ABUSE AND DEPENDENCE,,,4333.69,4550.37,14
APR-DRG,7763,OTHER DRUG ABUSE AND DEPENDENCE,,,7666.83,8050.17,14
APR-DRG,7764,OTHER DRUG ABUSE AND DEPENDENCE,,,15200.54,15960.57,14
APR-DRG,7921,EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,12399.87,13019.86,14
APR-DRG,7922,EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,15852.39,16645.01,14
APR-DRG,7923,EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,23908.28,25103.69,14
APR-DRG,7924,EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,46681.17,49015.23,14
APR-DRG,7931,MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,9514.19,9989.9,14
APR-DRG,7932,MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,12821.56,13462.64,14
APR-DRG,7933,MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,19609.8,20590.29,14
APR-DRG,7934,MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,38558.3,40486.22,14
APR-DRG,7941,NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,7718.36,8104.28,14
APR-DRG,7942,NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,10173.77,10682.46,14
APR-DRG,7943,NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,15289.0,16053.45,14
APR-DRG,7944,NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,28850.88,30293.42,14
APR-DRG,8101,HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION,,,4536.37,4763.19,14
APR-DRG,8102,HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION,,,6061.66,6364.74,14
APR-DRG,8103,HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION,,,9801.9,10292.0,14
APR-DRG,8104,HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION,,,20585.44,21614.71,14
APR-DRG,8111,ALLERGIC REACTIONS,,,3179.41,3338.38,14
APR-DRG,8112,ALLERGIC REACTIONS,,,4749.36,4986.83,14
APR-DRG,8113,ALLERGIC REACTIONS,,,9411.98,9882.58,14
APR-DRG,8114,ALLERGIC REACTIONS,,,19704.27,20689.48,14
APR-DRG,8121,POISONING OF MEDICINAL AGENTS,,,3472.27,3645.88,14
APR-DRG,8122,POISONING OF MEDICINAL AGENTS,,,4858.44,5101.36,14
APR-DRG,8123,POISONING OF MEDICINAL AGENTS,,,7458.13,7831.04,14
APR-DRG,8124,POISONING OF MEDICINAL AGENTS,,,14928.29,15674.7,14
APR-DRG,8131,OTHER COMPLICATIONS OF TREATMENT,,,5556.67,5834.5,14
APR-DRG,8132,OTHER COMPLICATIONS OF TREATMENT,,,6835.48,7177.25,14
APR-DRG,8133,OTHER COMPLICATIONS OF TREATMENT,,,10114.51,10620.24,14
APR-DRG,8134,OTHER COMPLICATIONS OF TREATMENT,,,19161.49,20119.56,14
APR-DRG,8151,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",,,4136.15,4342.96,14
APR-DRG,8152,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",,,5445.88,5718.17,14
APR-DRG,8153,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",,,9742.64,10229.77,14
APR-DRG,8154,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",,,21738.86,22825.8,14
APR-DRG,8161,TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,,,5850.39,6142.91,14
APR-DRG,8162,TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,,,6157.85,6465.74,14
APR-DRG,8163,TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,,,7565.49,7943.76,14
APR-DRG,8164,TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,,,14724.74,15460.98,14
APR-DRG,8171,INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,,,3432.77,3604.41,14
APR-DRG,8172,INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,,,4510.61,4736.14,14
APR-DRG,8173,INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,,,7836.02,8227.82,14
APR-DRG,8174,INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,,,16167.59,16975.97,14
APR-DRG,8411,EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT,,,45909.08,48204.53,14
APR-DRG,8412,EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT,,,45909.08,48204.53,14
APR-DRG,8413,EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT,,,67663.39,71046.56,14
APR-DRG,8414,EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT,,,211434.26,222005.97,14
APR-DRG,8421,BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS,,,14431.88,15153.47,14
APR-DRG,8422,BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS,,,21050.07,22102.57,14
APR-DRG,8423,BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS,,,39983.11,41982.27,14
APR-DRG,8424,BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS,,,108282.9,113697.05,14
APR-DRG,8431,EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT,,,5533.48,5810.15,14
APR-DRG,8432,EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT,,,8541.98,8969.08,14
APR-DRG,8433,EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT,,,12374.97,12993.72,14
APR-DRG,8434,EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT,,,24305.92,25521.22,14
APR-DRG,8441,PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT,,,4551.83,4779.42,14
APR-DRG,8442,PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT,,,7248.58,7611.01,14
APR-DRG,8443,PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT,,,11534.17,12110.88,14
APR-DRG,8444,PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT,,,27044.75,28396.99,14
APR-DRG,8501,"PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES",,,16569.52,17398.0,14
APR-DRG,8502,"PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES",,,22393.29,23512.95,14
APR-DRG,8503,"PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES",,,29963.93,31462.13,14
APR-DRG,8504,"PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES",,,69725.46,73211.73,14
APR-DRG,8511,GENDER RELATED PROCEDURES,,,19905.24,20900.5,14
APR-DRG,8512,GENDER RELATED PROCEDURES,,,20320.92,21336.97,14
APR-DRG,8513,GENDER RELATED PROCEDURES,,,32007.1,33607.46,14
APR-DRG,8514,GENDER RELATED PROCEDURES,,,109922.42,115418.54,14
APR-DRG,8601,REHABILITATION,,,10106.78,10612.12,14
APR-DRG,8602,REHABILITATION,,,12922.05,13568.15,14
APR-DRG,8603,REHABILITATION,,,16383.16,17202.32,14
APR-DRG,8604,REHABILITATION,,,20449.74,21472.23,14
APR-DRG,8611,"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",,,4480.55,4704.58,14
APR-DRG,8612,"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",,,5895.91,6190.71,14
APR-DRG,8613,"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",,,8870.06,9313.56,14
APR-DRG,8614,"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",,,14538.38,15265.3,14
APR-DRG,8621,OTHER AFTERCARE AND CONVALESCENCE,,,4588.76,4818.2,14
APR-DRG,8622,OTHER AFTERCARE AND CONVALESCENCE,,,8489.59,8914.07,14
APR-DRG,8623,OTHER AFTERCARE AND CONVALESCENCE,,,8746.39,9183.71,14
APR-DRG,8624,OTHER AFTERCARE AND CONVALESCENCE,,,9097.65,9552.53,14
APR-DRG,8631,NEONATAL AFTERCARE,,,11169.16,11727.62,14
APR-DRG,8632,NEONATAL AFTERCARE,,,21644.38,22726.6,14
APR-DRG,8633,NEONATAL AFTERCARE,,,42501.22,44626.28,14
APR-DRG,8634,NEONATAL AFTERCARE,,,82048.04,86150.44,14
APR-DRG,8901,HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS,,,7550.89,7928.43,14
APR-DRG,8902,HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS,,,7947.67,8345.05,14
APR-DRG,8903,HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS,,,13589.36,14268.83,14
APR-DRG,8904,HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS,,,28059.03,29461.98,14
APR-DRG,8921,HIV WITH MAJOR HIV RELATED CONDITION,,,6587.27,6916.63,14
APR-DRG,8922,HIV WITH MAJOR HIV RELATED CONDITION,,,7842.03,8234.13,14
APR-DRG,8923,HIV WITH MAJOR HIV RELATED CONDITION,,,10818.76,11359.7,14
APR-DRG,8924,HIV WITH MAJOR HIV RELATED CONDITION,,,18105.12,19010.38,14
APR-DRG,8931,HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS,,,8007.79,8408.18,14
APR-DRG,8932,HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS,,,8526.52,8952.85,14
APR-DRG,8933,HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS,,,11269.65,11833.13,14
APR-DRG,8934,HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS,,,16683.75,17517.94,14
APR-DRG,8941,HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS,,,5982.65,6281.78,14
APR-DRG,8942,HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS,,,7339.61,7706.59,14
APR-DRG,8943,HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS,,,10269.96,10783.46,14
APR-DRG,8944,HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS,,,16177.89,16986.78,14
APR-DRG,9101,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,,22883.69,24027.87,14
APR-DRG,9102,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,,24087.77,25292.16,14
APR-DRG,9103,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,,41949.84,44047.33,14
APR-DRG,9104,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,,62556.76,65684.6,14
APR-DRG,9111,EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,16091.15,16895.71,14
APR-DRG,9112,EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,19872.61,20866.24,14
APR-DRG,9113,EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,27235.41,28597.18,14
APR-DRG,9114,EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,58667.95,61601.35,14
APR-DRG,9121,MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,18508.77,19434.21,14
APR-DRG,9122,MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,19481.84,20455.93,14
APR-DRG,9123,MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,31441.99,33014.09,14
APR-DRG,9124,MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,54864.16,57607.37,14
APR-DRG,9301,MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE,,,7620.45,8001.47,14
APR-DRG,9302,MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE,,,8885.52,9329.8,14
APR-DRG,9303,MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE,,,14527.21,15253.57,14
APR-DRG,9304,MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE,,,29044.97,30497.22,14
APR-DRG,9501,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,13733.65,14420.33,14
APR-DRG,9502,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,18184.13,19093.34,14
APR-DRG,9503,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,27799.66,29189.64,14
APR-DRG,9504,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,51563.65,54141.83,14
APR-DRG,9511,MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,10494.98,11019.73,14
APR-DRG,9512,MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,14049.7,14752.19,14
APR-DRG,9513,MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,21273.37,22337.04,14
APR-DRG,9514,MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,38700.01,40635.01,14
APR-DRG,9521,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,8754.12,9191.83,14
APR-DRG,9522,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,11692.19,12276.8,14
APR-DRG,9523,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,18820.53,19761.56,14
APR-DRG,9524,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,36141.54,37948.62,14
CDT,D2956,removal of an indirect restoration on a natural tooth,,,2453.0,4602.0,6
CDT,D2989,excavation of a tooth resulting in the determination of non-restorability,,,2453.0,4602.0,6
CDT,D3471,surgical repair of root resorption - anterior,,,2453.0,4602.0,6
CDT,D3472,surgical repair of root resorption – premolar,,,2453.0,4602.0,6
CDT,D3473,surgical repair of root resorption – molar,,,2453.0,4602.0,6
CDT,D3501,surgical exposure of root surface without apicoectomy or repair of root resorption – anterior,,,2453.0,4602.0,6
CDT,D3502,surgical exposure of root surface without apicoectomy or repair of root resorption – premolar,,,2453.0,4602.0,6
CDT,D3503,surgical exposure of root surface without apicoectomy or repair of root resorption – molar,,,2453.0,4602.0,6
CDT,D3921,Decoronation or Submergence of An Erupted Tooth,,,2453.0,4602.0,6
CDT,D4286,removal of non-resorbable barrier,,,2453.0,4602.0,6
CDT,D5995,periodontal medicament carrier with peripheral seal – laboratory processed – maxillary,,,2453.0,4602.0,6
CDT,D5996,periodontal medicament carrier with peripheral seal – laboratory processed – mandibular,,,2453.0,4602.0,6
CDT,D6089,accessing and retorquing loose implant screw - per screw,,,2453.0,4602.0,6
CDT,D6105,removal of implant body not requiring bone removal or flap elevation,,,2453.0,4602.0,6
CDT,D6106,"guided tissue regeneration – resorbable barrier, per implant",,,2453.0,4602.0,6
CDT,D6107,"guided tissue regeneration – non-resorbable barrier, per implant",,,2453.0,4602.0,6
CDT,D6191,semi-precision abutment – placement,,,2453.0,4602.0,6
CDT,D6192,semi-precision attachment – placement,,,2453.0,4602.0,6
CDT,D6193,replacement of an implant screw,,,2453.0,4602.0,6
CDT,D6197,"replacement of restorative material used to close an access opening of a screw-retained implant supported prosthesis, per implant",,,2453.0,4602.0,6
CDT,D6198,Remove Interim Implant Component,,,2453.0,4602.0,6
CDT,D7252,partial extraction for immediate implant placement,,,2453.0,4602.0,6
CDT,D7259,nerve dissection,,,2453.0,4602.0,6
CDT,D7284,excisional biopsy of minor salivary glands,,,2453.0,4602.0,6
CDT,D7298,"Removal of Temporary Anchorage Device [Screw Retained Plate], Requiring Flap",,,2453.0,4602.0,6
CDT,D7299,"Removal of Temporary Anchorage Device, Requiring Flap",,,2453.0,4602.0,6
CDT,D7300,Removal of Temporary Anchorage Device Without Flap,,,2453.0,4602.0,6
CDT,D7509,marsupialization of odontogenic cyst,,,2453.0,4602.0,6
CDT,D7939,indexing for osteotomy using dynamic robotic assisted or dynamic navigation,,,2453.0,4602.0,6
CDT,D7956,"guided tissue regeneration, edentulous area – resorbable barrier, per site",,,2453.0,4602.0,6
CDT,D7957,"guided tissue regeneration, edentulous area – non-resorbable barrier, per site",,,2453.0,4602.0,6
CDT,D7961,buccal / labial frenectomy (frenulectomy),,,2453.0,4602.0,6
CDT,D7962,lingual frenectomy (frenulectomy),,,2453.0,4602.0,6
CDT,D7993,surgical placement of craniofacial implant – extra oral,,,2453.0,4602.0,6
CDT,D7994,surgical placement: zygomatic implant,,,2453.0,4602.0,6
CDT,D9949,Repair of Custom Sleep Apnea Appliance,,,2453.0,4602.0,6
CPT,0001U,RBC DNA HEA 35 AG 11 BLD GRP,,,699.84,3600.0,23
CPT,0002M,LIVER DIS 10 ASSAYS W/ASH,,,503.4,2517.0,17
CPT,0002U,ONC CLRCT 3 UR METAB ALG PLP,,,24.3,125.0,23
CPT,0003M,"HC FIBROSURE NASH, LIVER DISEASE, TEN BIOCHEMICAL ASSAYS W/ SERUM",901.0,495.55,270.3,2517.0,53
CPT,0003U,ONC OVAR 5 PRTN SER ALG SCOR,,,923.4,4750.0,23
CPT,0004M,SCOLIOSIS DNA ALYS,,,79.0,395.0,17
CPT,0005U,ONCO PRST8 3 GENE UR ALG,,,738.72,3800.0,23
CPT,0006M,ONC HEP GENE RISK CLASSIFIER,,,150.0,750.0,17
CPT,0007M,ONC GASTRO 51 GENE NOMOGRAM,,,375.0,1875.0,17
CPT,0007U,RX TEST PRSMV UR W/DEF CONF,,,111.23,572.15,23
CPT,0008U,HPYLORI DETCJ ABX RSTNC DNA,,,581.17,2989.55,23
CPT,0009U,ONC BRST CA ERBB2 AMP/NONAMP,,,104.0,535.0,23
CPT,0010U,NFCT DS STRN TYP WHL GEN SEQ,,,415.3,2136.3,23
CPT,0011M,ONC PRST8 CA MRNA 12 GEN ALG,,,738.72,3800.0,23
CPT,0011U,RX MNTR LC-MS/MS ORAL FLUID,,,111.23,572.15,23
CPT,0012M,ONC MRNA 5 GEN RSK URTHL CA,,,738.72,3800.0,23
CPT,0013M,ONC MRNA 5 GEN RECR URTHL CA,,,738.72,3800.0,23
CPT,0014M,APC,,,176.19,181.48,15
CPT,0014M,Lab/Pathology,,,880.95,880.95,1
CPT,0014M,Laboratory,,,880.95,880.95,1
CPT,0015M,HC ADRENAL MASS PANEL TUM BIOCHEM ASSAY 25 STRD MRK ALG,2917.0,1604.35,875.1,6526.85,53
CPT,0016M,ONC BLADDER MRNA 219 GEN ALG,,,3391.92,17448.15,23
CPT,0016U,ONC HMTLMF NEO RNA BCR/ABL1,,,159.37,819.8,23
CPT,0017M,ONC DLBCL MRNA 20 GENES ALG,,,2439.93,12551.05,23
CPT,0017U,ONC HMTLMF NEO JAK2 MUT DNA,,,89.09,458.3,23
CPT,0018M,TRNSPLJ RNL MEAS CD154+CLL,,,622.79,3203.65,23
CPT,0018U,ONC THYR 10 MICRORNA SEQ ALG,,,2918.03,15010.45,23
CPT,0019M,CV DS PLASMA ALYS PRTN BMRK,,,692.45,3562.0,23
CPT,0019U,ONC RNA TISS PREDICT ALG,,,3572.1,18375.0,23
CPT,0021U,ONC PRST8 DETCJ 8 AUTOANTB,,,738.72,3800.0,23
CPT,0022U,TGSAP NSM LUNG NEO DNA&RNA23,,,1895.4,2340.0,21
CPT,0023U,ONC AML DNA DETCJ/NONDETCJ,,,241.55,1242.55,23
CPT,0024U,GLYCA NUC MR SPECTRSC QUAN,,,33.24,170.95,23
CPT,0025U,TENOFOVIR LIQ CHROM UR QUAN,,,83.37,428.85,23
CPT,0026U,ONC THYR DNA&MRNA 112 GENES,,,3499.2,18000.0,23
CPT,0027U,JAK2 GENE TRGT SEQ ALYS,,,118.49,609.55,23
CPT,0029U,RX METAB ADVRS TRGT SEQ ALYS,,,721.49,3711.35,23
CPT,0030U,RX METAB WARF TRGT SEQ ALYS,,,130.37,670.65,23
CPT,0031A,APC,,,42.19,43.46,15
CPT,0031U,CYP1A2 GENE,,,169.91,874.05,23
CPT,0032U,COMT GENE,,,169.91,874.05,23
CPT,0033U,HTR2A HTR2C GENES,,,339.83,1748.1,23
CPT,0034A,APC,,,42.19,43.46,15
CPT,0034U,TPMT NUDT15 GENES,,,453.11,2330.85,23
CPT,0035U,"HC QUAKING INDUCED CONVERSION RT, NEURO CSF PRION PRTN QUAKG CONF CONV QUAL",915.0,503.25,274.5,2704.95,53
CPT,0036U,XOME TUM & NML SPEC SEQ ALYS,,,4646.16,23900.0,23
CPT,0037U,"HC FOUNDATIONONE CDX, TARG GEN SEQ ANLY, DNA 324 GENES",5333.5,2933.43,1600.05,17500.0,53
CPT,0038U,VITAMIN D SRM MICROSAMP QUAN,,,28.77,148.0,23
CPT,0039U,DNA ANTB 2STRAND HI AVIDITY,,,13.36,68.7,23
CPT,0040U,BCR/ABL1 GENE MAJOR BP QUAN,,,398.42,2049.5,23
CPT,0041U,B BRGDRFERI ANTB 5 PRTN IGM,,,16.73,86.05,23
CPT,0042T,HC CT CEREBRAL PERFUSION W CONTRAST CEREBRAL BLOOD FLOW,2114.0,1162.7,634.2,1828.61,76
CPT,0042U,B BRGDRFERI ANTB 12 PRTN IGG,,,16.73,86.05,23
CPT,0043U,TBRF B GRP ANTB 4 PRTN IGM,,,14.45,74.3,23
CPT,0044U,TBRF B GRP ANTB 4 PRTN IGG,,,14.45,74.3,23
CPT,0045U,ONC BRST DUX CARC IS 12 GENE,,,3764.56,19365.0,23
CPT,0046U,"HC MRD, FLT3 ITD VARIANTS, QUANT",2879.0,1583.45,396.03,2490.34,53
CPT,0047U,ONC PRST8 MRNA 17 GENE ALG,,,3764.56,19365.0,23
CPT,0048U,ONC SLD ORG NEO DNA 468 GENE,,,2837.85,14598.0,23
CPT,0049U,NPM1 GENE ANALYSIS QUAN,,,396.03,2037.15,23
CPT,0050U,TRGT GEN SEQ DNA 194 GENES,,,2834.94,14583.0,23
CPT,0051U,RX MNTR LC-MS/MS UR/BLD 31,,,188.29,968.55,23
CPT,0052U,LPOPRTN BLD W/5 MAJ CLASSES,,,32.91,169.3,23
CPT,0053U,Lab/Pathology,,,10150.0,10150.0,1
CPT,0053U,Laboratory,,,10150.0,10150.0,1
CPT,0054T,BONE SRGRY CMPTR FLUOR IMAGE,,,835.0,3533.0,6
CPT,0054U,RX MNTR 14+ DRUGS & SBSTS,,,144.79,744.8,23
CPT,0055T,BONE SRGRY CMPTR CT/MRI IMAG,,,835.0,3533.0,6
CPT,0055U,CARD HRT TRNSPL 96 DNA SEQ,,,3149.28,16200.0,23
CPT,0058U,"HC ANTI MERKEL CELL PANEL, ONC DETECT ANTB MCP VIRUS ONCOPROTEIN SRM QUANT",594.0,326.7,178.2,1614.8,53
CPT,0059U,"HC ANTI MERKEL VIRAL CAPSID SCREEN, ONC DTCT ANTB MCP VIRUS CAPSID PRTN SRM",594.0,326.7,178.2,1614.8,53
CPT,0060U,TWN ZYG GEN SEQ ALYS CHRMS2,,,737.79,3795.25,23
CPT,0061U,TC MEAS 5 BMRK SFDI M-S ALYS,,,24.4,125.5,23
CPT,0062U,AI SLE IGG&IGM ALYS 80 BMRK,,,370.05,1903.6,23
CPT,0063U,NEURO AUTISM 32 AMINES ALG,,,729.0,3750.0,23
CPT,0064U,ANTB TP TOTAL&RPR IA QUAL,,,30.46,156.65,23
CPT,0065U,SYFLS TST NONTREPONEMAL ANTB,,,17.59,90.45,23
CPT,0066U,APC,,,15.29,15.75,15
CPT,0066U,Lab/Pathology,,,76.45,76.45,1
CPT,0066U,Laboratory,,,76.45,76.45,1
CPT,0067U,ONC BRST IMHCHEM PRFL 4 BMRK,,,1843.88,9485.0,23
CPT,0068U,CANDIDA SPECIES PNL AMP PRB,,,138.64,713.15,23
CPT,0069U,ONC CLRCT MICRORNA MIR-31-3P,,,369.36,1900.0,23
CPT,0070U,CYP2D6 GEN COM&SLCT RAR VRNT,,,657.43,3381.85,23
CPT,0071T,HC FOCUSED US ABLATN UTER LEIOMYOMATA MRGFUS FIBROID LESS THAN 200 CC TISS,7416.0,4078.8,2224.8,9469.0,53
CPT,0071U,CYP2D6 FULL GENE SEQUENCE,,,583.2,3000.0,23
CPT,0072T,HC FOCUSED US ABLATN UTER LEIOMYOMATA MRGFUS FIBROID GREATER/EQ 200 CC TISS,7416.0,4078.8,2224.8,9469.0,53
CPT,0072U,CYP2D6 GEN CYP2D6-2D7 HYBRID,,,438.28,2254.55,23
CPT,0073U,CYP2D6 GEN CYP2D7-2D6 HYBRID,,,438.28,2254.55,23
CPT,0074U,CYP2D6 NONDUPLICATED GENE,,,438.28,2254.55,23
CPT,0075T,HC IN STENT EXTRA CRANIAL VERT INITIAL,4442.0,2443.1,1332.6,8363.0,38
CPT,0075U,CYP2D6 5' GENE DUP/MLT,,,438.28,2254.55,23
CPT,0076T,S&I STENT/CHEST VERT ART,,,2453.0,8363.0,7
CPT,0076U,CYP2D6 3' GENE DUP/MLT,,,438.28,2254.55,23
CPT,0077U,"HC M-PROTEIN ISOTOPE MALDI-TOF, IG PARAPROTEIN QUAL BLD/UR",298.0,163.9,42.22,257.77,53
CPT,0078U,APC,,,450.91,464.44,15
CPT,0078U,Lab/Pathology,,,2254.55,2254.55,1
CPT,0078U,Laboratory,,,2254.55,2254.55,1
CPT,0080U,ONC LNG 5 CLIN RSK FACTR ALG,,,3421.44,17600.0,23
CPT,0082U,RX TEST DEF 90+ RX/SBSTS UR,,,240.0,1234.6,23
CPT,0083U,ONC RSPSE CHEMO CNTRST TOMOG,,,162.67,836.75,23
CPT,0084U,RBC DNA GNOTYP 10 BLD GROUPS,,,699.84,3600.0,23
CPT,0086U,NFCT DS BACT&FNG ORG ID 6+,,,194.4,1000.0,23
CPT,0087U,CRD HRT TRNSPL MRNA 1283 GEN,,,3070.95,15797.1,23
CPT,0088U,TRNSPLJ KDN ALGRFT REJ 1494,,,3070.95,15797.1,23
CPT,0089U,ONC MLNMA PRAME & LINC00518,,,738.72,3800.0,23
CPT,0090U,ONC CUTAN MLNMA MRNA 23 GENE,,,1705.86,8775.0,23
CPT,0092U,ONC LNG 3 PRTN BMRK PLSM ALG,,,2418.34,12440.0,23
CPT,0093U,RX MNTR 65 COM DRUGS URINE,,,60.4,310.7,23
CPT,0094U,GENOME RAPID SEQUENCE ALYS,,,7369.9,37911.0,23
CPT,0095T,RMVL ARTIFIC DISC ADDL CRVCL,,,18485.0,18485.0,1
CPT,0095U,EE 2 PRTN BMRK MBP ELISA EST,,,750.37,3859.9,23
CPT,0096U,HPV HI RISK TYPES MALE URINE,,,34.11,175.45,23
CPT,0098T,REV ARTIFIC DISC ADDL,,,18485.0,18485.0,1
CPT,0100T,PROSTH RETINA RECEIVE&GEN,,,19979.0,34485.0,7
CPT,0101T,ESW MUSCSKEL SYS NOS,,,243.77,14658.0,22
CPT,0101U,HERED COLON CA DO 15 GENES,,,1695.12,8719.75,23
CPT,0102T,ESW PHY ANES LAT HMRL EPCNDL,,,3297.17,14658.0,22
CPT,0102U,HERED BRST CA RLTD DO 17 GEN,,,1267.44,6519.75,23
CPT,0103U,HERED OVA CA PNL 24 GENES,,,1695.12,8719.75,23
CPT,0105U,NEPH CKD MULT ECLIA TUM NEC,,,923.4,4750.0,23
CPT,0106T,TOUCH QUANT SENSORY TEST,,,39.89,41.08,15
CPT,0106U,GSTR EMPTG 7 TIMED BRTH SPEC,,,850.01,4372.45,23
CPT,0107T,VIBRATE QUANT SENSORY TEST,,,39.89,41.08,15
CPT,0107U,C DIFF TOX AG DETCJ IA STOOL,,,15.55,80.0,23
CPT,0108T,COOL QUANT SENSORY TEST,,,60.36,62.17,15
CPT,0108U,GI BARRETT ESOPH 9 PRTN BMRK,,,4811.4,24750.0,23
CPT,0109T,HEAT QUANT SENSORY TEST,,,39.89,41.08,15
CPT,0109U,ID ASPERGILLUS DNA 4 SPECIES,,,138.64,713.15,23
CPT,0110T,NOS QUANT SENSORY TEST,,,130.99,134.92,15
CPT,0110U,RX MNTR 1+ORAL ONC RX&SBSTS,,,26.35,135.55,23
CPT,0111U,ONC COLON CA KRAS&NRAS ALYS,,,663.19,3411.45,23
CPT,0112U,IADI 16S&18S RRNA GENES,,,346.16,1780.65,23
CPT,0113U,ONC PRST8 PCA3&TMPRSS2-ERG,,,738.72,3800.0,23
CPT,0114U,GI BARRETTS ESOPH VIM&CCNA1,,,1883.75,9690.05,23
CPT,0115U,RESPIR IADNA 18 VIRAL&2 BACT,,,267.64,1376.75,23
CPT,0116U,RX MNTR NZM IA 35+ORAL FLU,,,240.0,1234.6,23
CPT,0117U,PAIN MGMT 11 ENDOGENOUS ANAL,,,817.11,4203.25,23
CPT,0118U,TRNSPLJ DON-DRV CLL-FR DNA,,,2676.16,13766.25,23
CPT,0119U,CRD CERAMIDES LIQ CHROM PLSM,,,81.41,418.8,23
CPT,0120U,ONC B CLL LYMPHM MRNA 58 GEN,,,2439.93,12551.05,23
CPT,0121U,SC DIS VCAM-1 WHOLE BLOOD,,,494.95,2546.0,23
CPT,0122U,SC DIS P-SELECTIN WHL BLOOD,,,511.5,2631.15,23
CPT,0123U,MCHNL FRAGILITY RBC PRFLG,,,347.62,1788.15,23
CPT,0129U,HERED BRST CA RLTD DO PANEL,,,1267.44,6519.75,23
CPT,0130U,HERED COLON CA DO MRNA PNL,,,568.52,2924.5,23
CPT,0131U,HERED BRST CA RLTD DO PNL 13,,,690.12,3550.0,23
CPT,0132U,HERED OVA CA RLTD DO PNL 17,,,720.87,3708.2,23
CPT,0133U,HERED PRST8 CA RLTD DO 11,,,670.97,3451.45,23
CPT,0134U,HERED PAN CA MRNA PNL 18 GEN,,,727.43,3741.95,23
CPT,0135U,HERED GYN CA MRNA PNL 12 GEN,,,680.94,3502.8,23
CPT,0136U,ATM MRNA SEQ ALYS,,,396.03,2037.15,23
CPT,0137U,PALB2 MRNA SEQ ALYS,,,274.96,1414.4,23
CPT,0138U,BRCA1 BRCA2 MRNA SEQ ALYS,,,455.22,2341.65,23
CPT,0140U,NFCT DS FUNGI DNA 15 TRGT,,,152.36,783.75,23
CPT,0141U,NFCT DS BACT&FNG GRAM POS,,,152.36,783.75,23
CPT,0142U,NFCT DS BACT&FNG GRAM NEG,,,152.36,783.75,23
CPT,0143U,Lab/Pathology,,,572.15,572.15,1
CPT,0143U,Laboratory,,,572.15,572.15,1
CPT,0144U,Lab/Pathology,,,572.15,572.15,1
CPT,0144U,Laboratory,,,572.15,572.15,1
CPT,0145U,Lab/Pathology,,,572.15,572.15,1
CPT,0145U,Laboratory,,,572.15,572.15,1
CPT,0146U,Lab/Pathology,,,572.15,572.15,1
CPT,0146U,Laboratory,,,572.15,572.15,1
CPT,0147U,Lab/Pathology,,,572.15,572.15,1
CPT,0147U,Laboratory,,,572.15,572.15,1
CPT,0148U,Lab/Pathology,,,572.15,572.15,1
CPT,0148U,Laboratory,,,572.15,572.15,1
CPT,0149U,Lab/Pathology,,,572.15,572.15,1
CPT,0149U,Laboratory,,,572.15,572.15,1
CPT,0150U,Lab/Pathology,,,572.15,572.15,1
CPT,0150U,Laboratory,,,572.15,572.15,1
CPT,0152U,"HC KARIUS, INFECT DISEASE MCRB CELL FREE DNA PLASMA UNTARGET NEXT GEN SEQ",3466.0,1906.3,1039.8,10631.0,53
CPT,0153U,ONC BREAST MRNA 101 GENES,,,3070.95,15797.1,23
CPT,0154U,"HC FGFR MUTATION FUSION, ONC URTHL CA RNA FGFR3 GENE",2235.0,1229.25,468.64,2410.7,53
CPT,0155U,ONC BRST CA DNA PIK3CA GENE,,,267.14,1374.15,23
CPT,0156U,COPY NUMBER SEQUENCE ALYS,,,1691.28,8700.0,23
CPT,0157U,APC MRNA SEQ ALYS,,,274.96,1414.4,23
CPT,0158U,MLH1 MRNA SEQ ALYS,,,274.96,1414.4,23
CPT,0159U,MSH2 MRNA SEQ ALYS,,,274.96,1414.4,23
CPT,0160U,MSH6 MRNA SEQ ALYS,,,274.96,1414.4,23
CPT,0161U,PMS2 MRNA SEQ ALYS,,,274.96,1414.4,23
CPT,0162U,HERED COLON CA TRGT MRNA PNL,,,472.92,2432.7,23
CPT,0163T,OP Surgery - Grouper Table,,,18485.0,18485.0,1
CPT,0163U,ONC CLRCT SCR 3 PRTN ALG,,,379.81,1953.75,23
CPT,0164T,REMOVE LUMB ARTIF DISC ADDL,,,835.0,18485.0,7
CPT,0164U,GI IBS IA ANTI-CDTB&VINCULIN,,,108.88,560.1,23
CPT,0165T,REVISE LUMB ARTIF DISC ADDL,,,835.0,18485.0,7
CPT,0165U,PEANUT ALLG ASMT EPI PRB ALL,,,450.77,2318.8,23
CPT,0166U,LIVER DS 10 BIOCHEM ASY SRM,,,489.3,2517.0,23
CPT,0167U,APC,,,7.52,7.75,15
CPT,0167U,Lab/Pathology,,,37.6,37.6,1
CPT,0167U,Laboratory,,,37.6,37.6,1
CPT,0169U,NUDT15&TPMT GENE COM VRNT,,,453.11,2330.85,23
CPT,0170U,NEURO ASD RNA NEXT GEN SEQ,,,1705.86,8775.0,23
CPT,0171U,TRGT GEN SEQ ALYS PNL DNA 23,,,1476.52,7595.3,23
CPT,0172U,ONC SLD TUM ALYS BRCA1 BRCA2,,,2945.16,15150.0,23
CPT,0173U,PSYC GEN ALYS PANEL 14 GENES,,,453.11,2330.85,23
CPT,0174U,ONC SOLID TUMOR 30 PRTN TRGT,,,1268.82,6526.85,23
CPT,0175U,PSYC GEN ALYS PANEL 15 GENES,,,1298.68,6680.45,23
CPT,0176U,CDTB&VINCULIN IGG ANTB IA,,,62.4,320.95,23
CPT,0177U,ONC BRST CA DNA PIK3CA 11,,,267.14,1374.15,23
CPT,0178U,PEANUT ALLG ASMT EPI CLIN RX,,,446.99,2299.3,23
CPT,0179U,ONC NONSM CLL LNG CA ALYS 23,,,1888.8,9716.05,23
CPT,0180U,ABO GNOTYP ABO 7 EXONS,,,267.14,1374.15,23
CPT,0181U,CO GNOTYP AQP1 EXON 1,,,180.02,926.0,23
CPT,0182U,CROM GNOTYP CD55 EXONS 1-10,,,292.91,1506.75,23
CPT,0183U,DI GNOTYP SLC4A1 EXON 19,,,180.02,926.0,23
CPT,0184T,EXC RECTAL TUMOR ENDOSCOPIC,,,6049.25,14658.0,22
CPT,0184U,DO GNOTYP ART4 EXON 2,,,180.02,926.0,23
CPT,0185U,FUT1 GNOTYP FUT1 EXON 4,,,180.02,926.0,23
CPT,0186U,FUT2 GNOTYP FUT2 EXON 2,,,180.02,926.0,23
CPT,0187U,FY GNOTYP ACKR1 EXONS 1-2,,,267.14,1374.15,23
CPT,0188U,GE GNOTYP GYPC EXONS 1-4,,,267.14,1374.15,23
CPT,0189U,GYPA GNOTYP NTRNS 1 5 EXON 2,,,267.14,1374.15,23
CPT,0190U,GYPB GNOTYP NTRNS 1 5 SEUX 3,,,267.14,1374.15,23
CPT,0191U,IN GNOTYP CD44 EXONS 2 3 6,,,267.14,1374.15,23
CPT,0192U,JK GNOTYP SLC14A1 EXON 9,,,267.14,1374.15,23
CPT,0193U,JR GNOTYP ABCG2 EXONS 2-26,,,274.96,1414.4,23
CPT,0194U,KEL GNOTYP KEL EXON 8,,,180.02,926.0,23
CPT,0195U,KLF1 TARGETED SEQUENCING,,,364.74,1876.25,23
CPT,0196U,LU GNOTYP BCAM EXON 3,,,180.02,926.0,23
CPT,0197U,LW GNOTYP ICAM4 EXON 1,,,180.02,926.0,23
CPT,0198T,OCULAR BLOOD FLOW MEASURE,,,130.99,134.92,15
CPT,0198U,RHD&RHCE GNTYP RHD1-10&RHCE5,,,274.96,1414.4,23
CPT,0199U,SC GNOTYP ERMAP EXONS 4 12,,,267.14,1374.15,23
CPT,0200T,"HC UNILAT, PERC SACRAL AUGM, INJ, BAL/MECH, 1/MORE NDL, IMAG GUID, BONE BX",11588.0,6373.4,3476.4,18485.0,53
CPT,0200U,XK GNOTYP XK EXONS 1-3,,,267.14,1374.15,23
CPT,0201T,"HC BILAT, PERC SACRAL AUGM, INJ, BAL/MECH, 1/MORE NDL, IMAG GUID, BONE BX",12720.0,6996.0,3816.0,18485.0,53
CPT,0201U,YT GNOTYP ACHE EXON 2,,,180.02,926.0,23
CPT,0202T,POST VERT ARTHRPLST 1 LUMBAR,,,8363.0,17804.0,7
CPT,0202U,"HC RESPIRATORY EXTENDED NAAT PANEL, INFC DIS 22 TARGETS SARS-COV-2, RT-PCR",516.0,283.8,154.8,2083.9,53
CPT,0203U,AI IBD MRNA XPRSN PRFL 17,,,738.72,3800.0,23
CPT,0204U,APC,,,2919.6,3007.19,15
CPT,0204U,Lab/Pathology,,,14598.0,14598.0,1
CPT,0204U,Laboratory,,,14598.0,14598.0,1
CPT,0205U,OPH AMD ALYS 3 GENE VARIANTS,,,45.68,235.0,23
CPT,0206U,NEURO ALZHEIMER CELL AGGREGJ,,,2153.37,11077.0,23
CPT,0207T,CLEAR EYELID GLAND W/HEAT,,,130.99,4258.0,22
CPT,0207U,NEURO ALZHEIMER QUAN IMAGING,,,496.89,2556.0,23
CPT,0208T,AUDIOMETRY AIR ONLY,,,39.89,41.08,15
CPT,0209T,AUDIOMETRY AIR & BONE,,,39.89,41.08,15
CPT,0209U,CYTOG CONST ALYS INTERROG,,,765.11,3935.75,23
CPT,0210T,SPEECH AUDIOMETRY THRESHOLD,,,39.89,41.08,15
CPT,0210U,SYPHILIS TST ANTB IA QUAN,,,18.11,93.15,23
CPT,0211T,SPEECH AUDIOM THRESH & RECOG,,,39.89,41.08,15
CPT,0211U,ONC PAN-TUM DNA&RNA GNRJ SEQ,,,8218.26,42275.0,23
CPT,0212T,COMPRE AUDIOMETRY EVALUATION,,,158.99,163.76,15
CPT,0212U,RARE DS GEN DNA ALYS PROBAND,,,5321.9,27376.0,23
CPT,0213T,NJX PARAVERT W/US CER/THOR,,,904.71,4955.0,22
CPT,0213U,RARE DS GEN DNA ALYS EA COMP,,,2634.08,13549.75,23
CPT,0214T,NJX PARAVERT W/US CER/THOR,,,835.0,3533.0,6
CPT,0214U,RARE DS XOM DNA ALYS PROBAND,,,5078.31,26123.0,23
CPT,0215T,NJX PARAVERT W/US CER/THOR,,,835.0,3533.0,6
CPT,0215U,RARE DS XOM DNA ALYS EA COMP,,,2502.56,12873.25,23
CPT,0216T,NJX PARAVERT W/US LUMB/SAC,,,904.71,4955.0,22
CPT,0216U,NEURO INH ATAXIA DNA 12 COM,,,1493.98,7685.1,23
CPT,0217T,NJX PARAVERT W/US LUMB/SAC,,,835.0,3533.0,6
CPT,0217U,NEURO INH ATAXIA DNA 51 GENE,,,2136.8,10991.75,23
CPT,0218T,NJX PARAVERT W/US LUMB/SAC,,,835.0,3533.0,6
CPT,0218U,NEURO MUSC DYS DMD SEQ ALYS,,,2215.19,11395.0,23
CPT,0219T,PLMT POST FACET IMPLT CERV,,,10315.0,18485.0,7
CPT,0219U,NFCT AGT HIV GNRJ SEQ ALYS,,,704.7,3625.0,23
CPT,0220T,PLMT POST FACET IMPLT THOR,,,10315.0,18485.0,7
CPT,0220U,ONC BRST CA AI ASSMT 12 FEAT,,,686.48,3531.25,23
CPT,0221T,PLMT POST FACET IMPLT LUMB,,,7259.46,18485.0,22
CPT,0221U,ABO GNOTYP NEXT GNRJ SEQ ABO,,,267.14,1374.15,23
CPT,0222T,PLMT POST FACET IMPLT ADDL,,,835.0,3533.0,6
CPT,0222U,RHD&RHCE GNTYP NEXT GNRJ SEQ,,,274.96,1414.4,23
CPT,0223U,NFCT DS 22 TRGT SARS-COV-2,,,405.12,2083.9,23
CPT,0224U,ANTIBODY SARS-COV-2 TITER(S),,,50.0,257.15,23
CPT,0225U,NFCT DS DNA&RNA 21 SARSCOV2,,,405.12,2083.9,23
CPT,0226U,SVNT SARSCOV2 ELISA PLSM SRM,,,41.1,211.4,23
CPT,0227U,RX ASY PRSMV 30+RX/METABLT,,,60.4,310.7,23
CPT,0228U,ONC PRST8 MA MOLEC PRFL ALG,,,168.19,865.15,23
CPT,0229U,BCAT1&IKZF1 PRMTR MTHLN ALYS,,,373.25,1920.0,23
CPT,0230U,AR FULL SEQUENCE ANALYSIS,,,292.91,1506.75,23
CPT,0231U,CACNA1A FULL GENE ANALYSIS,,,822.57,4231.35,23
CPT,0232T,NJX PLATELET PLASMA,,,405.5,4258.0,22
CPT,0232U,CSTB FULL GENE ANALYSIS,,,267.14,1374.15,23
CPT,0233U,FXN GENE ANALYSIS,,,267.14,1374.15,23
CPT,0234T,TRLUML PERIP ATHRC RENAL ART,,,11524.29,21512.0,22
CPT,0234U,MECP2 FULL GENE ANALYSIS,,,513.09,2639.35,23
CPT,0235T,TRLUML PERIP ATHRC VISCERAL,,,2453.0,19884.0,7
CPT,0235U,PTEN FULL GENE ANALYSIS,,,583.2,3000.0,23
CPT,0236T,TRLUML PERIP ATHRC ABD AORTA,,,11524.29,21512.0,22
CPT,0236U,SMN1&SMN2 FULL GENE ANALYSIS,,,585.83,3013.5,23
CPT,0237T,TRLUML PERIP ATHRC BRCHIOCPH,,,11524.29,21512.0,22
CPT,0237U,CAR ION CHNLPTHY GEN SEQ PNL,,,568.52,2924.5,23
CPT,0238T,TRLUML PERIP ATHRC ILIAC ART,,,12463.0,24394.0,22
CPT,0238U,ONC LNCH SYN GEN DNA SEQ ALY,,,568.52,2924.5,23
CPT,0239U,TRGT GEN SEQ ALYS PNL 311+,,,3402.0,17500.0,23
CPT,0240U,APC,,,142.63,146.91,15
CPT,0240U,Lab/Drugs Fee Schedule,,,138.64,171.16,6
CPT,0240U,Lab/Pathology,,,713.15,713.15,1
CPT,0240U,Laboratory,,,713.15,713.15,1
CPT,0241U,APC,,,142.63,146.91,15
CPT,0241U,Lab/Drugs Fee Schedule,,,138.64,171.16,6
CPT,0241U,Lab/Pathology,,,713.15,713.15,1
CPT,0241U,Laboratory,,,713.15,713.15,1
CPT,0242U,TRGT GEN SEQ ALYS PNL 55-74,,,4860.0,25000.0,23
CPT,0243U,OB PE BIOCHEM ASSAY PGF ALG,,,62.6,322.05,23
CPT,0244U,ONC SOLID ORGN DNA 257 GENES,,,3402.0,17500.0,23
CPT,0245U,ONC THYR MUT ALYS 10 GEN&37,,,1230.62,6330.35,23
CPT,0246U,RBC DNA GNOTYP 16 BLD GROUPS,,,699.84,3600.0,23
CPT,0247U,OB PRTRM BRTH IBP4 SHBG MEAS,,,729.0,3750.0,23
CPT,0248U,ONC SPHRD CELL CUL 12 RX PNL,,,2948.91,15169.3,23
CPT,0249U,ONC BRST ALYS 32 PHSPRTN ALG,,,2156.99,11095.65,23
CPT,0250U,ONC SLD ORG NEO DNA 505 GENE,,,2837.85,14598.0,23
CPT,0251U,HEPCIDIN-25 ELISA SERUM/PLSM,,,16.79,86.35,23
CPT,0252U,FTL ANEUPLOIDY STR ALYS DNA,,,737.79,3795.25,23
CPT,0253T,INSERT AQUEOUS DRAIN DEVICE,,,4088.03,16799.0,22
CPT,0253U,RPRDTVE MED RNA GEN PRFL 238,,,3070.95,15797.1,23
CPT,0254U,REPRDTVE MED ALYS 24 CHRMSM,,,737.79,3795.25,23
CPT,0255U,ANDROLOGY INFERTILITY ASSMT,,,30.72,158.0,23
CPT,0256U,TMA/TMAO PRFL MS/MS UR ALG,,,155.48,799.75,23
CPT,0257U,VLCAD LEUK NZM ACTV WHL BLD,,,692.51,3562.35,23
CPT,0258U,AI PSOR MRNA 50-100 GEN ALG,,,3572.1,18375.0,23
CPT,0259U,NEPH CKD NUC MRS MEAS GFR,,,51.24,263.55,23
CPT,0260U,RARE DS ID OPT GENOME MAPG,,,1228.16,6317.65,23
CPT,0261U,ONC CLRCT CA IMG ALYS W/AI,,,2513.25,24750.0,23
CPT,0262U,ONC SLD TUM RT-PCR 7 GEN,,,3110.4,16000.0,23
CPT,0263T,IM B1 MRW CEL THER CMPL,,,4761.07,16799.0,22
CPT,0263U,NEURO ASD MEAS 16 C METBLT,,,729.0,3750.0,23
CPT,0264T,IM B1 MRW CEL THER XCL HRVST,,,4761.07,16799.0,22
CPT,0264U,RARE DS ID OPT GENOME MAPG,,,1228.16,6317.65,23
CPT,0265T,IM B1 MRW CEL THER HRVST ONL,,,4761.07,16799.0,22
CPT,0265U,RAR DO WHL GN&MTCDRL DNA ALS,,,5322.47,27379.0,23
CPT,0266T,APC,,,45729.51,47101.39,15
CPT,0266T,OP Surgery - Grouper Table,,,16700.0,28824.0,7
CPT,0266U,UNXPL CNST HRTBL DO GN XPRSN,,,3110.4,16000.0,23
CPT,0267T,APC,,,3494.72,3599.56,15
CPT,0267T,OP Surgery - Grouper Table,,,8363.0,14658.0,7
CPT,0267U,RARE DO ID OPT GEN MAPG&SEQ,,,6550.63,33696.65,23
CPT,0268T,APC,,,30967.26,31896.28,15
CPT,0268T,OP Surgery - Grouper Table,,,16700.0,28824.0,7
CPT,0268U,HEM AHUS GEN SEQ ALYS 15 GEN,,,591.14,3040.85,23
CPT,0269T,APC,,,6507.82,6703.05,15
CPT,0269T,OP Surgery - Grouper Table,,,10315.0,17804.0,7
CPT,0269U,HEM AUT DM CGEN TRMBCTPNA 22,,,591.14,3040.85,23
CPT,0270T,APC,,,3494.72,3599.56,15
CPT,0270T,OP Surgery - Grouper Table,,,8363.0,14658.0,7
CPT,0270U,HEM CGEN COAGJ DO 20 GENES,,,591.14,3040.85,23
CPT,0271T,APC,,,3494.72,3599.56,15
CPT,0271T,OP Surgery - Grouper Table,,,8363.0,14658.0,7
CPT,0271U,HEM CGEN NEUTROPENIA 24 GEN,,,591.14,3040.85,23
CPT,0272T,"HC INTERROG DEV EVAL, CAROTID SINUS BAROREFLEX, W/ INTERP & RPT",384.0,211.2,115.2,4258.0,159
CPT,0272U,HEM GENETIC BLD DO 60 GENES,,,591.14,3040.85,23
CPT,0273T,"HC INTERROG DEV EVAL, CAROTID SINUS BAROREFLEX, W/ INTERP & RPT, W/ PROGRAM",384.0,211.2,115.2,4258.0,159
CPT,0273U,HEM GEN HYPRFIBRNLYSIS 9 GEN,,,591.14,3040.85,23
CPT,0274T,PRQ LAMOT/LAM DCMPR CRV/THRC,,,7259.46,18485.0,23
CPT,0274U,HEM GEN PLTLT DO 62 GENES,,,591.14,3040.85,23
CPT,0275T,APC,,,7259.46,7477.24,15
CPT,0275T,OP Surgery - Grouper Table,,,10315.0,18485.0,7
CPT,0275T,Other Radiology,,,12704.05,12704.05,1
CPT,0275U,"HC P-SELECTIN EXPRESS(PEA), HEMAT(HIT), PLAT AB REACTIV FLOW CYTOMET, SERUM",685.0,376.75,17.86,592.53,53
CPT,0276U,HEM INH THROMBOCYTOPENIA 42,,,2380.0,12242.8,23
CPT,0277U,HEM GEN PLTLT FUNCJ DO 40,,,591.14,3040.85,23
CPT,0278T,TEMPR,,,158.99,4258.0,22
CPT,0278U,HEM GEN THROMBOSIS 14 GENES,,,591.14,3040.85,23
CPT,0279U,"HC HEMAT, VWF & COLLAGEN III BINDING BY ELISA, PLASMA, RPT",304.0,167.2,11.21,262.96,53
CPT,0280U,HEM VW FACTOR&CLGN IV BNDG,,,16.79,86.35,23
CPT,0281U,HEM VWD PROPEPTIDE AG LVL,,,16.79,86.35,23
CPT,0282U,"HC VERSITI RBC GENOTYP PANEL, GENOTYP 12 BLOOD GRP SYS TO PREDICT 44 RBC AG",835.0,459.25,250.5,3600.0,53
CPT,0283U,VW FACTOR TYPE 2B EVAL PLSM,,,17.88,92.0,23
CPT,0284U,"HC VWF, TYPE 2N, FACTOR VIII AND VWF BINDING EVAL, ELISA, PLASMA",632.0,347.6,16.79,546.68,53
CPT,0285U,ONC DS PROG&RSPSE MNTR RADJ,,,430.89,2216.55,23
CPT,0286U,CEP72 NUDT15&TPMT GENE ALYS,,,130.37,670.65,23
CPT,0287U,ONC THYR DNA&MRNA 112 GENES,,,3499.2,18000.0,23
CPT,0288U,ONC LUNG MRNA QUAN PCR 11&3,,,3764.56,19365.0,23
CPT,0289U,NEURO ALZHEIMER MRNA 24 GEN,,,738.72,3800.0,23
CPT,0290U,PAIN MGMT MRNA GEN XPRSN 36,,,738.72,3800.0,23
CPT,0291U,PSYC MOOD DO MRNA 144 GENES,,,1705.86,8775.0,23
CPT,0292U,PSYC STRS DO MRNA 72 GENES,,,1705.86,8775.0,23
CPT,0293U,PSYC SUICIDAL IDEA MRNA 54,,,738.72,3800.0,23
CPT,0294U,LNGVTY&MRTLTY RSK MRNA 18GEN,,,738.72,3800.0,23
CPT,0295U,ONC BRST DUX CARC 7 PROTEINS,,,1843.88,9485.0,23
CPT,0296U,ONC ORL&/OROP CA 20 MLC FEAT,,,1705.86,8775.0,23
CPT,0297U,ONC PAN TUM WHL GEN SEQ DNA,,,2837.85,14598.0,23
CPT,0298U,ONC PAN TUM WHL TRNS SEQ RNA,,,2837.85,14598.0,23
CPT,0299U,ONC PAN TUM WHL GEN OPT MAPG,,,1811.04,9316.1,23
CPT,0300U,ONC PAN TUM WHL GEN SEQ&OPT,,,4066.0,20915.65,23
CPT,0301U,IADNA BARTONELLA DDPCR,,,255.36,1313.6,23
CPT,0302U,IADNA BRTNLA DDPCR FLWG LIQ,,,351.25,1806.85,23
CPT,0303U,HEM RBC ADS WHL BLD HYPOXIC,,,2139.98,11008.1,23
CPT,0304U,HEM RBC ADS WHL BLD NORMOXIC,,,2017.67,10379.0,23
CPT,0305U,HEM RBC FNCLTY&DFRM SHR STRS,,,644.03,3312.9,23
CPT,0306U,ONC MRD NXT-GNRJ ALYS 1ST,,,3769.86,19392.25,23
CPT,0307U,ONC MRD NXT-GNRJ ALYS SBSQ,,,772.25,3972.45,23
CPT,0308T,INSJ OCULAR TELESCOPE PROSTH,,,16682.39,28824.0,22
CPT,0308U,CRD CAD ALYS 3 PRTN 3 PARAM,,,379.81,1953.75,23
CPT,0309U,CRD CV DS ALY 4 PRTN PLM ALG,,,379.81,1953.75,23
CPT,0310U,PED VSCLTS KD ALYS 3 BMRKS,,,379.81,1953.75,23
CPT,0311U,NFCT DS BCT QUAN ANTMCRB SC,,,7.86,40.4,23
CPT,0312T,OP Surgery - Grouper Table,,,24394.0,24394.0,1
CPT,0312U,AI DS SLE ALYS 8 IGG AUTOANT,,,817.11,4203.25,23
CPT,0313T,OP Surgery - Grouper Table,,,8363.0,8363.0,1
CPT,0313U,ONC PNCRS DNA&MRNA SEQ 74,,,3499.2,18000.0,23
CPT,0314T,OP Surgery - Grouper Table,,,8363.0,8363.0,1
CPT,0314U,ONC CUTAN MLNMA MRNA 35 GENE,,,1895.4,9750.0,23
CPT,0315T,OP Surgery - Grouper Table,,,8363.0,8363.0,1
CPT,0315U,ONC CUTAN SQ CLL CA MRNA 40,,,8262.0,42500.0,23
CPT,0316T,OP Surgery - Grouper Table,,,24394.0,24394.0,1
CPT,0316U,B BRGDRFERI LYME DS OSPA EVL,,,18.14,93.3,23
CPT,0317U,ONC LUNG CA 4-PRB FISH ASSAY,,,1973.16,10150.0,23
CPT,0318U,PED WHL GEN MTHYLTN ALYS 50+,,,1720.91,8852.4,23
CPT,0319U,NEPH RNA PRETRNSPL PERPH BLD,,,2575.8,13250.0,23
CPT,0320U,NEPH RNA PSTTRNSPL PERPH BLD,,,2575.8,13250.0,23
CPT,0321U,IADNA GU PTHGN 20BCT&FNG ORG,,,617.07,3174.2,23
CPT,0322U,NEURO ASD MEAS 14 ACYL CARN,,,729.0,3750.0,23
CPT,0323U,IADNA CNS PTHGN NEXT GEN SEQ,,,2066.67,10631.0,23
CPT,0326U,TRGT GEN SEQ ALYS PNL 83+,,,4860.0,25000.0,23
CPT,0327U,FTL ANEUPLOIDY TRSMY DNA SEQ,,,772.74,3975.0,23
CPT,0328U,DRUG ASSAY 120+ RX&METABLT,,,111.23,572.15,23
CPT,0329U,ONC NEO XOME&TRNS SEQ ALYS,,,3341.72,17189.9,23
CPT,0330T,"Tear film imaging, unilateral or bilateral, with interpretation and report",,,39.89,69.8,16
CPT,0330U,IADNA VAG PTHGN PANEL 27 ORG,,,405.12,2083.9,23
CPT,0331T,HEART SYMP IMAGE PLNR,,,1326.63,1366.43,15
CPT,0331U,ONC HL NEO OPT GEN MAPPING,,,1811.04,9316.1,23
CPT,0332T,"Myocardial sympathetic innervation imaging, planar qualitative and quantitative assessment; with tomographic SPECT",,,1326.63,1366.43,15
CPT,0332U,ONC PAN TUM GEN PRFLG 8 DNA,,,1110.08,5710.3,23
CPT,0333U,ONC LVR SURVEILANC HCC CFDNA,,,643.77,3311.6,23
CPT,0334U,ONC SLD ORGN TGSA DNA 84/+,,,2837.85,14598.0,23
CPT,0335T,INSJ SINUS TARSI IMPLANT,,,5480.0,18485.0,22
CPT,0335U,RARE DS WHL GEN SEQ FETAL,,,5078.31,26123.0,23
CPT,0336U,RARE DS WHL GEN SEQ BLD/SLV,,,2502.56,12873.25,23
CPT,0337U,ONC PLSM CELL DO&MYELOMA ID,,,2366.82,12175.0,23
CPT,0338T,TRNSCTH RENAL SYMP DENRV UNL,,,5793.88,17386.0,23
CPT,0338U,ONC SLD TUM CRCG TUM CL SLCT,,,2366.82,12175.0,23
CPT,0339T,TRNSCTH RENAL SYMP DENRV BIL,,,5793.88,17386.0,23
CPT,0339U,ONC PRST8 MRNA HOXC6 & DLX1,,,738.72,3800.0,23
CPT,0340U,ONC PAN CA ALYS MRD PLASMA,,,3810.24,19600.0,23
CPT,0341U,FTL ANEUP DNA SEQ CMPR ALYS,,,1847.0,9501.0,23
CPT,0342T,Therapeutic apheresis with selective HDL delipidation and plasma reinfusion,,,4761.07,16799.0,22
CPT,0342U,ONC PNCRTC CA MULT IA ECLIA,,,871.88,4485.0,23
CPT,0343U,ONC PRST8 XOM ALY 442 SNCRNA,,,738.72,3800.0,23
CPT,0344U,HEP NAFLD SEMIQ EVL 28 LIPID,,,769.99,3960.85,23
CPT,0345T,Transcatheter mitral valve repair percutaneous approach via the coronary sinus,,,2453.0,19884.0,7
CPT,0345U,PSYC GENOM ALYS PNL 15 GEN,,,1298.68,6680.45,23
CPT,0346U,APC,,,93.26,96.06,15
CPT,0346U,Lab/Pathology,,,466.3,466.3,1
CPT,0346U,Laboratory,,,466.3,466.3,1
CPT,0347T,INS BONE DEVICE FOR RSA,,,60.36,4258.0,22
CPT,0347U,RX METAB/PCX DNA 16 GEN ALYS,,,1298.68,6680.45,23
CPT,0348T,RSA SPINE EXAM,,,108.06,189.11,16
CPT,0348U,RX METAB/PCX DNA 25 GEN ALYS,,,721.49,3711.35,23
CPT,0349T,RSA UPPER EXTR EXAM,,,108.06,189.11,16
CPT,0349U,RX METAB/PCX DNA 27GEN RX IA,,,721.49,3711.35,23
CPT,0350T,RSA LOWER EXTR EXAM,,,89.48,156.58,16
CPT,0350U,RX METAB/PCX DNA 27 GEN ALYS,,,1298.68,6680.45,23
CPT,0351U,NFCT DS BCT/VIRAL TRAIL IP10,,,253.21,1302.5,23
CPT,0352U,APC,,,142.63,146.91,15
CPT,0352U,Lab/Pathology,,,713.15,713.15,1
CPT,0352U,Laboratory,,,713.15,713.15,1
CPT,0353U,APC,,,70.18,72.29,15
CPT,0353U,Lab/Pathology,,,350.9,350.9,1
CPT,0353U,Laboratory,,,350.9,350.9,1
CPT,0354U,APC,,,35.09,36.14,15
CPT,0354U,Lab/Pathology,,,175.45,175.45,1
CPT,0354U,Laboratory,,,175.45,175.45,1
CPT,0355U,APOL1 RISK VARIANTS,,,133.16,685.0,23
CPT,0356U,ONC OROP/ANAL 17 DNA DDPCR,,,1749.6,9000.0,23
CPT,0358T,BIA WHOLE BODY,,,24.89,25.63,15
CPT,0358U,NEURO ALYS ß-AMYL 1-42&1-40,,,253.21,1302.5,23
CPT,0359U,ONC PRST8 CA ALYS ALL PSA,,,738.72,3800.0,23
CPT,0360U,ONC LUNG ELISA 7 AUTOANT ALG,,,782.93,4203.25,23
CPT,0361U,"HC NEUROFILAMENT LIGHT CHAIN, DIGITAL IA, PLASMA, QUANT",1312.0,721.6,112.98,1134.88,53
CPT,0362T,BHV ID SUPRT ASSMT EA 15 MIN,,,30.27,31.18,15
CPT,0362U,ONC PAP THYR CA RNA 82&10,,,3499.2,18000.0,23
CPT,0363U,ONC URTHL MRNA 5 GEN ALG,,,738.72,3800.0,23
CPT,0364U,ONC HL NEO GEN SEQ ALYS ALG,,,1951.05,10036.25,23
CPT,0365U,ONC BLDR 10 UR HRBR URTHL CA,,,871.88,4485.0,23
CPT,0366U,ONC BLDR 10 PRB RECR BLDR CA,,,871.88,4485.0,23
CPT,0367U,ONC BLDR 10 FLWG TRURL RESCJ,,,876.92,4510.9,23
CPT,0368U,ONC CLRCT CA MUT&MTHYLTN MRK,,,405.12,2083.9,23
CPT,0369U,APC,,,416.78,429.28,15
CPT,0369U,Lab/Drugs Fee Schedule,,,405.12,500.14,6
CPT,0369U,Lab/Pathology,,,2083.9,2083.9,1
CPT,0369U,Laboratory,,,2083.9,2083.9,1
CPT,0370U,APC,,,416.78,429.28,15
CPT,0370U,Lab/Drugs Fee Schedule,,,405.12,500.14,6
CPT,0370U,Lab/Pathology,,,2083.9,2083.9,1
CPT,0370U,Laboratory,,,2083.9,2083.9,1
CPT,0371U,IADNA GU PTHGN SEMIQ DNA16&1,,,405.12,2083.9,23
CPT,0372U,NFCT DS GU PTHGN ARG DETCJ,,,405.12,2083.9,23
CPT,0373T,ADAPT BHV TX EA 15 MIN,,,30.27,31.18,15
CPT,0373U,APC,,,416.78,429.28,15
CPT,0373U,Lab/Drugs Fee Schedule,,,405.12,500.14,6
CPT,0373U,Lab/Pathology,,,2083.9,2083.9,1
CPT,0373U,Laboratory,,,2083.9,2083.9,1
CPT,0374U,APC,,,416.78,429.28,15
CPT,0374U,Lab/Drugs Fee Schedule,,,405.12,500.14,6
CPT,0374U,Lab/Pathology,,,2083.9,2083.9,1
CPT,0374U,Laboratory,,,2083.9,2083.9,1
CPT,0375U,ONC OVRN BCHM ASY 7 PRTN ALG,,,871.88,4485.0,23
CPT,0376U,ONC PRST8 CA IMG ALYS 128,,,686.48,3531.25,23
CPT,0377U,CV DS QUAN ADVSRM/PLSM LPRTN,,,46.25,237.9,23
CPT,0378U,RFC1 REPEAT XPNSJ VRNT ALYS,,,133.16,685.0,23
CPT,0379T,VIS FIELD ASSMNT TECH SUPPT,,,39.89,41.08,15
CPT,0379U,TGSAP SL OR NEO DNA523&RNA55,,,3196.43,16442.55,23
CPT,0380U,APC,,,416.78,429.28,15
CPT,0380U,Lab/Pathology,,,2083.9,2083.9,1
CPT,0380U,Laboratory,,,2083.9,2083.9,1
CPT,0381U,MAPLE SYRUP UR DS MNTR QUAN,,,42.89,220.6,23
CPT,0382U,HYPRPHENYLALNINMIA MNTR QUAN,,,50.19,258.2,23
CPT,0383U,TYROSINEMIA TYP I MNTR QUAN,,,50.59,260.25,23
CPT,0384U,NEPH CKD RSK HI STG KDN DS,,,729.0,3750.0,23
CPT,0385U,NEPH CKD ALG RSK DBTC KDN DS,,,379.81,1953.75,23
CPT,0387U,ONC MLNMA AMBRA1&AMLO,,,921.94,4742.5,23
CPT,0388U,ONC NONSM CLL LNG CA 37 GEN,,,3402.0,17500.0,23
CPT,0389U,PED FBRL KD IFI27&MCEMP1 RNA,,,68.24,351.0,23
CPT,0390U,OB PE KDR ENG&RBP4 IA ALG,,,62.6,322.05,23
CPT,0391U,ONC SLD TUM DNA&RNA 437 GEN,,,3499.2,18000.0,23
CPT,0392U,RX METAB GEN-RX IA 16 GENES,,,1298.68,6680.45,23
CPT,0393U,NEU PRKSN MSFL a-SYNCLN PRTN,,,525.84,2704.95,23
CPT,0394T,APC,,,267.24,275.26,15
CPT,0394U,PFAS 16 PFAS COMPND LC MS/MS,,,193.18,993.7,23
CPT,0395T,HDR ELCTR NTRST/NTRCV BRCHTX,,,705.05,726.2,15
CPT,0395U,ONC LNG MULTIOMICS PLSM ALG,,,775.13,3987.25,23
CPT,0397T,ERCP W/OPTICAL ENDOMICROSCPY,,,835.0,3533.0,6
CPT,0398T,OP Surgery - Grouper Table,,,19884.0,19884.0,1
CPT,0398U,GI BARET ESPH DNA MTHYLN ALY,,,1705.86,8775.0,23
CPT,0399U,NEURO CERE FOLATE DEFNCY SRM,,,291.6,1500.0,23
CPT,0400U,OB XPND CAR SCR 145 GENES,,,1416.09,7284.4,23
CPT,0401U,CRD C HRT DS 9 GEN 12 VRNTS,,,475.97,2448.4,23
CPT,0402T,HC COLLAGEN CROSS-LINKING OF CORNEA,5749.0,3161.95,1724.7,9469.0,53
CPT,0402U,NFCT AGT STI MULT AMP PRB TQ,,,138.64,713.15,23
CPT,0403U,ONC PRST8 MRNA 18 GEN 1ST UR,,,738.72,3800.0,23
CPT,0404T,OP Surgery - Grouper Table,,,19884.0,19884.0,1
CPT,0404U,ONC BRST SEMIQ MEAS THYM KN,,,313.92,1614.8,23
CPT,0405U,ONC PNCRTC 59 MTHLTN BLK MRK,,,1720.91,8852.4,23
CPT,0406U,ONC LUNG FLOW CYTMTRY 5 MRK,,,738.72,3800.0,23
CPT,0407U,NEPH DBTC CKD MULT ECLIA ALG,,,923.4,4750.0,23
CPT,0408T,INSJ/RPLC CARDIAC MODULJ SYS,,,19979.0,34485.0,22
CPT,0408U,IAAD BLK AC WV BSNSR SARSCV2,,,13.73,70.65,23
CPT,0409T,INSJ/RPLC CAR MODULJ PLS GN,,,19979.0,34485.0,22
CPT,0409U,ONC SLD TUM DNA 80 & RNA 36,,,2837.85,14598.0,23
CPT,0410T,INSJ/RPLC CAR MODULJ ATR ELT,,,8410.05,21512.0,22
CPT,0410U,ONC PNCRTC DNA WHL GN SEQ 5-,,,1127.52,5800.0,23
CPT,0411T,INSJ/RPLC CAR MODULJ VNT ELT,,,8410.05,21512.0,22
CPT,0411U,PSYC GENOM ALYS PNL 15 GEN,,,1298.68,6680.45,23
CPT,0412T,RMVL CARDIAC MODULJ PLS GEN,,,3698.26,14658.0,22
CPT,0412U,BETA AMYLOID Aß42/40 IMPRCIP,,,729.0,3750.0,23
CPT,0413T,RMVL CAR MODULJ TRANVNS ELT,,,3698.26,14658.0,22
CPT,0413U,ONC HL NEO OPT GEN MAPG DNA,,,1228.16,6317.65,23
CPT,0414T,RMVL & RPL CAR MODULJ PLS GN,,,19979.0,34485.0,22
CPT,0414U,ONC LNG AUG ALG ALY WHL SLD8,,,686.48,3531.25,23
CPT,0415T,REPOS CAR MODULJ TRANVNS ELT,,,628.28,4955.0,22
CPT,0415U,CV DS ACS BLD ALG 5 YR SCORE,,,379.81,1953.75,23
CPT,0416T,RELOC SKIN POCKET PLS GEN,,,1858.86,6766.0,22
CPT,0416U,APC,,,416.78,429.28,15
CPT,0416U,Lab/Pathology,,,2083.9,2083.9,1
CPT,0416U,Laboratory,,,2083.9,2083.9,1
CPT,0417T,PRGRMG EVAL CARDIAC MODULJ,,,37.89,39.03,15
CPT,0417U,RARE DS ALYS 335 NUC GENES,,,2762.95,14212.65,23
CPT,0418T,INTERRO EVAL CARDIAC MODULJ,,,37.89,39.03,15
CPT,0418U,ONC BRST AUG ALG ALY WHL SL8,,,686.48,3531.25,23
CPT,0419T,DSTRJ NEUROFIBROMA XTNSV,,,622.05,4258.0,22
CPT,0419U,NRPSYC GEN SEQ VRNT ALY 13,,,1298.68,6680.45,23
CPT,0420T,DSTRJ NEUROFIBROMA XTNSV,,,622.05,4258.0,22
CPT,0421T,APC,,,9396.95,9678.86,15
CPT,0421T,OP Surgery - Grouper Table,,,9733.0,16799.0,7
CPT,0421U,ONC CLRCT SCR SGL AMP 8 RNA,,,494.62,2544.35,23
CPT,0422T,TACTILE BREAST IMG UNI/BI,,,89.48,92.16,15
CPT,0423U,PSYC GENOMIC ALYS PNL 26 GEN,,,405.12,2083.9,23
CPT,0424T,OP Surgery - Grouper Table,,,24394.0,24394.0,1
CPT,0424U,ONC PRST8 XOM ALYS 53 SNCRNA,,,738.72,3800.0,23
CPT,0425T,OP Surgery - Grouper Table,,,19884.0,19884.0,1
CPT,0426T,OP Surgery - Grouper Table,,,24394.0,24394.0,1
CPT,0427T,OP Surgery - Grouper Table,,,24394.0,24394.0,1
CPT,0427U,MONOCYTE DSTRBJ WDTH WHL BLD,,,4.36,22.4,23
CPT,0428T,OP Surgery - Grouper Table,,,8363.0,8363.0,1
CPT,0429T,OP Surgery - Grouper Table,,,8363.0,8363.0,1
CPT,0429U,HPV OROP SWAB 14 HI-RISK TYP,,,34.11,175.45,23
CPT,0430T,OP Surgery - Grouper Table,,,8363.0,8363.0,1
CPT,0430U,GI MALABS AAT CALPRO PNCRTC,,,59.82,307.7,23
CPT,0431T,OP Surgery - Grouper Table,,,24394.0,24394.0,1
CPT,0431U,"HC STIFF PERSON GLYCINE RECEPTOR ALPHA IGG, SERUM/CSF LCBA QUAL",40.0,22.0,12.0,182.85,53
CPT,0432T,OP Surgery - Grouper Table,,,8363.0,8363.0,1
CPT,0432U,KLHL11 ANTB SR/CSF ASY QUAL,,,35.54,182.85,23
CPT,0433T,OP Surgery - Grouper Table,,,8363.0,8363.0,1
CPT,0433U,ONC PRST8 5 DNA REG MRK PCR,,,738.72,3800.0,23
CPT,0434U,RX METAB ADVRS VRNT ALYS 25,,,405.12,2083.9,23
CPT,0435U,ONC CHEMO RX CYTOX CSC 14 RX,,,2948.91,15169.3,23
CPT,0437T,IMPLTJ SYNTH RNFCMT ABDL WAL,,,835.0,3533.0,6
CPT,0437U,PSYC ANXIETY DO MRNA 15 BMRK,,,738.72,3800.0,23
CPT,0438U,RX METAB ADVRS VRNT ALYS 33,,,405.12,2083.9,23
CPT,0440T,ABLTJ PERC UXTR/PERPH NRV,,,3472.71,3472.71,1
CPT,0440T,"HC ABLATION, PERC, CYROABLATION, IMG GUID, UPPER EXTREM DISTAL/PERIPH NERVE",13657.0,7511.35,1984.4,16799.0,53
CPT,0441T,ABLTJ PERC LXTR/PERPH NRV,,,3472.71,3472.71,1
CPT,0441T,"HC ABLATION, PERC, CYROABLATION, IMG GUID, LOWER EXTREM DISTAL/PERIPH NERVE",9338.0,5135.9,1984.4,16799.0,53
CPT,0441U,"HC SEPSIS RISK ASSMT, WHOLE BLD, W/ ALGORITHMIC ANLYS & RESULT RPT",200.0,110.0,60.0,173.0,38
CPT,0442T,ABLTJ PERC PLEX/TRNCL NRV,,,11388.68,11388.68,1
CPT,0442T,"HC ABLATION, PERC, CYROABLATION, IMG GUID, NERVE PLEXUS/OTH TRUNCAL NERVE",20030.0,11016.5,6009.0,17325.95,53
CPT,0442U,NFCT DS RESPIR NFCTJ MXA&CRP,,,40.22,206.9,23
CPT,0443T,R-T SPCTRL ALYS PRST8 TISS,,,835.0,3533.0,6
CPT,0444T,1ST PLMT DRUG ELUT OC INS,,,835.0,3533.0,6
CPT,0444U,ONC SLD ORGN NEO TGSAP 361,,,2837.85,14598.0,23
CPT,0445T,SBSQT PLMT DRUG ELUT OC INS,,,835.0,3533.0,6
CPT,0445U,ABETA42 & PTAU181 ECLIA CSF,,,253.21,1302.5,23
CPT,0446T,INSJ IMPLTBL GLUCOSE SENSOR,,,835.0,4258.0,22
CPT,0446U,AI DS SLE ALYS 10 CYTOKINE,,,817.11,4203.25,23
CPT,0447T,RMVL IMPLTBL GLUCOSE SENSOR,,,201.92,4258.0,22
CPT,0447U,AI DS SLE ALYS 11 CYTOKINE,,,817.11,4203.25,23
CPT,0448T,REMVL INSJ IMPLTBL GLUC SENS,,,835.0,4258.0,22
CPT,0449T,INSJ AQUEOUS DRAIN DEV 1ST,,,5243.3,16799.0,22
CPT,0449U,CAR SCR SEV INH COND 5 GENES,,,1773.78,9124.4,23
CPT,0450T,INSJ AQUEOUS DRAIN DEV EACH,,,835.0,3533.0,6
CPT,0450U,APC,,,43.43,44.73,15
CPT,0451U,APC,,,43.43,44.73,15
CPT,0452U,ONC BLDR MTHYL PENK LTE-QMSP,,,186.62,960.0,23
CPT,0453U,ONC CLRCT CA CFDNA QPCR ASY,,,186.62,960.0,23
CPT,0454U,RARE DS ID OPT GENOME MAPG,,,1228.16,6317.65,23
CPT,0455U,NFCT AGT STI MULT AMP PRB UR,,,138.64,713.15,23
CPT,0457U,PFAS 9 CMPND LC-MS/MS PLS/SR,,,193.18,993.7,23
CPT,0458U,ONC BRST CA S100 A8&A9 ELISA,,,253.21,1302.5,23
CPT,0459U,ABETA42 & TTAU ECLIA CSF,,,253.21,1302.5,23
CPT,0462U,MELATONIN LVL TST SLP STD7/9,,,16.79,86.35,23
CPT,0464T,VISUAL EP TEST FOR GLAUCOMA,,,158.99,163.76,15
CPT,0464U,ONC CLRCT SCR QRTSA DNA MRK,,,575.34,2959.6,23
CPT,0465T,OP Surgery - Grouper Table,,,4258.0,4258.0,1
CPT,0465U,ONC URTHL CARC DNA QMSP 2GEN,,,1883.75,9690.05,23
CPT,0467U,ONC BLDR DNA NGS 60GEN&ANEUP,,,1476.52,7595.3,23
CPT,0468U,HEP NASH MIR-34A5P A2M YKL40,,,244.66,1258.5,23
CPT,0469U,RARE DS WHL GEN SEQ FTL SAMP,,,1164.4,5989.7,23
CPT,0471U,ONC CLRC CA 35 VRN KRAS&NRAS,,,738.72,3800.0,23
CPT,0472T,PRGRMG IO RTA ELTRD RA,,,304.77,313.91,15
CPT,0473T,REPRGRMG IO RTA ELTRD RA,,,93.28,96.08,15
CPT,0473U,ONC SLD TUM BLD/SLV 648 GENE,,,4374.0,22500.0,23
CPT,0474T,INSJ AQUEOUS DRG DEV IO RSVR,,,9733.0,16799.0,7
CPT,0474U,HERED PAN CA GSAP 88GENE NGS,,,1267.44,6519.75,23
CPT,0475U,HERED PRST8 CA GSAP 23 GENES,,,1267.44,6519.75,23
CPT,0476U,RX METAB PSYC 14GEN&CYP2D6,,,405.12,2083.9,23
CPT,0477U,RX METAB PSY 14&CYP2D6 GN-RX,,,405.12,2083.9,23
CPT,0479T,FXJL ABL LSR 1ST 100 SQ CM,,,622.05,4955.0,22
CPT,0479U,TAU PHOSPHORYLATED PTAU217,,,16.79,86.35,23
CPT,0480T,FXJL ABL LSR EA ADDL 100SQCM,,,835.0,3533.0,6
CPT,0480U,NFCT DS CSF METAG NGS ALYS,,,2066.67,10631.0,23
CPT,0481T,NJX AUTOL WBC CONCENTRATE,,,405.5,4258.0,22
CPT,0481U,IDH1 IDH2&TERT PROMOTER NGS,,,655.36,3371.2,23
CPT,0482U,OB PE BIOCHEM ASY SFLT1&PLGF,,,125.21,644.1,23
CPT,0483T,"HC TMVI WITH PROSTHETIC VALVE, PERCUTANEOUS APPROACH, TRANSSEPTAL PUNCTURE",47895.0,26342.25,2453.0,41429.18,38
CPT,0484T,TMVI TRANSTHORACIC EXPOSURE,,,2453.0,16786.0,7
CPT,0485T,OCT MID EAR I&R UNILATERAL,,,39.89,41.08,15
CPT,0486T,OCT MID EAR I&R BILATERAL,,,39.89,41.08,15
CPT,0487U,ONC SOL TUM CFCDNA TGSAP 84,,,2837.85,14598.0,23
CPT,0488U,OB FETAL AG NIPT CFDNA ALYS,,,737.79,3795.25,23
CPT,0489T,REGN CELL TX SCLDR HANDS,,,2453.0,8363.0,7
CPT,0490T,REGN CELL TX SCLDR H MLT INJ,,,2453.0,4602.0,7
CPT,0490U,ONC CUTAN/UVEAL MLNMA CD146,,,2366.82,12175.0,23
CPT,0491T,OP Surgery - Grouper Table,,,4258.0,4258.0,1
CPT,0491U,ONC SOL TUM CTC SLCT ER PRTN,,,2366.82,12175.0,23
CPT,0492U,ONC SOL TUM CTC SLCTN PD-L1,,,2366.82,12175.0,23
CPT,0493U,TRNSPL MED QUAN DD-CFDNA NGS,,,2676.16,13766.25,23
CPT,0494T,PREP & CANNULJ CDVR DON LUNG,,,2453.0,16786.0,7
CPT,0494U,RBC AG FTL RHD GENE ALYS NGS,,,737.79,3795.25,23
CPT,0495T,MNTR CDVR DON LNG 1ST 2 HRS,,,2453.0,8363.0,7
CPT,0495U,ONC PRST8 ALYS CRCG PLSM PRT,,,738.72,3800.0,23
CPT,0496T,MNTR CDVR DON LNG EA ADDL HR,,,2453.0,8363.0,7
CPT,0497U,ONC PRST8 MRNA RT-PCR 6GENES,,,3764.56,19365.0,23
CPT,0499T,OP Surgery - Grouper Table,,,5761.0,5761.0,1
CPT,0499U,ONC CLRCT&LNG DNA NGS 8GENES,,,581.17,2989.55,23
CPT,0500U,AUTOINFLAM DS VEXAS SYND DNA,,,170.49,877.0,23
CPT,0502U,HPV E6/E7 MRK HI-RSK TYP CRV,,,34.11,175.45,23
CPT,0503U,NEURO ALZ DS ßAMYL&TAU PRTN,,,729.0,3750.0,23
CPT,0504U,NFCT DS UTI ID 17 PATH ORGS,,,405.12,2083.9,23
CPT,0505T,EV FEMPOP ARTL REVSC,,,11524.29,21512.0,23
CPT,0505U,NFCT DS VAG INFCTJ ID 32ORGS,,,660.74,3398.85,23
CPT,0506T,MAC PGMT OPT DNS MEAS HFP,,,60.36,62.17,15
CPT,0506U,GI BARRETTS ESOPHGL CELL 89,,,1883.75,9690.05,23
CPT,0507T,NEAR IFR 2IMG MIBMN GLND I&R,,,60.36,62.17,15
CPT,0507U,ONC OVR DNA WHOLE GEN W/5HMC,,,1127.52,5800.0,23
CPT,0509T,"HC ELECTRORETINOGRAPHY W/ INTERP AND REPORT, PATTERN (PERG)",840.0,462.0,252.0,726.6,106
CPT,0510T,RMVL SINUS TARSI IMPLANT,,,3297.17,14658.0,22
CPT,0511T,RMVL&RINSJ SINUS TARSI IMPLT,,,5480.0,18485.0,22
CPT,0511U,ONC SOL TUM 3DMICROENVIR 36+,,,2948.91,15169.3,23
CPT,0512T,ESW INTEG WND HLG 1ST WND,,,201.92,4258.0,22
CPT,0512U,ONC PRST8 ALYS DGTZ IMG MSI,,,686.48,3531.25,23
CPT,0513T,ESW INTEG WND HLG EA ADDL,,,835.0,3533.0,6
CPT,0513U,ONC PRST8 ALG ALYS MSI&HRD,,,686.48,3531.25,23
CPT,0514U,GI IBD IA QUAN DETER ADL LVL,,,37.49,192.85,23
CPT,0515T,INSJ WCS LV COMPL SYS,,,19979.0,34485.0,22
CPT,0515U,GI IBD IA QUAN DETER IFX LVL,,,37.49,192.85,23
CPT,0516T,INSJ WCS LV ELTRD ONLY,,,10634.87,21512.0,22
CPT,0516U,RX METAB RXGENOMIC GNOTYP 40,,,405.12,2083.9,23
CPT,0517T,INSJ WCS LV BOTH COMPNT PG,,,10634.87,21512.0,22
CPT,0517U,THER RX MNTR 80+ PSYACTIV RX,,,240.0,1234.6,23
CPT,0518T,RMVL PG WCS LV BATTERY ONLY,,,3698.26,14658.0,22
CPT,0518U,THER RX MNTR 90+ PN&MTL HLTH,,,240.0,1234.6,23
CPT,0519T,RMV&RPLCMT PG WCS LV BOTH,,,8363.0,14658.0,22
CPT,0519U,THER RX MNTR MEDS P/D/A 110+,,,240.0,1234.6,23
CPT,0520T,RMV&RPLCMT PG WCS LV BATTERY,,,10634.87,34485.0,22
CPT,0520U,THER RX MNTR 200+ RX/SBSTS,,,240.0,1234.6,23
CPT,0521T,INTERROG DEV EVAL WCS IP,,,24.89,25.63,15
CPT,0522T,PRGRMG DEV EVAL WCS IP,,,37.89,39.03,15
CPT,0523T,NTRAPX C FFR W/3D FUNCJL MAP,,,835.0,3533.0,6
CPT,0524T,EV CATH DIR CHEM ABLTJ W/IMG,,,3198.49,14658.0,23
CPT,0525T,INSJ/RPLCMT COMPL IIMS,,,12463.0,21512.0,22
CPT,0526T,INSJ/RPLCMT IIMS ELTRD ONLY,,,8410.05,21512.0,22
CPT,0527T,INSJ/RPLCMT IIMS IMPLT MNTR,,,8410.05,21512.0,22
CPT,0528T,PRGRMG DEV EVAL IIMS IP,,,37.89,39.03,15
CPT,0529T,INTERROG DEV EVAL IIMS IP,,,37.89,39.03,15
CPT,0530T,REMOVAL COMPLETE IIMS,,,3698.26,14658.0,22
CPT,0531T,REMOVAL IIMS ELECTRODE ONLY,,,3698.26,14658.0,22
CPT,0532T,REMOVAL IIMS IMPLT MNTR ONLY,,,3698.26,14658.0,22
CPT,0537T,OP Surgery - Grouper Table,,,4258.0,4258.0,1
CPT,0537U,ONC CLRCT CA CFDNA >2500 DMR,,,1495.0,1539.85,15
CPT,0538T,OP Surgery - Grouper Table,,,4258.0,4258.0,1
CPT,0539T,OP Surgery - Grouper Table,,,4258.0,4258.0,1
CPT,0540T,OP Surgery - Grouper Table,,,4258.0,4258.0,1
CPT,0541T,MYOCARDIAL IMAGING MCG,,,539.2,943.59,16
CPT,0543T,TA MV RPR W/ARTIF CHORD TEND,,,2453.0,19884.0,7
CPT,0544T,TCAT MV ANNULUS RCNSTJ,,,2453.0,19884.0,7
CPT,0545T,TCAT TV ANNULUS RCNSTJ,,,2453.0,19884.0,7
CPT,0547T,B1 MATRL QUAL TST MCRIND TIB,,,8363.0,8363.0,1
CPT,0553T,OP Surgery - Grouper Table,,,19884.0,19884.0,1
CPT,0555T,B1 STR&FX RSK TRANSMIS DATA,,,24.89,25.63,15
CPT,0556T,B1 STR & FX RSK ASSESSMENT,,,245.64,253.0,15
CPT,0558T,CT SCAN F/BIOMCHN CT ALYS,,,89.48,92.16,15
CPT,0559T,ANTMC MDL 3D PRINT 1ST CMPNT,,,60.36,105.63,16
CPT,0561T,ANTMC GUIDE 3D PRINT 1ST GD,,,60.36,105.63,16
CPT,0563T,"HC SP ONLY, EVACUATION MEIBOMIAN GLANDS, MANUAL GLAND EXPRESSION, BILAT",131.0,72.05,39.3,4258.0,53
CPT,0563T,"HC TEARCARE SP ONLY, EVACUATION MEIBOMIAN GLANDS USING HEAT, BILATERAL",559.0,307.45,60.36,4258.0,53
CPT,0564T,Lab/Pathology,,,148.09,148.09,1
CPT,0564T,Laboratory,,,148.09,148.09,1
CPT,0565T,AUTOL CELL IMPLT ADPS HRVG,,,835.0,4258.0,7
CPT,0566T,AUTOL CELL IMPLT ADPS NJX,,,835.0,4258.0,7
CPT,0567T,OP Surgery - Grouper Table,,,13936.0,13936.0,1
CPT,0568T,OP Surgery - Grouper Table,,,8363.0,8363.0,1
CPT,0569T,"HC TRANSCATHETER TRICUSPID VALVE REPAIR, PERCUT APPROACH, INIT PROSTHESIS",32802.0,18041.1,2453.0,28373.73,38
CPT,0570T,TTVR PERQ EA ADDL PROSTH,,,2453.0,19884.0,7
CPT,0571T,HC INSERT/RPLCMT ICDS W/ SUBSTERNAL ELECTRODE INCLD IMG GUID AND EPS EVAL,81452.5,44798.88,19979.0,70456.41,53
CPT,0572T,HC INSERTION OF SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELECTRODE,21025.0,11563.75,6307.5,21512.0,53
CPT,0573T,HC REMOVAL OF SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELECTRODE,9245.5,5085.03,2773.65,19884.0,53
CPT,0574T,HC REPOSITIONING OF PREVIOUSLY IMPLANTED SUBSTERNAL IMPLT DFB PACING ELTRD,9245.5,5085.03,2773.65,19884.0,53
CPT,0575T,PRGRMG DEV EVAL ICDS SS IP,,,37.89,39.03,15
CPT,0576T,INTERROG DEV EVAL ICDS SS IP,,,37.89,39.03,15
CPT,0577T,HC ELECTROPHYSIOLOGIC EVALUATION OF ICDS WITH SUBSTERNAL ELECTRODE,3084.0,1696.2,925.2,24494.0,53
CPT,0579T,REM INTERROG DEV ICDS TECH,,,37.89,39.03,15
CPT,0580T,HC REMOVAL OF SUBSTERNAL IMPLANTABLE DEFIBRILLATOR PULSE GENERATOR ONLY,9245.5,5085.03,2773.65,19884.0,53
CPT,0581T,ABLTJ MAL BRST TUM PERQ CRTX,,,3891.31,9469.0,23
CPT,0582T,TRURL ABLTJ MAL PRST8 TISS,,,2453.0,13936.0,7
CPT,0583T,TMPST AUTO TUBE DLVR SYS,,,1505.28,6766.0,22
CPT,0584T,PERQ ISLET CELL TRANSPLANT,,,2453.0,24394.0,7
CPT,0585T,LAPS ISLET CELL TRANSPLANT,,,2453.0,24394.0,7
CPT,0586T,OPEN ISLET CELL TRANSPLANT,,,2453.0,24394.0,7
CPT,0587T,PERQ IMPLTJ/RPLCMT ISDNS PTN,,,2932.0,11671.13,23
CPT,0588T,REVISION/REMOVAL ISDNS PTN,,,3494.72,14658.0,23
CPT,0589T,ELEC ALYS SMPL PRGRMG IINS,,,93.28,96.08,15
CPT,0590T,ELEC ALYS CPLX PRGRMG IINS,,,93.28,96.08,15
CPT,0594T,OSTEOT HUM XTRNL LNGTH DEV,,,7259.46,18485.0,22
CPT,0596T,TEMP FML IU VLV-PMP 1ST INSJ,,,678.28,4955.0,22
CPT,0597T,TEMP FML IU VALVE-PMP RPLCMT,,,678.28,4955.0,22
CPT,0598T,R-T FLUOR WOUND IMG 1ST SITE,,,316.44,553.78,16
CPT,0600T,ABLT IRE 1+ O/T LV/PRST8 PRQ,,,10315.0,17804.0,22
CPT,0601T,ABLTJ IRE 1+TUMORS OPEN,,,10315.0,17804.0,22
CPT,0609T,MRS DISC PAIN ACQUISJ DATA,,,245.64,253.0,15
CPT,0611T,MRS DISC PAIN ALG ALYS DATA,,,245.64,253.0,15
CPT,0613T,PERQ TCAT INTRATRL SEPTL SHT,,,2453.0,19884.0,7
CPT,0614T,HC REMOVAL & REPLACEMENT OF SUBSTERNAL IMPLT DEFIBRILLATOR PULSE GENERATOR,57024.5,31363.48,17107.35,49326.19,53
CPT,0615T,AUTO ALYS BINOCULAR EYE MVMT,,,130.99,134.92,15
CPT,0616T,OP Surgery - Grouper Table,,,5761.0,5761.0,1
CPT,0617T,OP Surgery - Grouper Table,,,13936.0,13936.0,1
CPT,0618T,OP Surgery - Grouper Table,,,13936.0,13936.0,1
CPT,0619T,APC,,,9396.95,9678.86,15
CPT,0619T,OP Surgery - Grouper Table,,,5480.0,13936.0,7
CPT,0620T,EVASC VEN ARTLZ TIBL/PRNL VN,,,62243.14,62243.14,1
CPT,0620T,"HC ENDOVASC VEN ART, TIB/PERON VEIN, W INTRVASC STENT GRAFT, INCL IMG GUID",58789.0,32333.95,12463.0,50852.49,53
CPT,0621T,TRABECULOSTOMY INTERNO LASER,,,2453.0,16799.0,22
CPT,0622T,TRABECULOSTOMY INT LSR W/SCP,,,2453.0,5761.0,7
CPT,0625T,APC,,,965.9,994.88,15
CPT,0625T,Other Radiology,,,1690.32,1690.32,1
CPT,0627T,PERQ NJX ALGC FLUOR LMBR 1ST,,,10315.0,22881.71,23
CPT,0628T,PERQ NJX ALGC FLUOR LMBR EA,,,835.0,3533.0,6
CPT,0629T,PERQ NJX ALGC CT LMBR 1ST,,,10315.0,22881.71,23
CPT,0630T,PERQ NJX ALGC CT LMBR EA,,,835.0,3533.0,6
CPT,0631T,APC,,,24.89,25.63,15
CPT,0632T,PERQ TCAT US ABLTJ NRV P-ART,,,12463.0,21512.0,22
CPT,0633T,CT BREAST W/3D UNI C-,,,108.06,111.3,15
CPT,0634T,CT BREAST W/3D UNI C+,,,180.9,186.33,15
CPT,0635T,CT BREAST W/3D UNI C-/C+,,,180.9,186.33,15
CPT,0636T,CT BREAST W/3D BI C-,,,245.64,253.0,15
CPT,0637T,CT BREAST W/3D BI C+,,,362.92,373.8,15
CPT,0638T,CT BREAST W/3D BI C-/C+,,,362.92,373.8,15
CPT,0640T,NCNTC IFR SPCTRSC O/T PAD 1,,,39.89,41.08,15
CPT,0643T,HC TRANSCATHETER LEFT VENTRICULAR RESTORATION DEVICE IMPLT INCL RT/LT CATH,45653.0,25109.15,2453.0,39489.85,38
CPT,0644T,"HC TRNCATH REM/DEBULK INTRCARD MASS VIA SUCTION DEV, PERC, INCL IMG GUID",17142.0,9428.1,5142.6,17804.0,53
CPT,0645T,TCAT IMPLTJ C SINS RDCTJ DEV,,,12463.0,21512.0,22
CPT,0646T,"HC TTVI/REPLC W/ PROSTH VALVE, PERC APPROACH, WHEN PERFORMED",23801.0,13090.55,2453.0,20587.87,38
CPT,0647T,INSJ GTUBE PERQ MAG GASTRPXY,,,1927.72,6766.0,22
CPT,0648T,QUAN MR TIS WO MRI 1ORGN,,,965.9,994.88,15
CPT,0649T,QUAN MR TISS W/MRI 1ORGN,,,965.9,994.88,15
CPT,0650T,PRGRMG DEV EVAL SCRMS REMOTE,,,37.89,39.03,15
CPT,0651T,MAG CTRLD CAPSULE ENDOSCOPY,,,952.75,6766.0,21
CPT,0652T,EGD FLX TRANSNASAL DX BR/WA,,,1927.72,6766.0,22
CPT,0653T,EGD FLX TRANSNASAL BX 1/MLT,,,1927.72,6766.0,22
CPT,0654T,EGD FLX TRANSNASAL TUBE/CATH,,,3866.16,6766.0,22
CPT,0655T,TPRNL FOCAL ABLTJ MAL PRST8,,,5165.97,9469.0,22
CPT,0656T,ANT LMBR VRT BDY TETH <7 SEG,,,2453.0,18485.0,7
CPT,0657T,ANT LMBR VRT BDY TETH 8+ SEG,,,2453.0,18485.0,7
CPT,0658T,ELEC IMPD SPECTRSC 1+SKN LES,,,60.36,62.17,15
CPT,0659T,TCAT INTRA-C NFS SUPERSAT O2,,,2453.0,19884.0,7
CPT,0660T,IMPLT ANT SGM IO NBIO RX SYS,,,2453.0,16799.0,22
CPT,0661T,RMVL&RIMPLTJ ANT SGM IMPLT,,,2453.0,16799.0,22
CPT,0662T,APC,,,1778.86,1832.22,15
CPT,0664T,DON HYSTERECTOMY OPEN CDVR,,,2453.0,8363.0,7
CPT,0665T,DON HYSTERECTOMY OPEN LIV,,,2453.0,8363.0,7
CPT,0666T,DON HYSTERECTOMY LAPS LIV,,,2453.0,8363.0,7
CPT,0667T,DON HYSTERECTOMY RCP UTER,,,2453.0,8363.0,7
CPT,0668T,BKBENCH PREP DON UTER ALGRFT,,,2453.0,8363.0,7
CPT,0669T,BKBENCH RCNSTJ DON UTER VEN,,,2453.0,8363.0,7
CPT,0670T,BKBENCH RCNSTJ DON UTER ARTL,,,2453.0,8363.0,7
CPT,0671T,INSJ ANT SGM AQ DRG DEV 1+,,,5243.3,9469.0,22
CPT,0672T,NDOVAG CRYG RF REMDL TISS,,,2453.0,13936.0,7
CPT,0673T,ABLTJ B9 THYR NDUL PERQ LASR,,,1646.49,6766.0,23
CPT,0674T,LAPS INSJ NW/RPCMT PRM ISDSS,,,2453.0,31896.28,22
CPT,0675T,LAPS INSJ NW/RPCMT ISDSS 1LD,,,2453.0,21512.0,22
CPT,0676T,LAPS INSJ NW/RPCMT ISDSS EA,,,994.0,8363.0,7
CPT,0677T,LAPS REPOS LEAD ISDSS 1ST LD,,,2453.0,17804.0,22
CPT,0678T,LAPS REPOS LEAD ISDSS EA ADD,,,994.0,8363.0,7
CPT,0679T,LAPS RMVL LEAD ISDSS,,,2453.0,17804.0,22
CPT,0680T,INSJ/RPLCMT PG ONLY ISDSS,,,2453.0,22445.54,22
CPT,0681T,RLCJ PULSE GEN ONLY ISDSS,,,2453.0,14658.0,22
CPT,0682T,REMOVAL PULSE GEN ONLY ISDSS,,,2453.0,14658.0,22
CPT,0683T,PRGRMG DEV EVAL ISDSS IP,,,37.89,39.03,15
CPT,0685T,INTERROG DEV EVAL ISDSS IP,,,37.89,39.03,15
CPT,0686T,"HC HISTOTRIPSY OF MALIGNANT HEPATOCELLULAR TISSUE, INCL IMG GUID",43228.0,23775.4,12968.4,37392.22,53
CPT,0689T,QUAN US TIS CHARAC W/O DX US,,,89.48,156.58,16
CPT,0692T,HC ULTRAFILTRATION,2000.0,1100.0,600.0,1730.0,53
CPT,0693T,COMPRE FUL BDY 3D MTN ALYS,,,356.18,366.86,15
CPT,0696T,BDY SURF MAPG PM/CVDFB F/UP,,,37.89,39.03,15
CPT,0697T,QUAN MR TIS WO MRI MLT ORGN,,,965.9,994.88,15
CPT,0698T,QUAN MR TISS W/MRI MLT ORGN,,,965.9,994.88,15
CPT,0699T,NJX PST CHMBR EYE MEDICATION,,,2317.68,9469.0,22
CPT,0707T,NJX B1 SUB MTRL SBCHDRL DFCT,,,3297.17,14658.0,22
CPT,0708T,ID CA IMMNTX PREP & 1ST NJX,,,2453.0,4602.0,6
CPT,0709T,ID CA IMMNTX EACH ADDL NJX,,,2453.0,4602.0,6
CPT,0712T,N-NVS ARTL PLAQ ALYS QUAN,,,89.48,92.16,15
CPT,0714T,TPLA B9 PRST8 HYPRPLSA<50ML,,,5165.97,13936.0,22
CPT,0716T,CAR ACOUS WAVFRM REC CAD RSK,,,60.36,3533.0,21
CPT,0717T,ADRC THER PRTL RC TEAR,,,3720.28,14658.0,22
CPT,0718T,ADRC THER PRTL RC TEAR NJX,,,3720.28,14658.0,22
CPT,0719T,PST VRT JT RPLCMT LMBR 1 SGM,,,2453.0,8363.0,7
CPT,0720T,APC,,,1033.87,1064.89,15
CPT,0720T,OP Surgery - Grouper Table,,,3917.0,6766.0,7
CPT,0721T,QUAN CT TISS CHARAC W/O CT,,,661.04,680.87,15
CPT,0722T,QUAN CT TISS CHARAC W/CT,,,661.04,680.87,15
CPT,0723T,QMRCP W/O DX MRI SM ANAT SES,,,965.9,994.88,15
CPT,0724T,QMRCP W/DX MRI SAME ANATOMY,,,965.9,994.88,15
CPT,0725T,VESTIBULAR DEV IMPLTJ UNI,,,2453.0,13936.0,7
CPT,0726T,RMVL IMPLT VSTIBULAR DEV UNI,,,2453.0,13936.0,7
CPT,0727T,RMVL&RPLCMT IMPLT VSTBLR DEV,,,2453.0,13936.0,7
CPT,0730T,TRABECULOTOMY LSR W/OCT GDN,,,2453.0,5761.0,7
CPT,0731T,AUGMNT AI-BASED FCL PHNT A/R,,,60.36,62.17,15
CPT,0732T,IMMNTX ADMN ELECTROPORATN IM,,,2453.0,4602.0,6
CPT,0733T,REM R-T MTN NREHAB THER SPLY,,,356.18,366.86,15
CPT,0735T,PREP TUM CAV IORT PRIM CRNOT,,,835.0,3533.0,6
CPT,0736T,COLONIC LAVAGE 35+L WATER,,,158.99,4258.0,22
CPT,0737T,XENOGRAFT IMPLTJ ARTCLR SURF,,,2453.0,18485.0,22
CPT,0739T,ABLTJ MAL PRST8 MAG FLD NDCT,,,2453.0,4602.0,6
CPT,0740T,REM AUTON ALG NSLN CAL SETUP,,,60.36,62.17,15
CPT,0741T,REM AUTON ALG NSLN DATA COLL,,,37.89,39.03,15
CPT,0743T,B1 STR & FX RSK VRT FX ASSMT,,,245.64,253.0,15
CPT,0744T,INSJ BIOPROSTC VLV FEM VN,,,5493.27,17804.0,22
CPT,0745T,CAR ABLT RAD ARR N-INVAS LOC,,,2453.0,4602.0,6
CPT,0746T,CAR ABLT RAD ARR CNV LOC MAP,,,2453.0,4602.0,6
CPT,0747T,CAR ABLT RAD ARRHYT DLVR RAD,,,2453.0,4602.0,6
CPT,0748T,NJX STM CL PRDCT ANL SFT TIS,,,2453.0,4602.0,6
CPT,0764T,ASSTV ALG ECG RSK ASMT CNCRT,,,130.99,134.92,15
CPT,0765T,ASSTV ALG ECG RSK ASMT PREV,,,130.99,134.92,15
CPT,0766T,TC MAG STIMJ PN 1ST NERVE,,,316.44,325.94,15
CPT,0775T,OP Surgery - Grouper Table,,,24394.0,24394.0,1
CPT,0778T,SMMG CNCRNT APPL IMU SNR,,,158.99,163.76,15
CPT,0779T,GI MYOELECTRICAL ACTV STUDY,,,539.2,555.37,15
CPT,0780T,HC INSTILLATION OF FECAL MICROBIOTA SSP VIA RECTAL ENEMA INTO LWR GI TRACT,1966.5,1081.58,130.99,4258.0,53
CPT,0781T,BRNCHSC RF DSTRJ PULM NRV BI,,,2453.0,17386.0,7
CPT,0782T,BRNCHSC RF DSTRJ PLM NRV UNI,,,2453.0,17386.0,7
CPT,0783T,"HC TRANSCUTANEOUS AURICULAR NEUROSTIM, SETUP, CALIBRATION & PT EDU OF EQUIP",1571.0,864.05,158.99,1358.92,53
CPT,0784T,INS/RPLMT ELTRD RA SPI NSTIM,,,12463.0,21512.0,22
CPT,0785T,REVJ/RMVL NEA SPI W/NSTIM,,,3494.72,14658.0,22
CPT,0786T,INSJ/RPLCMT PRQ RA SAC NSTIM,,,12463.0,21512.0,7
CPT,0787T,REVJ/RMVL NEA SAC W/NSTIM,,,3494.72,14658.0,22
CPT,0788T,ELEC ALY SMP IINS SP/SAC NRV,,,93.28,96.08,15
CPT,0789T,ELEC ALY CPX IINS SP/SAC NRV,,,93.28,96.08,15
CPT,0790T,REVJ RPLCMT/RMVL VRT TETHRG,,,2453.0,18485.0,7
CPT,0793T,PRQ TCAT THRM ABLT NRV P-ART,,,12463.0,24394.0,22
CPT,0794T,PT SPEC ALG RX-ONC TX OPTION,,,60.36,3533.0,23
CPT,0795T,"HC TRANSCATH INSERT/REPLC PERM LEADLESS PMK, R ATRIAL/R VENTR, IMG GUID-DEV EVAL",48450.5,26647.78,12463.0,41909.68,53
CPT,0796T,TCAT INS 2CHMBR LDLS PM RA,,,12463.0,24394.0,22
CPT,0797T,TCAT INS 2CHMBR LDLS PM RV,,,12463.0,24394.0,22
CPT,0798T,TCAT RMV 2CHMBR LDLS PM CMPL,,,3198.49,14658.0,22
CPT,0799T,TCAT RMVL 2CHMBR LDLS PM RA,,,3198.49,14658.0,22
CPT,0800T,TCAT RMVL 2CHMBR LDLS PM RV,,,3198.49,14658.0,22
CPT,0801T,TCAT RMV&RPL 2CHMBR LDLS PM,,,12463.0,24394.0,22
CPT,0802T,TCAT RMV&RPL2CHMB LDLS PM RA,,,12463.0,24394.0,22
CPT,0803T,TCAT RMV&RPL2CHMB LDLS PM RV,,,12463.0,24394.0,22
CPT,0804T,PRGRMG EVL LDLS PM 2CHMBR IP,,,37.89,39.03,15
CPT,0805T,TCAT S&IVC PRSTC VL IMPL PRQ,,,2453.0,19884.0,7
CPT,0806T,TCAT S&IVC PRSTC VL IMPL OPN,,,2453.0,19884.0,7
CPT,0807T,PULM TISS VNTJ ALYS PREV CT,,,316.44,553.78,16
CPT,0808T,PULM TISS VNTJ ALYS W/CT,,,316.44,553.78,16
CPT,0809T,OP Surgery - Grouper Table,,,24394.0,24394.0,1
CPT,0810T,SUBRTA NJX RX AGT W/VTRC,,,4258.0,16799.0,22
CPT,0811T,REM MLT DAY UROFLOW SETUP,,,130.96,134.89,15
CPT,0812T,REM MLT DAY UROFLOW DEV SPLY,,,158.99,163.76,15
CPT,0813T,EGD VOL ADJMT BARIATRIC BALO,,,952.75,6766.0,22
CPT,0814T,PRQ NJX BIOD OSTEO MATRL FEM,,,2453.0,24394.0,7
CPT,0816T,OPN INSJ/RPLCMT INS PTN SUBQ,,,12463.0,24394.0,22
CPT,0817T,OPN INSJ/RPLCMT INS PTN SUBF,,,12463.0,24394.0,22
CPT,0818T,REVJ/RMVL INS PTN SUBQ,,,3494.72,14658.0,22
CPT,0819T,REVJ/RMVL INS PTN SUBF,,,3494.72,14658.0,22
CPT,0823T,"HC TRANSCATH INSERT/REPLC PERM LEADLESS PMK, ATRIAL, IMG GUID-DEV EVAL",48450.5,26647.78,12463.0,41909.68,53
CPT,0824T,TCAT RMV 1CHMBR LDLS PM RA,,,3198.49,14658.0,22
CPT,0825T,TCAT RMV&RPL1CHMB LDLS PM RA,,,12463.0,24394.0,22
CPT,0826T,PRGRMG EVL LDLS PM 1CHMBR IP,,,37.89,39.03,15
CPT,0857T,OPTO-ACOUSTIC IMG BREAST UNI,,,108.06,189.11,16
CPT,0861T,RMVL PG WCS LV BOTH COMPNT,,,3698.26,14658.0,22
CPT,0862T,RLCJ PG WCS LV BATTERY ONLY,,,1858.86,6766.0,22
CPT,0863T,RLCJ PG WCS LV TRNSMTR ONLY,,,1858.86,6766.0,22
CPT,0864T,LOW NTSTY ESWT CORPUS CVRNSM,,,247.15,254.56,15
CPT,0865T,QUAN MRI ALYS BRN W/O DX MRI,,,245.64,253.0,15
CPT,0866T,QUAN MRI ALYS BRN W/DX MRI,,,245.64,253.0,15
CPT,0867T,TPLA B9 PRST8 HYPRPLSA>=50ML,,,5165.97,13936.0,22
CPT,0868T,HI-RES GASTRIC EP MAPPING,,,539.2,555.37,15
CPT,0869T,NJX B1 SUB MTRL HW FIXJ AUG,,,3297.17,14658.0,22
CPT,0870T,IMP SUBQ PRTL ASCTS PMP SYS,,,2453.0,24394.0,7
CPT,0871T,RPLCMT SUBQ PRTL ASCITES PMP,,,2453.0,24394.0,7
CPT,0872T,RPLCMT NDWLLG BLDR&PRTL CATH,,,2453.0,24394.0,7
CPT,0873T,REVJ SUBQ PRTL ASCT PMP SYS,,,2453.0,24394.0,7
CPT,0874T,RMVL PERTL ASCITES PMP SYS,,,2453.0,13936.0,7
CPT,0877T,AUGMNT ALYS CH CT ILD W/O CT,,,661.04,680.87,15
CPT,0878T,AUGMNT ALYS CH CT ILD W/CT,,,661.04,680.87,15
CPT,0881T,CRYOTHERAPY ORAL CAVITY,,,405.5,417.67,15
CPT,0882T,INTRAOP THER ESTIM PN UE 1ST,,,835.0,3533.0,6
CPT,0883T,INTRAOP THER ESTIM PN UE EA,,,835.0,3533.0,6
CPT,0884T,ESPHGSC FLX 1ST TNDSC DILAT,,,6049.25,10404.0,22
CPT,0885T,COLSC FLX 1ST TNDSC DILAT,,,5761.0,10404.0,22
CPT,0886T,SGMDSC FLX 1ST TNDSC DILAT,,,5761.0,10404.0,22
CPT,0888T,HISTOTRIPSY MAL RENAL TISSUE,,,16786.0,18317.53,16
CPT,0889T,PRSNLZ TRGT DVL ARHFCMRIGTBS,,,965.9,994.88,15
CPT,0890T,ARHFCMRIGTBS 1ST TX DAY,,,3811.26,3925.6,15
CPT,0891T,ARHFCMRIGTBS SBSQ TX DAY,,,3811.26,3925.6,15
CPT,0892T,ARHFCMRIGTBS SBSQ PER TX DAY,,,3811.26,3925.6,15
CPT,0893T,N-INVAS ASSMT BLD OXYGNATION,,,60.36,62.17,15
CPT,0894T,CANNULATION LIVER ALLOGRAFT,,,2453.0,16786.0,7
CPT,0895T,CONNJ LVR ALGRFT PRFU DEV 1,,,16786.0,16786.0,1
CPT,0896T,CONNJ LVR ALGRFT PRFU DEV EA,,,8363.0,8363.0,1
CPT,0897T,N-INVAS AUGMNT ARRHYT ALYS,,,1033.87,1064.89,15
CPT,0898T,N-INVAS PRST8 CANCER EST MAP,,,1033.87,1064.89,15
CPT,0901T,PLMT BONE MARROW SMPLG PORT,,,2453.0,4602.0,6
CPT,0902T,QTC NTRVL AUGMNT ALG ALY ECG,,,130.99,134.92,15
CPT,0904T,ECG ALG 12 LD RDCD TRCG ONLY,,,60.36,62.17,15
CPT,0906T,COMS THER 1ST APPL<=50 SQ CM,,,201.92,207.98,15
CPT,0908T,OPN IMP INT NSTM SYS VGS NRV,,,2453.0,24394.0,7
CPT,0909T,RPLCMT INT NSTIM SYS VGS NRV,,,2453.0,19884.0,7
CPT,0910T,RMVL INT NSTIM SYS VAGUS NRV,,,2453.0,13936.0,7
CPT,0913T,PRQ TCAT THER RX NTRAC BALO1,,,5793.88,17804.0,21
CPT,0914T,PRQ TCAT THR RX NTRC BAL SEP,,,835.0,3533.0,6
CPT,0915T,INSJ PERM CCM-D SYS PG&ELTRD,,,19979.0,34485.0,22
CPT,0916T,INSJ PERM CCM-D SYS PG ONLY,,,19979.0,34485.0,22
CPT,0917T,INSJ PERM CCM-D SYS 1 LEAD,,,8410.05,21512.0,22
CPT,0918T,INSJ PERM CCM-D SYS DUAL LD,,,8410.05,21512.0,22
CPT,0919T,RMVL PERM CCM-D SYS PG ONLY,,,3698.26,14658.0,22
CPT,0920T,RMVL PERM CCM-D SYS 1 PAC LD,,,3698.26,14658.0,22
CPT,0921T,RMVL PERM CCM-D SYS 1 DFB LD,,,3698.26,14658.0,22
CPT,0922T,RMVL PERM CCM-D SYS DUAL LD,,,3698.26,14658.0,22
CPT,0923T,RMVL&RPLCMT PERM CCM-D PG,,,19979.0,34485.0,22
CPT,0924T,RPOS PRV CCM-D TRNSVNS ELTRD,,,628.28,4955.0,22
CPT,0925T,RLCJ SKIN POCKET CCM-D PG,,,1858.86,6766.0,22
CPT,0926T,PRGRMG DEV EVAL CCM-D IP,,,37.89,39.03,15
CPT,0927T,INTERROG DEV EVAL CCM-D IP,,,37.89,39.03,15
CPT,0929T,REM INTERROG DEV CCM-D TECH,,,37.89,39.03,15
CPT,0930T,EPHYS EVAL CCM-D LD 1ST IMPL,,,1233.66,6766.0,21
CPT,0931T,EPHYS EVAL CCM-D LD SEPARATE,,,1233.66,6766.0,21
CPT,0932T,N-INVS DET HRT FAIL AUG ECHO,,,304.77,313.91,15
CPT,0933T,TCAT IMPL WRLS L ATR PRS SNR,,,3268.52,16799.0,22
CPT,0935T,CYSTO W/RNL PEL SYMP DNRVTJ,,,2453.0,4602.0,7
CPT,0941T,CYSTO FLX INS&XPNS URTL SCAF,,,2453.0,8363.0,7
CPT,0942T,CYSTO FLX RMV&RPLC URTL SCAF,,,2453.0,24394.0,7
CPT,0943T,CYSTO FLX RMVL URTL SCAFFOLD,,,2453.0,8363.0,7
CPT,0944T,HC 3D CONTOUR SIMULAJ TRGT LVR LES & MRGN MICRWV ABLT,614.0,337.7,184.2,2524.0,53
CPT,0945T,INTRAOP ASSMT ABNL TUM TISS,,,2453.0,4602.0,6
CPT,0946T,ORTHO IMPL MVMT ALYS PAIR CT,,,108.06,111.3,15
CPT,0949T,REM INTERROG DEV CCM TECH,,,37.89,39.03,15
CPT,0950T,ABLTJ B9 PRST8 TISSUE HIFU,,,9396.95,9678.86,15
CPT,0956T,PRT CRN CH CR&TUN ELT S-SCLP,,,22865.01,23550.96,15
CPT,0957T,REV S-SCLP ELTR RA RCVR&TLMT,,,1626.34,1675.13,15
CPT,0958T,RMV S-SCLP ELTR RA RCVR&TLMT,,,3297.17,3396.09,15
CPT,0959T,RMV/RPLC MAGNET COIL ASSEM,,,1646.49,1695.88,15
CPT,0960T,RPL S-SCLP ELTR RA RCVR&TLMT,,,22865.01,23550.96,15
CPT,0962T,ASSTV ALG ALYS ACOUS&ECG REC,,,130.99,134.92,15
CPT,0963T,ANOSC SBMCSL NJX BULKING AGT,,,1198.18,1234.13,15
CPT,0964T,I&CUST PREP JAW XPNSJ 1ARCH,,,3295.61,3394.48,15
CPT,0965T,I&CST PRP JW XPN DL ARCH NON,,,3295.61,3394.48,15
CPT,0966T,I&CST PRP JW XPN DL ARCH FXD,,,3295.61,3394.48,15
CPT,0967T,TRANAL INS TMP CLRC ANST DEV,,,1198.18,1234.13,15
CPT,0970T,ABLT B9 BRST TUM PERQ LSR EA,,,3891.31,6809.8,16
CPT,0971T,ABLT MAL BRST TUM PQ LSR UNI,,,3891.31,6809.8,16
CPT,0973T,SLCTV NZMTC DBRDMT T/A/L 1ST,,,406.0,418.18,15
CPT,0975T,SLCTV NZMTC DBRDMT S/N/HF 1,,,406.0,418.18,15
CPT,0977T,UPR GI BLD DETCJ SNR CAPSULE,,,952.75,981.33,15
CPT,0981T,TCAT IMPL WRLS IVC SNR,,,18247.62,18795.05,15
CPT,0982T,REM MNTR IMPL IVC SNR SET-UP,,,130.96,134.89,15
CPT,0983T,REM MNTR IMPL IVC SNR PHYS,,,37.89,39.03,15
CPT,10004,"HC CYTO W WO SM PRP, FINE NEEDLE ASPIR BIOPSY, W/O IMG GUID, EA AD LES (AD)",583.0,320.65,48.01,3533.0,53
CPT,10004,"HC FINE NEEDLE ASPIR BIOPSY, W/O IMG GUID, EA ADDL LESION (AD)",576.5,317.075,48.01,3533.0,901
CPT,10005,"HC FINE NEEDLE ASPIRATION BIOPSY, INCL US GUID, FIRST LESION",2416.0,1328.8,714.99,4955.0,795
CPT,10006,"HC FINE NEEDLE ASPIRATION BIOPSY, INCL US GUID, EA ADDL LESION (AD)",1327.5,730.125,55.09,3533.0,742
CPT,10007,FNA BX W/FLUOR GDN 1ST LES,,,1251.23,1251.23,1
CPT,10007,"HC FINE NEEDLE ASPIRATION BIOPSY, INCL FLUORO GUID, FIRST LESION",2205.5,1213.025,645.9,4955.0,212
CPT,10008,FNA BX W/FLUOR GDN EA ADDL,,,227.43,227.43,1
CPT,10008,"HC FINE NEEDLE ASPIRATION BIOPSY, INCL FLUORO GUID, EA ADDL LESION (AD)",1214.5,667.9749999999999,129.96,3533.0,212
CPT,10009,"HC FINE NEEDLE ASPIRATION BIOPSY, INCL CT GUID, FIRST LESION",5167.0,2841.8500000000004,714.99,4955.0,265
CPT,10010,"HC FINE NEEDLE ASPIRATION BIOPSY, INCL CT GUID, EA ADDL LESION (AD)",1214.5,667.9749999999999,215.97,3533.0,265
CPT,10011,"HC FINE NEEDLE ASPIRATION BIOPSY, INCL MR GUID, FIRST LESION",4830.0,2656.5,714.99,4955.0,159
CPT,10012,"HC FINE NEEDLE ASPIRATION BIOPSY, INCL MR GUID, EA ADDL LESION (AD)",1214.5,667.9749999999999,330.3,3533.0,114
CPT,10021,"HC CYTO W WO SM PRP, FINE NEEDLE ASPIR BIOPSY, W/O IMG GUID, FIRST LESION",893.0,491.15,267.9,4258.0,53
CPT,10021,"HC FINE NEEDLE ASPIR BIOPSY, W/O IMG GUID, FIRST LESION",741.5,407.825,198.0,4258.0,1007
CPT,10030,HC CATH PLACE DRAIN SOFT TISSUE W IMAG PERC,1901.0,1045.55,570.3,4955.0,371
CPT,10030,IMG GID FLU COLL DRG SFT TIS,,,1251.23,1251.23,1
CPT,10035,"HC PLACE SOFT TISSUE LOCALIZ DEVICE(S), PERC, INCL IMAG GUID, FIRST LESION",2105.0,1157.75,631.5,4955.0,265
CPT,10035,PLMT SFT TISS LOCLZJ DEV 1ST,,,1251.23,1251.23,1
CPT,10036,"HC PLACE SOFT TISSUE LOCALIZ DEVICE(S), PERC, INCL IMAG G, EA ADL LES (ADD)",984.0,541.2,263.52,3533.0,159
CPT,10036,PLMT SFT TISS LOCLZJ DEV EA,,,461.16,461.16,1
CPT,10040,HC ACNE SURG,268.5,147.675,15.0,4258.0,106
CPT,10060,"HC INCISION AND DRAINAGE OF ABSCESS, SIMPLE OR SINGLE",670.0,368.5,193.2,4258.0,1378
CPT,10061,"HC INCISION AND DRAINAGE OF ABSCESS, COMPLICATED OR MULTIPLE",868.5,477.67499999999995,253.2,4258.0,954
CPT,10080,"HC INCISION AND DRAINAGE OF PILONIDAL CYST, SIMPLE",1620.5,891.2750000000001,477.6,4955.0,265
CPT,10081,"HC INCISION AND DRAINAGE OF PILONIDAL CYST, COMPLICATED",1711.0,941.05,513.3,4955.0,53
CPT,10120,"HC INCISION AND REMOVAL FOREIGN BODY, SUBCUTANEOUS TISSUES, SIMPLE",1271.5,699.325,360.6,4258.0,742
CPT,10121,"HC INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES, COMPLICATED",5832.0,3207.6,1646.49,6766.0,159
CPT,10140,"HC INCISION AND DRAINAGE HEMATOMA, SEROMA OR FLUID COLLECTION",3454.5,1899.975,1010.7,6766.0,1060
CPT,10160,"HC PUNCTURE ASPIRATION OF ABSCESS, HEMATOMA, BULLA, OR CYST",897.0,493.35,269.1,4258.0,1060
CPT,10180,"HC INCISION AND DRAINAGE, COMPLEX, POSTOPERATIVE WOUND INFECTION",7194.0,3956.7,2158.2,9469.0,318
CPT,11000,"HC DEBRIDEMENT EXTENSIVE ECZEMATOUS/INFECTED SKIN, UP TO 10% BODY SURFACE",1185.0,651.75,355.5,4258.0,53
CPT,11001,DBRDMT ECZ/INFCT SKN EA ADDL,,,24.88,3533.0,21
CPT,11004,DBRDMT SKIN XTRNL GENT&PER,,,496.77,4602.0,22
CPT,11005,DBRDMT SKIN ABDOMINAL WALL,,,663.96,4602.0,22
CPT,11006,DBRDMT SKIN XTRNL GENT PER,,,608.5,4602.0,22
CPT,11008,RMV PRSTC MTRL/MESH ABD WALL,,,233.1,14658.0,22
CPT,11010,DEBRIDE SKIN AT FX SITE,,,714.99,4955.0,22
CPT,11011,HC DBRDMT INCLD REMVL FOREIGN MATERIAL FRACTURE &/DISLC SKN SUBQ T/M/F MUSC,2472.0,1359.6,714.99,4955.0,106
CPT,11012,HC DEBRIDEMENT SKIN SUBQ TISS MUSCLE BONE AT OPEN FX DISLOC SITE,5363.0,2949.65,1608.9,8363.0,53
CPT,11042,"HC DEBRIDEMENT, SUBCUTANEOUS TISSUE, FIRST 20 SQ CM OR LESS",1173.5,645.425,341.4,4258.0,689
CPT,11043,"HC DEBRIDEMENT, MUSCLE AND/OR FASCIA, FIRST 20 SQ CM OR LESS",1755.0,965.25,434.7,4258.0,371
CPT,11044,"HC DEBRIDEMENT, BONE, FIRST 20 SQ CM OR LESS",4528.5,2490.675,956.1,5761.0,424
CPT,11045,"HC DEBRIDEMENT, SUBCUTANEOUS TISSUE, EA ADDL 20 SQ CM/PART THEREOF (ADD ON)",473.0,260.15,36.12,3533.0,371
CPT,11046,"HC DEBRIDEMENT, MUSCLE AND/OR FASCIA, EA ADL 20 SQ CM, OR PART THEREOF (AD)",581.0,319.55,65.27,3533.0,159
CPT,11047,"HC DEBRIDEMENT, BONE, EA ADDL 20 SQ CM, OR PART THEREOF (ADD ON)",2122.0,1167.1,107.79,3533.0,106
CPT,11055,"HC PARING/CUTTING BENIGN HYPERKERATOTIC LESION, SINGLE LESION",257.0,141.35,77.1,4258.0,265
CPT,11056,"HC PARING/CUTTING BENIGN HYPERKERATOTIC LESION, 2-4 LESIONS",393.0,216.15,117.9,4258.0,212
CPT,11057,"HC PARING/CUTTING BENIGN HYPERKERATOTIC LESION, MORE THAN 4 LESIONS",559.0,307.45,167.7,4258.0,106
CPT,11102,"HC TANGENTIAL BIOPSY SKIN, SINGLE LESION",541.0,297.55,162.3,4258.0,954
CPT,11103,"HC TANGENTIAL BIOPSY SKIN, EA SEPARATE/ADDL LESION (AD)",329.5,181.22500000000002,45.53,3533.0,848
CPT,11104,"HC PUNCH BIOPSY SKIN, SINGLE LESION",807.0,443.85,213.6,4258.0,1219
CPT,11105,"HC PUNCH BIOPSY SKIN, EA SEPARATE/ADDL LESION (AD)",386.0,212.3,54.51,3533.0,954
CPT,11106,"HC INCISIONAL BIOPSY SKIN, SINGLE LESION",1225.0,673.75,332.7,4955.0,1007
CPT,11107,"HC INCISIONAL BIOPSY SKIN, EA SEPARATE/ADDL LESION (AD)",1027.0,564.8499999999999,64.54,3533.0,848
CPT,11200,"HC REM SKIN TAGS, UP TO AND INCLUDING 15 LESIONS",342.0,188.1,15.0,4258.0,1219
CPT,11201,"HC REM SKIN TAGS, EA ADDITIONAL 10 LESIONS, OR PART THEREOF (ADD ON CODE)",223.0,122.65,16.82,3533.0,212
CPT,11300,"HC SHAVE EPIDERM/DERM LES, SGL LES, TRNK, ARMS, LEGS, DIAM 0.5 CM OR LESS",970.0,533.5,291.0,4258.0,159
CPT,11301,"HC SHAVE EPIDERM/DERM LES, SGL LES, TRNK, ARMS, LEGS, DIAM 0.6-1.0 CM",487.0,267.85,146.1,4258.0,106
CPT,11302,"HC SHAVE EPIDERM/DERM LES, SGL LES, TRNK, ARMS, LEGS, DIAM 1.1-2.0 CM",487.0,267.85,146.1,4258.0,106
CPT,11303,"HC SHAVE SKIN LESION TRUNK ARM LEG, OVER 2.0 CM",970.0,533.5,291.0,4258.0,53
CPT,11305,"HC SHAVE EPIDERM/DERM LES, SGL LES, SCLP, NK, HND, FT, DIAM 0.5 CM/LESS",487.0,267.85,146.1,4258.0,106
CPT,11306,HC SHAVE SKIN LESN SCLP NCK EXTREMITIES 0.6-1.0 CM,487.0,267.85,146.1,4258.0,106
CPT,11307,HC SHAVE SKIN LESN SCLP NCK EXTREMITIES 1.1-2.0 CM,487.0,267.85,146.1,4258.0,106
CPT,11308,SHAVE SKIN LESION >2.0 CM,,,406.0,4258.0,22
CPT,11310,"HC SHAVE EPIDERM/DERM LES, SGL LES, FACE, EARS, MUC MEMBR, DIAM 0.5 CM/LESS",512.0,281.6,153.6,4258.0,212
CPT,11311,"HC SHAVE EPIDERM/DERM LES, SGL LES, FACE, EARS, MUC MEMBR, DIAM 0.6-1.0 CM",487.0,267.85,146.1,4258.0,106
CPT,11312,HC SHAVE SKIN LESION FACE 1.1-2.0 CM,970.0,533.5,291.0,4258.0,106
CPT,11313,SHAVE SKIN LESION >2.0 CM,,,406.0,4258.0,22
CPT,11400,"HC EXC, BEN LES INCL MARG, EXCPT SKN TG, TRNK ARMS LGS, DIA 0.5 CM OR LESS",1357.0,746.3499999999999,380.4,4955.0,530
CPT,11401,"HC EXC, BEN LES INCL MARG, EXCPT SKN TG, TRNK ARMS LGS, DIA 0.6-1.0 CM",1268.0,697.4,272.7,4258.0,795
CPT,11402,"HC EXC, BEN LES INCL MARG, EXCPT SKN TG, TRNK ARMS LGS, DIA 1.1-2.0 CM",1445.5,795.0250000000001,377.1,4955.0,477
CPT,11403,"HC EXC, BEN LES INCL MARG, EXCPT SKN TG, TRNK ARMS LGS, DIA 2.1-3.0 CM",2069.5,1138.225,513.3,4955.0,583
CPT,11404,"HC EXC, BEN LES INCL MARG, EXCPT SKN TG, TRNK ARMS LGS, DIA 3.1-4.0 CM",4050.5,2227.7749999999996,1182.6,6766.0,477
CPT,11406,"HC EXC, BEN LES INCL MARG, EXCPT SKN TG, TRNK ARMS LGS, DIA OVER 4.0 CM",4140.5,2277.2749999999996,1182.6,6766.0,265
CPT,11420,"HC EXC, BEN LES INCL MARG, EXCPT SKN TG, SCLP NK HND FT GEN, DIA 0.5CM/LESS",2560.5,1408.275,668.7,5761.0,583
CPT,11421,"HC EXC, BEN LES INCL MARG, EXCPT SKN TG, SCLP NK HND FT GEN, DIA 0.6-1.0 CM",2396.5,1318.075,682.2,4955.0,689
CPT,11422,"HC EXC, BEN LES INCL MARG, EXCPT SKN TG, SCLP NK HND FT GEN, DIA 1.1-2.0 CM",3161.0,1738.55,948.3,5761.0,477
CPT,11423,"HC EXC, BEN LES INCL MARG, EXCPT SKN TG, SCLP NK HND FT GEN, DIA 2.1-3.0 CM",4180.5,2299.275,1239.3,6766.0,424
CPT,11424,"HC EXC, BEN LES INCL MARG, EXCPT SKN TG, SCLP NK HND FT GEN, DIA 3.1-4.0 CM",4515.0,2483.25,1354.5,6766.0,265
CPT,11426,"HC EXC, BEN LES INCL MARG, EXCPT SKN TG, SCLP NK HND FT GEN, DIA OVR 4.0 CM",7977.5,4387.625,2187.3,9469.0,530
CPT,11440,"HC EXC BEN LES INCL MARG, EXCPT SKN TAG, FACE, EARS, DIAM 0.5 CM/LESS",1747.0,960.8499999999999,477.9,4955.0,477
CPT,11441,"HC EXC BEN LES INCL MARG, EXCPT SKN TAG, FACE, EARS, DIAM 0.6-1.0 CM",2070.0,1138.5,540.0,4955.0,424
CPT,11442,HC EXC BENIGN LESION INCL MARGIN FACE 1.1-2.0 CM,2005.0,1102.75,601.5,4955.0,371
CPT,11443,HC EXC BENIGN LESION INCL MARGIN FACE 2.1-3.0 CM,4200.0,2310.0,1260.0,5761.0,212
CPT,11444,HC EXC BENIGN LESION INCL MARGIN FACE 3.1-4.0 CM,4515.0,2483.25,1354.5,5761.0,159
CPT,11446,"HC EXC BENIGN LESION INCL MARGIN FACE, DIAM OVER 4.0 CM",6909.0,3799.95,2072.7,9469.0,159
CPT,11450,HC EXC SKIN SUBQ TISS HIDRADENITIS AXILLARY SIMPL-INTERMED REPR,6909.0,3799.95,2072.7,9469.0,53
CPT,11451,HC EXC OF SKIN AND SUBQ TISSUE FOR HIDRADENITIS AXILLARY W/ COMPLEX REPAIR,6909.0,3799.95,2072.7,9469.0,53
CPT,11462,EXC SKN HDRDNT ING SMPL/NTRM,,,2908.42,9469.0,22
CPT,11463,EXC SKN HDRDNT ING COMPLEX,,,2908.42,9469.0,22
CPT,11470,EXC SKN H/P/P/U SMPL/NTRM,,,2908.42,9469.0,22
CPT,11471,"HC EXCISION SKIN AND SUBCUT TISSUE FOR HIDRADENITIS, COMPLEX REPAIR",6909.0,3799.95,2072.7,9469.0,106
CPT,11600,"HC EXC, MALG LES INCL MARG, TRUNK, ARMS/LEGS, DIA 0.5 CM/LESS",1279.0,703.45,333.6,4955.0,477
CPT,11601,"HC EXC, MALG LES INCL MARG, TRUNK, ARMS/LEGS, DIA 0.6-1.0 CM",1445.5,795.0250000000001,377.1,4955.0,477
CPT,11602,"HC EXC, MALG LES INCL MARG, TRUNK, ARMS/LEGS, DIA 1.1-2.0 CM",1602.0,881.0999999999999,390.9,4258.0,477
CPT,11603,"HC EXC, MALG LES INCL MARG, TRUNK, ARMS/LEGS, DIA 2.1-3.0 CM",1821.0,1001.55,441.6,4955.0,477
CPT,11604,"HC EXC, MALG LES INCL MARG, TRUNK, ARMS/LEGS, DIA 3.1-4.0 CM",1983.0,1090.65,454.2,4955.0,477
CPT,11606,"HC EXC, MALG LES INCL MARG, TRUNK, ARMS/LEGS, DIA OVER 4.0 CM",3892.75,2141.015,1046.55,6766.0,318
CPT,11620,"HC EXC, MALG LES INCL MARG, SCALP, NECK, HANDS, FT, GENIT, DIA 0.5 CM/LESS",2125.5,1169.025,543.3,5761.0,371
CPT,11621,"HC EXC, MALG LES INCL MARG, SCALP, NECK, HANDS, FT, GENIT, DIA 0.6-1.0 CM",2207.5,1214.125,513.3,4955.0,371
CPT,11622,"HC EXC, MALG LES INCL MARG, SCALP, NECK, HANDS, FT, GENIT, DIA 1.1-2.0 CM",2826.5,1554.5749999999998,513.3,4955.0,371
CPT,11623,"HC EXC, MALG LES INCL MARG, SCALP, NECK, HANDS, FT, GENIT, DIA 2.1-3.0 CM",3931.75,2162.465,1046.55,5761.0,371
CPT,11624,"HC EXC, MALG LES INCL MARG, SCALP, NECK, HANDS, FT, GENIT, DIA 3.1-4.0 CM",4319.75,2375.8650000000002,1046.55,6766.0,424
CPT,11626,"HC EXC, MALG LES INCL MARG, SCALP, NECK, HANDS, FT, GENIT, DIA OVER 4.0 CM",6114.0,3362.7,1834.2,9469.0,159
CPT,11640,"HC EXC, MALG LES INCL MARG, FACE, EARS, EYLDS, NOSE, LIPS, DIA 0.5 CM/LESS",1680.0,924.0,437.7,4955.0,371
CPT,11641,"HC EXC, MALG LES INCL MARG, FACE, EARS, EYLDS, NOSE, LIPS, DIA 0.6-1.0 CM",1890.0,1039.5,494.7,4955.0,371
CPT,11642,"HC EXC, MALG LES INCL MARG, FACE, EARS, EYLDS, NOSE, LIPS, DIA 1.1-2.0 CM",2371.0,1304.05,498.6,4955.0,424
CPT,11643,"HC EXC, MALG LES INCL MARG, FACE, EARS, EYLDS, NOSE, LIPS, DIA 2.1-3.0 CM",3086.0,1697.3000000000002,902.7,5761.0,371
CPT,11644,"HC EXC, MALG LES INCL MARG, FACE, EARS, EYLDS, NOSE, LIPS, DIA 3.1-4.0 CM",4055.75,2230.665,1046.55,6766.0,265
CPT,11646,"HC EXC, MALG LES INCL MARG, FACE, EARS, EYLDS, NOSE, LIPS, DIA OVER 4.0 CM",6114.0,3362.7,1834.2,9469.0,159
CPT,11719,"HC TRIM NONDYSTROPHIC NAILS, ANY NUMBER",233.0,128.15,60.36,4258.0,265
CPT,11720,"HC DEBRIDEMENT OF NAIL(S) BY ANY METHOD, 1-5",213.0,117.15,60.36,4258.0,212
CPT,11721,"HC DEBRIDEMENT OF NAIL(S) BY ANY METHOD, 6 OR MORE",212.0,116.6,60.36,4258.0,159
CPT,11730,"HC AVULSION NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE, SINGLE",636.0,349.8,190.8,4258.0,212
CPT,11732,"HC AVULSION NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE, EA ADDL (ADD ON CODE)",231.0,127.05,30.26,3533.0,106
CPT,11740,HC EVACUATION SUBUNGUAL HEMATOMA,277.0,152.35,83.1,4258.0,106
CPT,11750,"HC EXCISION NAIL AND NAIL MATRIX, PARTIAL/COMPLETE, FOR PERMANENT REMOVAL",1603.0,881.65,406.0,4258.0,106
CPT,11755,HC BIOPSY NAIL UNIT,1711.0,941.05,513.3,4955.0,53
CPT,11760,HC REPAIR NAIL BED,1449.0,796.95,434.7,4258.0,106
CPT,11762,HC RECONSTRUCTION OF NAIL BED WITH GRAFT,4927.0,2709.85,1478.1,6766.0,53
CPT,11765,HC WEDGE EXCISION SKIN OF NAIL FOLD,970.0,533.5,291.0,4258.0,106
CPT,11770,"HC EXCISION OF PILONIDAL CYST OR SINUS, SIMPLE",6909.0,3799.95,2072.7,9469.0,53
CPT,11771,"HC EXC OF PILONIDAL CYST OR SINUS, EXTENSIVE",6909.0,3799.95,2072.7,9469.0,53
CPT,11772,"HC EXC OF PILONIDAL CYST OR SINUS, COMPLICATED",6909.0,3799.95,2072.7,9469.0,53
CPT,11900,"HC INJECTION, INTRALESIONAL, UP TO AND INCLUDING 7 LESIONS",406.5,223.575,117.9,4258.0,1060
CPT,11901,"HC INJECTION, INTRALESIONAL, MORE THAN 7 LESIONS",441.0,242.55,130.8,4258.0,424
CPT,11920,CORRECT SKIN COLOR 6.0 CM/<,,,622.05,4258.0,22
CPT,11921,CORRECT SKN COLOR 6.1-20.0CM,,,622.05,4258.0,22
CPT,11922,CORRECT SKIN COLOR EA 20.0CM,,,56.02,3533.0,21
CPT,11950,SUBQ NJX FILLING MATRL 1CC/<,,,201.92,4258.0,22
CPT,11951,SUBQ NJX FIL MATRL 1.1-5.0CC,,,622.05,4258.0,22
CPT,11952,SUBQ NJX FIL MATRL 5.1-10CC,,,622.05,4258.0,22
CPT,11954,SUBQ NJX FIL MATRL>10.0 CC,,,622.05,4955.0,22
CPT,11960,INSERT TISSUE EXPANDER(S),,,3720.28,14658.0,22
CPT,11970,RPLCMT TISS XPNDR PERM IMPLT,,,7259.46,18485.0,22
CPT,11971,HC REMOVE TISSUE EXPANDER(S) W/O INSERTION OF IMPLANT,7247.0,3985.85,2174.1,9469.0,53
CPT,11976,"HC REMOVAL, IMPLANTABLE CONTRACEPTIVE CAPSULES",2033.0,1118.15,609.9,4955.0,265
CPT,11980,HC IMPLANT HORMONE PELLET(S),969.0,532.95,290.7,4258.0,212
CPT,11981,"HC INSERTION, DRUG-DELIVERY IMPLANT",375.0,206.25,94.5,4258.0,371
CPT,11982,"HC REMOVAL, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT",1198.0,658.9,358.5,4258.0,424
CPT,11983,"HC REMOVAL, W/ REINSERTION, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT",1196.5,658.075,357.6,4258.0,212
CPT,12001,HC SIM REPR SUPRF WND SCLP NK AX GENIT TRNK/EXTRM (INCL HND FT) 2.5 CM/LESS,803.0,441.65,201.92,4258.0,318
CPT,12002,HC SIM REPR SUPRF WND SCLP NK AX GENIT TRNK/EXTRM (INCL HND FT) 2.6-7.5 CM,880.0,484.0,201.92,4258.0,159
CPT,12004,HC SIM REPR SUPRF WND SCLP NK AX GENIT TRNK/EXTRM (INCL HND FT) 7.6-12.5 CM,924.0,508.2,201.92,4258.0,106
CPT,12005,HC SIM REPR SUPRF WND SCLP NK AX GENIT TRNK/EXTRM (INCL HND FT) 12.6-20.0CM,1070.0,588.5,321.0,4258.0,106
CPT,12006,HC SIM REPR SUPRF WND SCLP NK AX GENIT TRNK/EXTRM (INCL HND FT) 20.1-30.0CM,1251.0,688.05,375.3,4258.0,106
CPT,12007,HC SIM REPR SUPRF WND SCLP NK AX GENIT TRNK/EXTRM (INCL HND FT) OVR 30.0 CM,1414.0,777.7,201.92,4258.0,106
CPT,12011,"HC SIM REPR SUPRF WND FACE, EARS, EYLDS, NOSE, LIPS/MUC MEMB, 2.5 CM/LESS",853.0,469.15,201.92,4258.0,371
CPT,12013,"HC SIM REPR SUPRF WND FACE, EARS, EYLDS, NOSE, LIPS/MUC MEMB, 2.6-5.0 CM",827.0,454.85,201.92,4258.0,159
CPT,12014,"HC SIM REPR SUPRF WND FACE, EARS, EYLDS, NOSE, LIPS/MUC MEMB, 5.1-7.5 CM",848.0,466.4,201.92,4258.0,159
CPT,12015,"HC SIM REPR SUPRF WND FACE, EARS, EYLDS, NOSE, LIPS/MUC MEMB, 7.6-12.5 CM",925.0,508.75,201.92,4258.0,159
CPT,12016,"HC SIM REPR SUPRF WND FACE, EARS, EYLDS, NOSE, LIPS/MUC MEMB,12.6-20.0 CM",936.0,514.8,280.8,4258.0,159
CPT,12017,"HC SIMP REPR SUPFCL WNDS FACE EARS EYLDS NOSE LIPS MUC MEMB, 20.1-30.0 CM",970.0,533.5,291.0,4258.0,106
CPT,12018,"HC SIMP REPR SUPFCL WNDS FACE EARS EYLDS NOSE LIPS MUC MEMB, OVER 30.0 CM",1000.0,550.0,201.92,4258.0,159
CPT,12020,"HC TREATMENT OF SUPERFICIAL WOUND DEHISCENCE, SIMPLE CLOSURE",1380.0,759.0,414.0,4258.0,265
CPT,12021,"HC TREATMENT SUPERFICIAL WOUND DEHISCENCE, WITH PACKING",1086.0,597.3,325.8,4258.0,477
CPT,12031,"HC REPR, INTERM, WND SCALP, AX, TRUNK/EXTREM (EXCL HND FT), 2.5 CM/LESS",895.0,492.25,221.4,4258.0,530
CPT,12032,"HC REPR, INTERM, WND SCALP, AX, TRUNK/EXTREM (EXCL HND FT), 2.6-7.5 CM",985.25,541.89,268.05,4258.0,583
CPT,12034,"HC REPR, INTERM, WND SCALP, AX, TRUNK/EXTREM (EXCL HND FT), 7.6-12.5 CM",1149.5,632.225,301.2,4258.0,371
CPT,12035,"HC REPR, INTERM, WND SCALP, AX, TRUNK/EXTREM (EXCL HND FT), 12.6-20.0 CM",1289.5,709.2249999999999,334.8,4258.0,371
CPT,12036,"HC REPR, INTERM, WND SCALP, AX, TRUNK/EXTREM (EXCL HND FT), 20.1-30.0 CM",1942.5,1068.375,547.2,4258.0,371
CPT,12037,"HC REPR, INTERM, WND SCALP, AX, TRUNK/EXTREM (EXCL HND FT), OVER 30.0 CM",5865.5,3226.025,1579.8,6766.0,371
CPT,12041,"HC REPR, INTERM, WND NECK, HANDS, FEET/GENIT, 2.5 CM/LESS",713.0,392.15,209.7,4258.0,371
CPT,12042,"HC REPR, INTERM, WND NECK, HANDS, FEET/GENIT, 2.6 -7.5 CM",1070.0,588.5,307.5,4258.0,265
CPT,12044,"HC REPR, INTERM, WND NECK, HANDS, FEET/GENIT,7.6-12.5 CM",1208.5,664.675,347.1,4258.0,265
CPT,12045,"HC REPR, INTERM, WND NECK, HANDS, FEET/GENIT, 12.6-20.0 CM",1598.5,879.175,450.3,4258.0,265
CPT,12046,"HC REPR, INTERM, WND NECK, HANDS, FEET/GENIT, 20.1-30.0 CM",1708.0,939.4,508.8,4955.0,265
CPT,12047,"HC REPR, INTERM, WND NECK, HANDS, FEET/GENIT, OVER 30.0 CM",5009.5,2755.225,1478.1,6766.0,265
CPT,12051,"HC REPR, INTERM, WND FACE, EARS, EYLDS, NOSE, LIPS/MUC MEMBR, 2.5 CM/LESS",910.5,500.77500000000003,230.1,4258.0,371
CPT,12052,"HC REPR, INTERM, WND FACE, EARS, EYLDS, NOSE, LIPS/MUC MEMBR, 2.6-5.0 CM",954.0,524.7,240.3,4258.0,371
CPT,12053,"HC REPR, INTERM, WND FACE, EARS, EYLDS, NOSE, LIPS/MUC MEMBR, 5.1-7.5 CM",1043.0,573.6500000000001,302.7,4258.0,371
CPT,12054,"HC REPR, INTERM, WND FACE, EARS, EYLDS, NOSE, LIPS/MUC MEMBR, 7.6-12.5 CM",1121.0,616.55,334.2,4258.0,265
CPT,12055,"HC REPR, INTERM, WND FACE, EARS, EYLDS, NOSE, LIPS/MUC MEMBR, 12.6-20.0 CM",1252.0,688.6,375.6,4258.0,265
CPT,12056,"HC REPR, INTERM, WND FACE, EARS, EYLDS, NOSE, LIPS/MUC MEMBR, 20.1-30.0 CM",1155.0,635.25,303.0,4258.0,265
CPT,12057,"HC REPR, INTERM, WND FACE, EARS, EYLDS, NOSE, LIPS/MUC MEMBR, OVER 30.0 CM",1316.5,724.075,384.9,4258.0,265
CPT,13100,"HC REPR, COMPLX, TRUNK, 1.1-2.5 CM",1696.0,932.8,508.8,4258.0,318
CPT,13101,"HC REPR, COMPLX, TRUNK, 2.6 CM TO 7.5 CM",1672.5,919.875,494.7,4258.0,318
CPT,13102,"HC REPR, COMPLX, TRUNK, EA ADL 5 CM/LESS (AD)",1336.5,735.075,105.09,3533.0,318
CPT,13120,"HC REPR, COMPLX, SCALP, ARMS/LEGS, 1.1-2.5 CM",1380.0,759.0,414.0,4258.0,318
CPT,13121,"HC REPR, COMPLX, SCALP, ARMS/LEGS 2.6-7.5 CM",1660.0,913.0,487.2,4258.0,318
CPT,13122,"HC REPR, COMPLX, SCALP, ARMS/LEGS, EA ADL 5 CM/LESS (AD)",337.5,185.625,96.0,3533.0,318
CPT,13131,"HC REPR, COMPLX, FOREHD, FACE, NK, AX, GENIT, HND/FT, 1.1-2.5 CM",1363.0,749.6500000000001,383.1,4258.0,318
CPT,13132,"HC REPR, COMPLX, FOREHD, FACE, NK, AX, GENIT, HND/FT, 2.6-7.5 CM",1667.0,916.8499999999999,491.4,4258.0,318
CPT,13133,"HC REPR, COMPLX, FOREHD, FACE, NK, AX, GENIT, HND/FT, EA ADL 5 CM/LESS (AD)",1037.5,570.625,153.08,3533.0,318
CPT,13151,"HC REPR, COMPLX, EYELID, NOSE, EARS/LIPS, 1.1-2.5 CM",1245.0,684.75,333.0,4258.0,265
CPT,13152,"HC REPR, COMPLX, EYELID, NOSE, EARS/LIPS, 2.6-7.5 CM",1749.5,962.2249999999999,498.9,4258.0,265
CPT,13153,"HC REPR, COMPLX, EYELID, NOSE, EARS/LIPS, EA ADL 5 CM/LESS (AD)",974.5,535.975,167.73,3533.0,265
CPT,13160,HC SECONDARY CLOSURE SURG WND DEHISCENCE COMPLX,5658.0,3111.9,1697.4,6766.0,318
CPT,14000,TIS TRNFR TRUNK 10 SQ CM/<,,,1858.86,6766.0,22
CPT,14001,TIS TRNFR TRUNK 10.1-30SQCM,,,1858.86,6766.0,22
CPT,14020,TIS TRNFR S/A/L 10 SQ CM/<,,,1858.86,6766.0,22
CPT,14021,TIS TRNFR S/A/L 10.1-30 SQCM,,,1858.86,6766.0,22
CPT,14040,"HC ADJCNT TIS TRNSFR/REARR, FOREHD FACE NECK AX GENIT HND/FT, 10 SQ CM/LESS",5222.0,2872.1,1566.6,6766.0,53
CPT,14041,TIS TRNFR F/C/C/M/N/A/G/H/F,,,1858.86,6766.0,22
CPT,14060,"HC ADJCNT TIS TRNSFR/REARR, EYELIDS, NOSE EARS/LIPS, 10 SQ CM/LESS",3537.0,1945.35,1061.1,6766.0,106
CPT,14061,TIS TRNFR E/N/E/L10.1-30SQCM,,,1858.86,6766.0,22
CPT,14301,TIS TRNFR ANY 30.1-60 SQ CM,,,3720.28,14658.0,22
CPT,14302,TIS TRNFR ADDL 30 SQ CM,,,190.87,3533.0,21
CPT,14350,FILLETED FINGER/TOE FLAP,,,1858.86,6766.0,22
CPT,15002,WOUND PREP TRK/ARM/LEG,,,1858.86,6766.0,22
CPT,15003,WOUND PREP ADDL 100 CM,,,61.44,3533.0,21
CPT,15004,WOUND PREP F/N/HF/G,,,622.05,4258.0,22
CPT,15005,WND PREP F/N/HF/G ADDL CM,,,103.69,3533.0,21
CPT,15011,HRV SKN CLL SSP AGRFT 1ST 25,,,1858.86,6766.0,22
CPT,15012,HRV SKN CLL SSP AGRFT EA ADD,,,835.0,3533.0,6
CPT,15013,PREPJ SKN CLL SSP AGRFT 1ST,,,4258.0,17804.0,22
CPT,15014,PREPJ SKN CLL SSP AGRFT EA,,,835.0,3533.0,6
CPT,15015,APP SKN CL SSP AGRFT T/A/L 1,,,1858.86,6766.0,22
CPT,15016,APP SKN CL SSP AGRF T/A/L EA,,,835.0,3533.0,6
CPT,15017,APP SKN CLL SSP F/N/G/HF 1ST,,,1858.86,6766.0,22
CPT,15018,APP SKN CLL SSP F/N/G/HF EA,,,835.0,3533.0,6
CPT,15040,HARVEST CULTURED SKIN GRAFT,,,1858.86,6766.0,22
CPT,15050,PINCH GRAFT UP TO 2 CM DIAM,,,622.05,4258.0,22
CPT,15100,SPLT AGRFT T/A/L 1ST 100SQCM,,,1858.86,6766.0,22
CPT,15101,SPLT AGRFT T/A/L EA ADDL 100,,,165.37,3533.0,21
CPT,15110,EPIDRM AGRFT T/A/L 1ST 100,,,1858.86,6766.0,22
CPT,15111,EPIDRM AGRFT T/A/L EA ADDL,,,100.04,3533.0,21
CPT,15115,EPDRM AGRFT F/S/N/H/F/G/M 1,,,1858.86,6766.0,22
CPT,15116,EPDRM AGRFT F/S/N/H/F/G/M EA,,,135.15,3533.0,21
CPT,15120,SPLT AGRFT F/S/N/H/F/G/M 1ST,,,3720.28,14658.0,22
CPT,15121,SPLT AGRFT F/S/N/H/F/G/M EA,,,184.65,3533.0,21
CPT,15130,DRM AGRFT T/A/L 1ST 100 SQCM,,,1858.86,9469.0,22
CPT,15131,DRM AGRFT T/A/L EA ADDL,,,87.74,3533.0,21
CPT,15135,"HC DERM AUTGRFT, FACE SCALP NECK GENIT HAND FT MULT DIG, 1ST 100 SQCM/LESS",6939.0,3816.45,2081.7,14658.0,53
CPT,15136,DRM AGRFT F/S/N/H/F/G/M EA,,,86.5,3533.0,21
CPT,15150,TIS CLTR SKN AGRFT T/A/L 1ST,,,1858.86,6766.0,22
CPT,15151,TIS CLTR SKN AGRFT T/A/L ADD,,,102.97,3533.0,21
CPT,15152,TIS CLTR SKN AGRFT T/A/L EA,,,135.96,3533.0,21
CPT,15155,TIS CLTR AGRFT F/S/N/H/F/G 1,,,3720.28,14658.0,22
CPT,15156,TIS CLT AGRFT F/S/N/H/F/G AD,,,138.04,3533.0,21
CPT,15157,TIS CLT AGRFT F/S/N/H/F/G EA,,,153.88,3533.0,21
CPT,15200,FTH/GFT FR TRNK 20 SQ CM/<,,,1858.86,9469.0,22
CPT,15201,FTH/GFT FR TRNK EACH ADDL,,,125.24,3533.0,21
CPT,15220,FTH/GFT FR S/A/L 20 SQ CM/<,,,1858.86,6766.0,22
CPT,15221,FTH/GFT FR S/A/L EACH ADDL,,,115.34,3533.0,21
CPT,15240,"HC FULL THICK GRAFT, FOREHD FACE NECK AX GENIT HND/FT, 20 SQ CM/LESS",4434.0,2438.7,1330.2,6766.0,53
CPT,15241,FTH/GFT F/C/C/M/N/A/G/H/F EA,,,157.06,3533.0,21
CPT,15260,FTH/GFT FR N/E/E/L 20 SQCM/<,,,1858.86,6766.0,22
CPT,15261,FTH/GFT FR N/E/E/L EACH ADDL,,,185.56,3533.0,21
CPT,15271,"HC APL HI SK SUB GFT TK AR LG, TOT WND SA UP TO 100 SQCM, 1ST 25 SQCM/LESS",4399.0,2419.45,1319.7,6766.0,159
CPT,15272,"HC APL HI SK SUB GFT TK AR LG, TOT WND SA UP TO 100 SQCM, EA AD 25 SQCM(AD)",246.0,135.3,22.25,3533.0,159
CPT,15273,"HC APL HI SK SUB GFT TK AR LG, TOT WND SA GR THN/EQ 100 SQCM, 1ST 100 SQCM",7251.0,3988.05,2175.3,14658.0,106
CPT,15274,"HC APL HI SK SUB GFT TK AR LG, TOT WND SA GR THN/EQ 100SQCM, EA AD100SQ(AD)",870.0,478.5,71.55,3533.0,106
CPT,15275,"HC APL HI SK SUB GFT FC EXTR, TOT WND SA UP TO 100 SQCM, 1ST 25 SQCM/LESS",4511.5,2481.325,1346.1,6766.0,265
CPT,15276,"HC APL HI SK SUB GFT FC EXTR, TOT WND SA UP TO 100 SQCM, EA AD 25 SQCM (AD)",246.0,135.3,29.82,3533.0,106
CPT,15277,"HC APL HI SK SUB GFT FC EXTR, TOT WND SA GR THN/EQ 100 SQCM, 1ST 100 SQCM",5285.0,2906.75,1585.5,6766.0,106
CPT,15278,"HC APL HI SK SUB GFT FC EXTR, TOT WND SA GR THN/EQ 100SQCM, EA AD 100SQ(AD)",870.0,478.5,84.43,3533.0,106
CPT,15570,SKIN PEDICLE FLAP TRUNK,,,1858.86,6766.0,22
CPT,15572,SKIN PEDICLE FLAP ARMS/LEGS,,,3720.28,14658.0,22
CPT,15574,PEDCLE FH/CH/CH/M/N/AX/G/H/F,,,1858.86,6766.0,22
CPT,15576,PEDICLE E/N/E/L/NTRORAL,,,1858.86,6766.0,22
CPT,15600,DELAY FLAP TRUNK,,,3720.28,14658.0,22
CPT,15610,DELAY FLAP ARMS/LEGS,,,1858.86,9469.0,22
CPT,15620,DELAY FLAP F/C/C/N/AX/G/H/F,,,1858.86,6766.0,22
CPT,15630,DELAY FLAP EYE/NOS/EAR/LIP,,,1858.86,6766.0,22
CPT,15650,TRANSFER SKIN PEDICLE FLAP,,,1858.86,6766.0,22
CPT,15730,MDFC FLAP W/PRSRV VASC PEDCL,,,3720.28,14658.0,22
CPT,15731,FOREHEAD FLAP W/VASC PEDICLE,,,3720.28,14658.0,22
CPT,15733,MUSC MYOQ/FSCQ FLP H&N PEDCL,,,3720.28,14658.0,22
CPT,15734,MUSCLE-SKIN GRAFT TRUNK,,,3720.28,14658.0,22
CPT,15736,"HC MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; UPPER EXTREMITY",6609.0,3634.95,1858.86,6766.0,106
CPT,15738,"HC MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; LOWER EXTREMITY",11620.0,6391.0,3486.0,14658.0,106
CPT,15740,ISLAND PEDICLE FLAP GRAFT,,,1858.86,6766.0,22
CPT,15750,NEUROVASCULAR PEDICLE FLAP,,,3720.28,14658.0,22
CPT,15756,FREE MYO/SKIN FLAP MICROVASC,,,2049.11,9469.0,22
CPT,15757,FREE SKIN FLAP MICROVASC,,,2039.92,9469.0,22
CPT,15758,FREE FASCIAL FLAP MICROVASC,,,2032.43,9469.0,22
CPT,15760,HC COMPOSITE SKIN GRAFT,7707.0,4238.85,1858.86,6766.0,53
CPT,15769,GRFG AUTOL SOFT TISS DIR EXC,,,3720.28,14658.0,22
CPT,15770,DERMA-FAT-FASCIA GRAFT,,,3720.28,14658.0,22
CPT,15771,GRFG AUTOL FAT LIPO 50 CC/<,,,3720.28,14658.0,22
CPT,15772,GRFG AUTOL FAT LIPO EA ADDL,,,173.61,3533.0,21
CPT,15773,GRFG AUTOL FAT LIPO 25 CC/<,,,1858.86,6766.0,22
CPT,15774,GFRG AUTOL FAT LIPO EA ADDL,,,169.35,3533.0,21
CPT,15775,HAIR TRNSPL 1-15 PUNCH GRFTS,,,406.0,4258.0,22
CPT,15776,HAIR TRNSPL >15 PUNCH GRAFTS,,,406.0,4258.0,22
CPT,15777,ACELLULAR DERM MATRIX IMPLT,,,189.84,3533.0,21
CPT,15778,IMPL ABSRB MSH/PRSTH DLY CLS,,,339.02,19884.0,22
CPT,15780,DERMABRASION TOTAL FACE,,,2908.42,9469.0,22
CPT,15781,DERMABRASION SEGMENTAL FACE,,,714.99,4955.0,22
CPT,15782,DERMABRASION OTHER THAN FACE,,,2908.42,5761.0,22
CPT,15783,DERMABRASION SUPRFL ANY SITE,,,406.0,4258.0,22
CPT,15786,ABRASION LESION SINGLE,,,201.92,4258.0,22
CPT,15787,ABRASION LESIONS ADD-ON,,,27.71,3533.0,21
CPT,15788,CHEMICAL PEEL FACIAL EPIDRM,,,406.0,4258.0,22
CPT,15789,CHEMICAL PEEL FACIAL DERMAL,,,622.05,4258.0,22
CPT,15792,CHEM PEEL NONFACIAL EPIDRM,,,622.05,4955.0,22
CPT,15793,CHEMICAL PEEL NONFACIAL DRM,,,406.0,4258.0,22
CPT,15819,OP Surgery - Grouper Table,,,5761.0,5761.0,1
CPT,15820,BLEPHAROPLASTY LOWER EYELID,,,1858.86,6766.0,22
CPT,15821,BLEPHARP LWR EYELID FAT PAD,,,1858.86,6766.0,22
CPT,15822,HC BLEPHAROPLASTY UPR EYELID,5934.0,3263.7,1780.2,6766.0,53
CPT,15823,BLEPHARP UPR EYELID XCSV SKN,,,1858.86,6766.0,22
CPT,15824,RHYTIDECTOMY FOREHEAD,,,1858.86,6766.0,22
CPT,15825,RHYTDCT NCK PLTYSML TGHTG,,,3720.28,14658.0,22
CPT,15826,RHYTIDECTOMY GLBLR FRN LINES,,,3720.28,14658.0,22
CPT,15828,RHYTIDECTOMY CHEEK CHN & NCK,,,3720.28,14658.0,22
CPT,15829,RHYTIDECTOMY SMAS FLAP,,,3720.28,14658.0,22
CPT,15830,EXC EXCESSIVE SKIN ABDOMEN,,,6627.11,17386.0,22
CPT,15832,EXC EXCESSIVE SKIN THIGH,,,2908.42,9469.0,22
CPT,15833,EXC EXCESSIVE SKIN LEG,,,2908.42,9469.0,22
CPT,15834,EXC EXCESSIVE SKIN HIP,,,2908.42,9469.0,22
CPT,15835,EXC EXCESSIVE SKIN BUTTOCK,,,2908.42,9469.0,22
CPT,15836,EXC EXCESSIVE SKIN ARM,,,2908.42,8363.0,22
CPT,15837,EXC EXCSV SKIN FOREARM/HAND,,,2908.42,8363.0,22
CPT,15838,EXC EXCSV SUBMENTAL FAT PAD,,,2908.42,8363.0,22
CPT,15839,"HC EXCISION,EXCESSIVE SKIN & SUBQ TISSUE(INCL LIPECTOMY) OTHER AREA",7006.0,3853.3,2101.8,8363.0,53
CPT,15840,NERVE PALSY FASCIAL GRAFT,,,3720.28,14658.0,22
CPT,15841,NERVE PALSY MUSCLE GRAFT,,,3720.28,14658.0,22
CPT,15842,NERVE PALSY MICROSURG GRAFT,,,1858.86,6766.0,22
CPT,15845,SKIN AND MUSCLE REPAIR FACE,,,3720.28,14658.0,22
CPT,15847,EXC SKIN ABD ADD-ON,,,835.0,3533.0,6
CPT,15850,OP Surgery - Grouper Table,,,4258.0,4258.0,1
CPT,15851,REMOVAL SUTR/STAPLE REQ ANES,,,1858.86,6766.0,22
CPT,15852,DRESSING CHANGE NOT FOR BURN,,,622.05,4258.0,22
CPT,15853,REMOVAL SUTR/STAPL XREQ ANES,,,10.32,3533.0,21
CPT,15854,REMOVAL SUTR&STAPL XREQ ANES,,,13.11,3533.0,21
CPT,15860,IV NJX TST VASC FLO FLAP/GRF,,,405.5,4258.0,22
CPT,15876,SUCTION LIPECTOMY HEAD&NECK,,,3720.28,14658.0,22
CPT,15877,SUCTION LIPECTOMY TRUNK,,,3720.28,14658.0,22
CPT,15878,SUCTION LIPECTOMY UPR EXTREM,,,1858.86,6766.0,22
CPT,15879,SUCTION LIPECTOMY LWR EXTREM,,,3720.28,14658.0,22
CPT,15920,EXC COCCYGL PR ULC PRIM SUTR,,,2908.42,8363.0,22
CPT,15922,EXC COCCYGL PR ULC FLAP CLSR,,,3720.28,14658.0,22
CPT,15931,EXC SACRAL PR ULC PRIM SUTR,,,2908.42,9469.0,22
CPT,15933,EXC SAC PR ULC PRIM STR OSTC,,,2908.42,9469.0,22
CPT,15934,EXC SACRAL PR ULC SKN FLAP,,,3720.28,14658.0,22
CPT,15935,EXC SAC PR ULC SKN FLP OSTC,,,3720.28,14658.0,22
CPT,15936,EXC SAC PR ULC PREP MUS FLAP,,,1858.86,6766.0,22
CPT,15937,EXC SAC PR ULC PREP MUS OSTC,,,1858.86,6766.0,22
CPT,15940,EXC ISCHIAL PR ULC PRIM SUTR,,,2908.42,9469.0,22
CPT,15941,EXC ISCH PR ULC PRM SUT OSTC,,,2908.42,9469.0,22
CPT,15944,EXC ISCH PR ULC SKN FLP CLSR,,,3720.28,14658.0,22
CPT,15945,EXC ISCH PR ULC SKN FLP OSTC,,,1858.86,6766.0,22
CPT,15946,EXC ISCH PR ULC PREP MUS FLP,,,1858.86,9469.0,22
CPT,15950,EXC TRCHNTR PR ULC PRIM SUTR,,,1646.49,9469.0,22
CPT,15951,EXC TRCHNTR PR ULC OSTC,,,2908.42,9469.0,22
CPT,15952,EXC TRCHNTR PR ULC FLP CLSR,,,1858.86,9469.0,22
CPT,15953,EXC TRCHNTR PR ULC FLP OSTC,,,3720.28,14658.0,22
CPT,15956,EXC TRCHNTR PR ULC PREP FLAP,,,1858.86,6766.0,22
CPT,15958,EXC TRCHNTR PR ULC PREP OSTC,,,3720.28,14658.0,22
CPT,15999,UNLISTED PX EXC PRESSURE ULC,,,714.99,29323.0,22
CPT,16000,HC INITIAL TREATMENT OF BURN(S),512.0,281.6,153.6,4258.0,53
CPT,16020,HC DRESS DEBRIDE PARTIAL-THICKNESS BURNS SMALL,523.0,287.65,156.9,4258.0,106
CPT,16025,HC DRESS DEBRIDE PARTIAL-THICKNESS BURNS MEDIUM,807.0,443.85,201.92,4258.0,53
CPT,16030,HC DRESS DEBRIDE PARTIAL-THICKNESS BURNS LARGE,1113.0,612.15,333.9,4258.0,53
CPT,16035,ESCHAROTOMY 1ST INCISION,,,406.0,4258.0,22
CPT,16036,ESCHAROTOMY EA ADDL INCISION,,,71.66,6766.0,22
CPT,17000,HC DESTRUCT PRE-MALIG 1ST LESION,331.0,182.05,99.3,4258.0,318
CPT,17003,"HC DESTRUCT PRE-MALIG 2-14 LESIONS, EACH",96.0,52.8,6.25,3533.0,318
CPT,17004,"HC DESTRUCTION PREMALIGNANT LESIONS, 15 OR MORE LESIONS",970.0,533.5,291.0,4258.0,106
CPT,17106,DSTR CUT VSC PRLF LES<10SQCM,,,406.0,4258.0,22
CPT,17107,"HC DESTRUCTION CUTANEOUS VASCULAR PROLIFERATIVE LESIONS, 10-50 SQ CM",826.0,454.3,37.5,4258.0,106
CPT,17108,DSTR CUT VSC PRLF LES>50SQCM,,,1858.86,6766.0,22
CPT,17110,"HC DESTRUCT BEN LES OTH THAN SKIN TAGS/CUTAN VASC PROLIF LES, UP TO 14 LES",341.0,187.55,15.0,4258.0,1007
CPT,17111,"HC DESTRUCT BEN LES OTH THAN SKIN TAGS/CUTAN VASC PROLIF LES, 15/MORE LES",487.0,267.85,146.1,4258.0,106
CPT,17250,HC CHEMICAL CAUTERIZATION GRANULATION TISSUE,647.0,355.85,185.7,4258.0,1219
CPT,17260,"HC DESTR, MALG LES, TRUNK, ARMS/LEGS, DIA 0.5 CM/LESS",461.0,253.55,138.3,4258.0,265
CPT,17261,"HC DESTR, MALG LES, TRUNK, ARMS/LEGS, DIA 0.6-1.0 CM",493.0,271.15,146.1,4258.0,265
CPT,17262,"HC DESTR, MALG LES, TRUNK, ARMS/LEGS, DIA 1.1-2.0 CM",490.0,269.5,147.0,4258.0,53
CPT,17263,"HC DESTR, MALG LES, TRUNK, ARMS/LEGS, DIA 2.1-3.0 CM",500.0,275.0,150.0,4258.0,53
CPT,17264,DSTRJ MAL LES T/A/L 3.1-4.0,,,406.0,4258.0,22
CPT,17266,DSTRJ MAL LES T/A/L >4.0 CM,,,406.0,4258.0,22
CPT,17270,"HC DESTR, MALG LES, SCALP, NECK, HANDS, FEET, GENIT, DIA 0.5 CM/LESS",487.0,267.85,146.1,4258.0,53
CPT,17271,"HC DESTR, MALG LES, SCALP, NECK, HANDS, FEET, GENIT, DIA 0.6-1.0 CM",487.0,267.85,146.1,4258.0,53
CPT,17272,"HC DESTR, MALG LES, SCALP, NECK, HANDS, FEET, GENIT, DIA 1.1-2.0 CM",487.0,267.85,146.1,4258.0,53
CPT,17273,DSTR MAL LES S/N/H/F/G 2.1-3,,,406.0,4258.0,22
CPT,17274,DSTR MAL LES S/N/H/F/G 3.1-4,,,406.0,4258.0,22
CPT,17276,DSTR MAL LES S/N/H/F/G >4.0,,,406.0,4258.0,22
CPT,17280,"HC DESTR, MALG LES, FACE, EARS, EYLDS, NOSE, LIPS, MUC MEMB,DIA 0.5 CM/LESS",487.0,267.85,146.1,4258.0,53
CPT,17281,"HC DESTR, MALG LES, FACE, EARS, EYLDS, NOSE, LIPS, MUC MEMB, DIA 0.6-1.0 CM",970.0,533.5,201.92,4258.0,53
CPT,17282,DSTR MAL LS F/E/E/N/L/M1.1-2,,,201.92,4258.0,22
CPT,17283,DSTR MAL LS F/E/E/N/L/M2.1-3,,,406.0,4258.0,22
CPT,17284,DSTR MAL LS F/E/E/N/L/M3.1-4,,,622.05,4258.0,22
CPT,17286,DSTR MAL LS F/E/E/N/L/M>4.0,,,622.05,4258.0,22
CPT,17311,MOHS 1 STAGE H/N/HF/G,,,622.05,4258.0,22
CPT,17312,MOHS ADDL STAGE,,,379.8,3533.0,21
CPT,17313,MOHS 1 STAGE T/A/L,,,622.05,4258.0,22
CPT,17314,MOHS ADDL STAGE T/A/L,,,364.08,3533.0,21
CPT,17315,MOHS SURG ADDL BLOCK,,,74.5,3533.0,21
CPT,17340,CRYOTHERAPY FOR ACNE,,,60.36,4258.0,22
CPT,17360,CHEMICAL EXFOLIATION ACNE,,,201.92,4258.0,22
CPT,17380,ELECTROLYSIS EPILATION EA 30,,,622.05,4258.0,22
CPT,17999,UNLISTD PX SKN MUC MEMB SUBQ,,,201.92,29323.0,22
CPT,19000,HC PUNCT ASPIR CYST BREAST,1871.5,1029.3249999999998,543.3,4955.0,424
CPT,19001,"HC PUNCT ASPIR CYST BREAST, EA ADL CYST (AD)",508.5,279.67499999999995,23.92,3533.0,371
CPT,19020,"HC MASTOTOMY W EXPLORATION/DRAINAGE OF ABSCESS, DEEP",3488.5,1918.6750000000002,1045.2,9469.0,318
CPT,19030,HC INJ PROC ONLY FOR MAMMARY DUCTOGRAM/GALACTOGRAM,270.0,148.5,81.0,3533.0,53
CPT,19030,NJX PX ONLY MAM DUCTO/GLCTO,,,261.14,261.14,1
CPT,19081,BX BREAST 1ST LESION STRTCTC,,,2881.35,2881.35,1
CPT,19081,HC BX BREAST STEREOTACTIC GUIDE 1ST LESION,5208.0,2864.4,1562.4,6766.0,106
CPT,19082,BX BREAST ADD LESION STRTCTC,,,598.58,598.58,1
CPT,19082,HC BX BREAST STEREOTACTIC GUIDE EA ADDL LESION,7136.0,3924.8,342.04,6172.64,106
CPT,19083,HC BX BREAST US GUIDE 1ST LESION,4810.5,2645.7749999999996,1264.2,6766.0,424
CPT,19084,HC BX BREAST US GUIDE EA ADDL LESION,6719.0,3695.45,335.4,5811.94,159
CPT,19085,HC BX BREAST MR GUIDE 1ST LESION,6059.5,3332.725,1646.49,6766.0,106
CPT,19086,HC BX BREAST MR GUIDE EA ADDL LESION,4836.0,2659.8,523.37,4183.14,106
CPT,19100,"HC BX BREAST, PERC, NEEDLE CORE, WO IMG GUID",2313.0,1272.15,693.9,6766.0,159
CPT,19101,HC BX BREAST OPEN INCISIONAL WO IMAG GUID,10118.0,5564.9,3035.4,9469.0,53
CPT,19105,"HC ABLATION, CRYOSURG, FIBROADENOMA, INCL US GUID, EACH",8599.0,4729.45,2579.7,14658.0,53
CPT,19110,NIPPLE EXPLORATION,,,3891.31,9469.0,22
CPT,19112,EXCISE BREAST DUCT FISTULA,,,3891.31,9469.0,22
CPT,19120,"HC EXC CYST, FIBROADENOMA, ABERR BRST TISS, DUCT/NIP/AREOLAR LES,1/MORE LES",10737.0,5905.35,3221.1,9469.0,424
CPT,19125,EXCISION BREAST LESION,,,3891.31,9469.0,22
CPT,19126,EXCISION ADDL BREAST LESION,,,137.46,3533.0,21
CPT,19281,HC PLC BREAST LOCALZ DEV PERC MAMMO GUIDE 1ST LESION,2458.0,1351.9,737.4,6766.0,53
CPT,19282,HC PLC BREAST LOCALZ DEV PERC MAMMO GUIDE EA AD LESION,2418.0,1329.9,155.48,3533.0,53
CPT,19283,HC PLC BREAST LOCALZ DEV PERC STEREOTAC GUID 1ST LESION,3512.0,1931.6,714.99,4955.0,53
CPT,19283,PERQ DEV BREAST 1ST STRTCTC,,,1251.23,1251.23,1
CPT,19284,HC PLC BREAST LOCALZ DEV PERC STEREOTAC GUID EA AD LESION,3225.0,1773.75,169.62,3533.0,53
CPT,19284,PERQ DEV BREAST ADD STRTCTC,,,296.84,296.84,1
CPT,19285,HC PLC BREAST LOCALZ DEV PERC US GUIDE 1ST LESION,2379.0,1308.45,713.7,4955.0,159
CPT,19286,HC PLC BREAST LOCALZ DEV PERC US GUIDE EA AD LESION,2104.0,1157.2,265.78,3533.0,53
CPT,19287,HC PLC BREAST LOCALZ DEV PERC MR GUIDE 1ST LESION,7564.0,4160.2,714.99,6542.86,53
CPT,19288,HC PLC BREAST LOCALZ DEV PERC MR GUIDE EA AD LESION,6755.0,3715.25,432.42,5843.08,53
CPT,19294,PREPJ TUM CAV IORT PRTL MAST,,,141.09,3533.0,21
CPT,19296,PLACE PO BREAST CATH FOR RAD,,,9724.07,19884.0,22
CPT,19297,PLACE BREAST CATH FOR RAD,,,80.56,17804.0,21
CPT,19298,PLACE BREAST RAD TUBE/CATHS,,,6627.11,17804.0,22
CPT,19300,MASTECTOMY FOR GYNECOMASTIA,,,3891.31,9469.0,22
CPT,19301,PARTIAL MASTECTOMY,,,3891.31,9469.0,22
CPT,19302,P-MASTECTOMY W/LN REMOVAL,,,6627.11,17386.0,22
CPT,19303,MAST SIMPLE COMPLETE,,,6627.11,17386.0,22
CPT,19305,MAST RADICAL,,,1009.44,17386.0,22
CPT,19306,MAST RAD URBAN TYPE,,,1077.23,17386.0,22
CPT,19307,MAST MOD RAD,,,6627.11,17386.0,22
CPT,19316,MASTOPEXY,,,6627.11,17386.0,22
CPT,19318,BREAST REDUCTION,,,6627.11,17386.0,22
CPT,19325,BREAST AUGMENTATION W/IMPLT,,,9724.07,19884.0,22
CPT,19328,RMVL INTACT BREAST IMPLANT,,,3891.31,14658.0,22
CPT,19330,RMVL RUPTURED BREAST IMPLANT,,,3891.31,14658.0,22
CPT,19340,INSJ BREAST IMPLT SM D MAST,,,6627.11,17386.0,22
CPT,19342,INSJ/RPLCMT BRST IMPLT SEP D,,,9724.07,19884.0,22
CPT,19350,NIPPLE/AREOLA RECONSTRUCTION,,,3891.31,9469.0,22
CPT,19355,CORRECT INVERTED NIPPLE(S),,,3891.31,14658.0,22
CPT,19357,TISS XPNDR PLMT BRST RCNSTJ,,,10315.0,19884.0,22
CPT,19361,BRST RCNSTJ LATSMS DRSI FLAP,,,1402.73,17386.0,22
CPT,19364,BRST RCNSTJ FREE FLAP,,,2431.97,17386.0,22
CPT,19367,BRST RCNSTJ 1 PDCL TRAM FLAP,,,1593.36,17386.0,22
CPT,19368,BRST RCNSTJ 1PDCL TRAM ANAST,,,1944.25,17386.0,22
CPT,19369,BRST RCNSTJ 2 PDCL TRAM FLAP,,,1807.15,17386.0,22
CPT,19370,REVJ PERI-IMPLT CAPSULE BRST,,,3891.31,14658.0,22
CPT,19371,PERI-IMPLT CAPSLC BRST COMPL,,,3891.31,14658.0,22
CPT,19380,REVJ RECONSTRUCTED BREAST,,,6627.11,17386.0,22
CPT,19396,DESIGN CUSTOM BREAST IMPLANT,,,3891.31,14658.0,22
CPT,19499,UNLISTED PROCEDURE BREAST,,,3891.31,29323.0,22
CPT,20100,EXPL PENTRG WOUND NECK,,,517.5,4258.0,22
CPT,20101,EXPL PENTRG WOUND CHEST,,,1858.86,6766.0,22
CPT,20102,HC EXPLORE PENETRATING WOUND ABDOMEN-FLANK-BACK,4457.0,2451.35,1337.1,6766.0,53
CPT,20103,HC EXPLORE WND EXTREMITY,3566.0,1961.3,1069.8,4955.0,53
CPT,20150,EXCISION EPIPHYSEAL BAR,,,3297.17,16799.0,22
CPT,20200,MUSCLE BIOPSY SUPERFICIAL,,,1646.49,6766.0,22
CPT,20205,HC BX MUSCLE DEEP,4879.0,2683.45,1463.7,8363.0,53
CPT,20206,"HC BIOPSY MUSCLE, PERCUTANEOUS NEEDLE",3909.0,2149.95,795.6,6766.0,477
CPT,20220,"HC BIOPSY, BONE, TROCAR, OR NEEDLE, SUPERFICIAL",3072.5,1689.875,645.9,5761.0,318
CPT,20225,"HC BIOPSY, BONE, TROCAR, OR NEEDLE, DEEP",4380.0,2409.0,1314.0,6766.0,265
CPT,20240,"HC BIOPSY, BONE, OPEN, SUPERFICIAL",9581.0,5269.55,2874.3,9469.0,106
CPT,20245,"HC BIOPSY, BONE, OPEN; DEEP",10150.0,5582.5,2908.42,9469.0,159
CPT,20250,BIOPSY VRT BDY OPEN THORACIC,,,3297.17,14658.0,22
CPT,20251,BIOPSY VRT BDY OPEN LMBR/CRV,,,7259.46,18485.0,22
CPT,20500,"HC INJ SINUS TRACT, THERAPEUTIC",1813.0,997.15,543.9,6766.0,53
CPT,20501,"HC INJECTION SINUS TRACT, DIAGNOSTIC (SINOGRAM)",798.0,438.9,128.0,3533.0,159
CPT,20501,NJX SINUS TRACT DIAGNOSTIC,,,224.0,224.0,1
CPT,20520,HC REMOVAL OF FOREIGN BODY IN MUSCLE OR TENDON SHEATH; SIMPLE,2620.0,1441.0,786.0,5761.0,106
CPT,20525,RMVL FB MUSC/TDN DEEP/COMP,,,2908.42,9469.0,22
CPT,20526,"HC INJECTION, THERAPEUTIC, CARPAL TUNNEL",797.0,438.35,239.1,4258.0,212
CPT,20527,HC INJ ENZYME PALMAR FASCIAL CORD,800.0,440.0,240.0,4258.0,53
CPT,20550,"HC INJECTION(S), SINGLE TENDON SHEATH/LIGAMENT, APONEUROSIS",975.0,536.25,292.5,4258.0,583
CPT,20551,"HC INJECTION(S), SINGLE TENDON ORIGIN/INSERTION",811.0,446.05,242.1,4258.0,371
CPT,20552,"HC INJECTION(S), SINGLE OR MULTIPLE TRIGGER POINT(S), 1 OR 2 MUSCLE(S)",870.0,478.5,261.0,4258.0,1060
CPT,20553,"HC INJECTION(S), SINGLE OR MULTIPLE TRIGGER POINT(S), 3 OR MORE MUSCLES",1325.0,728.75,299.97,4258.0,583
CPT,20555,PLACE NDL MUSC/TIS FOR RT,,,3297.17,9469.0,22
CPT,20560,HC OT NEEDLE INSERTION(S) WITHOUT INJECTION(S) 1 OR 2 MUSCLE(S),30.0,16.5,9.0,384.0,424
CPT,20560,"HC OT SP ONLY, DRY NEEDLING MAINTENANCE, 1 OR 2 MUSCLES",50.0,27.5,24.89,46.0,200
CPT,20560,HC PT NEEDLE INSERTION(S) WITHOUT INJECTION(S) 1 OR 2 MUSCLE(S),30.0,16.5,9.0,384.0,424
CPT,20560,"HC PT SP ONLY, DRY NEEDLING MAINTENANCE, 1 OR 2 MUSCLES",50.0,27.5,24.89,46.0,200
CPT,20561,HC OT NEEDLE INSERTION(S) WITHOUT INJECTION(S) 3 OR MORE MUSCLES,50.0,27.5,15.0,384.0,424
CPT,20561,"HC OT SP ONLY, DRY NEEDLING MAINTENANCE, 3 OR MORE MUSCLES",50.0,27.5,24.89,46.0,200
CPT,20561,HC PT NEEDLE INSERTION(S) WITHOUT INJECTION(S) 3 OR MORE MUSCLES,50.0,27.5,15.0,384.0,371
CPT,20561,"HC PT SP ONLY, DRY NEEDLING MAINTENANCE, 3 OR MORE MUSCLES",50.0,27.5,24.89,46.0,200
CPT,20600,"HC ARTHROCENTESIS, ASPIR/INJ, SMALL JT/BURSA, WO US GUID",772.5,424.875,219.9,4258.0,742
CPT,20604,"HC ARTHROCENTESIS, ASPIR/INJ, SMALL JT/ BURSA, W US GUID",1024.0,563.2,299.97,4258.0,371
CPT,20605,"HC ARTHROCENTESIS, ASPIR/INJ, INTERMED JT/BURSA, WO US GUID",877.5,482.625,249.3,4258.0,795
CPT,20606,"HC ARTHROCENTESIS, ASPIR/INJ, INTERMED JT/BURSA, W US GUID",1501.0,825.55,450.3,4955.0,424
CPT,20610,"HC ARTHROCENTESIS, ASPIR/INJ, MAJOR JT/BURSA, WO US GUID",1074.0,590.7,294.3,4258.0,1166
CPT,20611,"HC ARTHROCENTESIS, ASPIR/INJ, MAJOR JT/BURSA, W US GUID",1696.0,932.8,299.97,4258.0,477
CPT,20612,HC ASPIRATION AND/OR INJECTION GANGLION CYST(S) ANY LOCATION,800.0,440.0,240.0,4258.0,371
CPT,20615,HC ASPIRATION AND INJECTION FOR TREATMENT OF BONE CYST,1901.0,1045.55,570.3,4955.0,53
CPT,20650,HC INSERT AND REM BONE PIN,7695.0,4232.25,2308.5,14658.0,53
CPT,20660,APPLY REM FIXATION DEVICE,,,1626.34,6766.0,22
CPT,20661,APPLICATION HALO CRANIAL,,,463.68,5761.0,22
CPT,20662,APPLICATION HALO PELVIC,,,1626.34,9469.0,22
CPT,20663,APPLICATION HALO FEMORAL,,,3297.17,14658.0,22
CPT,20664,APPL HALO CRANIAL 6+PINS,,,779.89,6766.0,22
CPT,20665,RMVL TONGS/HALO ANTHR INDIV,,,405.5,4258.0,22
CPT,20670,HC REMOVE SUPERFICIAL IMPLANT,4648.0,2556.4,1394.4,6766.0,212
CPT,20680,HC REMOVE DEEP IMPLANT,9265.0,5095.75,2779.5,9469.0,53
CPT,20690,HC APPLICATION UNIPLANE EXTERNAL FIXATION SYSTEM,13096.0,7202.8,3928.8,18485.0,106
CPT,20692,HC APPLICATION MULTIPLANE EXTERNAL FIXATION SYSTEM,30783.0,16930.65,8488.0,26627.3,106
CPT,20693,HC ADJUSTMENT OR REVISION OF EXTERNAL FIXATION SYSTEM REQUIRING ANESTHESIA,19900.0,10945.0,5970.0,18485.0,106
CPT,20694,"HC REMOVAL, UNDER ANESTHESIA, OF EXTERNAL FIXATION SYSTEM",5605.0,3082.75,1626.34,6766.0,106
CPT,20696,APP MLTPLN UNI XTRNL FIX 1ST,,,8488.0,24394.0,22
CPT,20697,HC APP MULTIPLN UNI EXT FIX W/STEREOTACTIC COMP-ASST ADJ INCLD IMG EXCHANGE,3269.0,1797.95,980.7,5761.0,53
CPT,20700,MNL PREP&INSJ DP RX DLVR DEV,,,74.12,3533.0,21
CPT,20701,RMVL DEEP RX DELIVERY DEVICE,,,56.44,3533.0,21
CPT,20702,MNL PREP&INSJ IMED RX DEV,,,125.84,3533.0,21
CPT,20703,RMVL IMED RX DELIVERY DEVICE,,,92.01,3533.0,21
CPT,20704,MNL PREP&INSJ I-ARTIC RX DEV,,,132.39,3533.0,21
CPT,20705,RMVL I-ARTIC RX DELIVERY DEV,,,109.24,3533.0,21
CPT,20802,REPLANTATION ARM COMPLETE,,,2445.51,21512.0,22
CPT,20805,REPLANT FOREARM COMPLETE,,,2899.94,21512.0,22
CPT,20808,REPLANTATION HAND COMPLETE,,,3492.41,21512.0,22
CPT,20816,REPLANTATION DIGIT COMPLETE,,,1830.73,18485.0,22
CPT,20822,REPLANTATION DIGIT COMPLETE,,,1626.34,9469.0,22
CPT,20824,REPLANTATION THUMB COMPLETE,,,1834.76,18485.0,22
CPT,20827,REPLANTATION THUMB COMPLETE,,,1629.15,18485.0,22
CPT,20838,REPLANTATION FOOT COMPLETE,,,2482.02,21512.0,22
CPT,20900,REMOVAL OF BONE FOR GRAFT,,,7259.46,18485.0,22
CPT,20902,"HC BONE GRAFT, ANY DONOR AREA; MAJOR OR LARGE",13096.0,7202.8,3928.8,18485.0,106
CPT,20910,REMOVE CARTILAGE FOR GRAFT,,,622.05,4258.0,22
CPT,20912,REMOVE CARTILAGE FOR GRAFT,,,3720.28,14658.0,22
CPT,20920,REMOVAL OF FASCIA FOR GRAFT,,,1858.86,6766.0,22
CPT,20922,REMOVAL OF FASCIA FOR GRAFT,,,1858.86,9469.0,22
CPT,20924,REMOVAL OF TENDON FOR GRAFT,,,7259.46,18485.0,22
CPT,20930,SP BONE ALGRFT MORSEL ADD-ON,,,835.0,3533.0,6
CPT,20931,SP BONE ALGRFT STRUCT ADD-ON,,,93.45,3533.0,21
CPT,20932,HC OSTEOARTICULAR ALLOGRAFT W/ARTICULAR SURF & BONE (ADD ON),5587.0,3072.85,662.59,4832.76,106
CPT,20933,HC HEMICORTICAL INTERCALARY ALLOGRAFT PARTIAL (ADD ON),5587.0,3072.85,607.87,4832.76,106
CPT,20934,HC INTERCALARY ALLOGRAFT COMPLETE (ADD ON),5587.0,3072.85,662.16,4832.76,106
CPT,20936,SP BONE AGRFT LOCAL ADD-ON,,,8488.0,14658.0,6
CPT,20937,SP BONE AGRFT MORSEL ADD-ON,,,143.08,14658.0,21
CPT,20938,SP BONE AGRFT STRUCT ADD-ON,,,155.11,14658.0,21
CPT,20939,BONE MARROW ASPIR BONE GRFG,,,59.74,3533.0,21
CPT,20950,HC MONITOR INTRSTITIAL FLD PRESS MUSC COMPART SYND,1283.0,705.65,384.9,4955.0,106
CPT,20955,FIBULA BONE GRAFT MICROVASC,,,2197.58,18485.0,22
CPT,20956,ILIAC BONE GRAFT MICROVASC,,,2350.74,18485.0,22
CPT,20957,MT BONE GRAFT MICROVASC,,,2449.83,18485.0,22
CPT,20962,OTHER BONE GRAFT MICROVASC,,,2393.66,18485.0,22
CPT,20969,BONE/SKIN GRAFT MICROVASC,,,2444.13,18485.0,22
CPT,20970,BONE/SKIN GRAFT ILIAC CREST,,,2536.11,18485.0,22
CPT,20972,BONE/SKIN GRAFT METATARSAL,,,7259.46,18485.0,22
CPT,20973,BONE/SKIN GRAFT GREAT TOE,,,7259.46,18485.0,22
CPT,20974,ESTIM AID BONE HEALG N-INVAS,,,78.11,4258.0,22
CPT,20975,ESTIM AID BONE HEALG INVASIV,,,156.4,3533.0,21
CPT,20979,LW NTSTY US STIMJ BONE HEALG,,,24.89,4258.0,22
CPT,20982,ABLATE BONE TUMOR(S) PERQ,,,22881.71,22881.71,1
CPT,20982,"HC ABLAT THER REDUCT/ERADICAT 1/MORE BONE TUMORS, PERC, RADFREQ",17557.5,9656.625,4788.3,18485.0,265
CPT,20983,"HC ABLATION THERAPY REDUCT 1 OR MORE BONE TUMORS, W IMAG GUID, CRYOABLATION",14659.0,8062.45,4397.7,18485.0,106
CPT,20985,CPTR-ASST DIR MS PX,,,127.19,3533.0,21
CPT,20999,"HC CRYO-ABLATION SOFT TISSUE TUMOR, UNLIST PROC, MSK, GENERAL",4274.0,2350.7,243.77,29323.0,53
CPT,21010,INCISION OF JAW JOINT,,,3295.61,9469.0,22
CPT,21011,EXC FACE LES SC <2 CM,,,1646.49,5761.0,22
CPT,21012,EXC FACE LES SBQ 2 CM/>,,,1646.49,5761.0,22
CPT,21013,EXC FACE TUM DEEP < 2 CM,,,1646.49,5761.0,22
CPT,21014,EXC FACE TUM DEEP 2 CM/>,,,2908.42,8363.0,22
CPT,21015,RESECT FACE/SCALP TUM < 2 CM,,,2908.42,8363.0,22
CPT,21016,RESECT FACE/SCALP TUM 2 CM/>,,,2908.42,9469.0,22
CPT,21025,"HC EXCISION OF BONE, MANDIBLE",18985.0,10441.75,5695.5,16799.0,106
CPT,21026,EXCISION OF FACIAL BONE(S),,,5480.0,13936.0,22
CPT,21029,CONTOUR OF FACE BONE LESION,,,3295.61,9469.0,22
CPT,21030,EXCISE MAX/ZYGOMA B9 TUMOR,,,5480.0,13936.0,22
CPT,21031,REMOVE EXOSTOSIS MANDIBLE,,,3295.61,9469.0,22
CPT,21032,REMOVE EXOSTOSIS MAXILLA,,,3295.61,9469.0,22
CPT,21034,EXCISE MAX/ZYGOMA MAL TUMOR,,,6011.49,16799.0,22
CPT,21040,EXCISE MANDIBLE LESION,,,3295.61,9469.0,22
CPT,21044,HC EXCISION MALIGNANT TUMOR MANDIBLE,11536.0,6344.8,3460.8,16799.0,106
CPT,21045,EXTENSIVE JAW SURGERY,,,1092.56,16799.0,22
CPT,21046,REMOVE MANDIBLE CYST COMPLEX,,,6011.49,16799.0,22
CPT,21047,EXCISE LWR JAW CYST W/REPAIR,,,6011.49,16799.0,22
CPT,21048,REMOVE MAXILLA CYST COMPLEX,,,6011.49,16799.0,22
CPT,21049,EXCIS UPPR JAW CYST W/REPAIR,,,6011.49,16799.0,22
CPT,21050,REMOVAL OF JAW JOINT,,,6011.49,16799.0,22
CPT,21060,REMOVE JAW JOINT CARTILAGE,,,6011.49,16799.0,22
CPT,21070,REMOVE CORONOID PROCESS,,,6011.49,16799.0,22
CPT,21073,MNPJ OF TMJ W/ANESTH,,,1505.28,6766.0,22
CPT,21076,IMPRES&PREP SURG OBT PROSTH,,,1505.28,6766.0,22
CPT,21077,IMPRES&PREP ORBITAL PROSTH,,,6011.49,16799.0,22
CPT,21079,IMPRES&PREP INTRM OBT PROSTH,,,3295.61,16799.0,22
CPT,21080,IMPRES&PREP DEF OBT PROSTH,,,3295.61,16799.0,22
CPT,21081,IMPRES&PREP MNDBL RES PROSTH,,,6011.49,16799.0,22
CPT,21082,IMPRES&PREP PALTL AUG PROSTH,,,3295.61,16799.0,22
CPT,21083,IMPRES&PREP PALTL LFT PROSTH,,,3295.61,16799.0,22
CPT,21084,IMPRES&PREP SP AID PROSTH,,,3295.61,16799.0,22
CPT,21085,IMPRES&PREP ORAL SURG SPLINT,,,235.98,4258.0,22
CPT,21086,IMPRES&PREP AURICULAR PROSTH,,,3295.61,16799.0,22
CPT,21087,IMPRES&PREP NASAL PROSTH,,,6011.49,16799.0,22
CPT,21088,IMPRES&PREP FACIAL PROSTH,,,3295.61,16799.0,22
CPT,21089,UNLISTED MAXLFCL PROSTH PX,,,235.98,4258.0,22
CPT,21100,MAXILLOFACIAL FIXATION,,,6011.49,16799.0,22
CPT,21110,HC INTERDENTAL FIXATION,2669.0,1467.95,800.7,6766.0,53
CPT,21116,INJECTION JAW JOINT X-RAY,,,191.32,3533.0,22
CPT,21120,GENIOPLASTY AUGMENTATION,,,5480.0,13936.0,22
CPT,21121,GENIOP SLDG OSTEOT 1,,,3295.61,9469.0,22
CPT,21122,GENIOP SLDG OSTEOT 2/>,,,5480.0,13936.0,22
CPT,21123,GENIOP SLDG AUGMENTATION,,,3295.61,9469.0,22
CPT,21125,AUGMENTATION MNDBLR PROSTC,,,5480.0,13936.0,22
CPT,21127,AUGMENTATION MNDBLR B1 GRF,,,6011.49,16799.0,22
CPT,21137,RDCTJ FOREHEAD CNTRG ONLY,,,3295.61,9469.0,22
CPT,21138,RDCTJ FOREHEAD CNTRG&PROSTC,,,6011.49,16799.0,22
CPT,21139,RDCTJ FOREHEAD CNTRG&SETBACK,,,6011.49,16799.0,22
CPT,21141,RCNSTJ MIDFACE LEFORT I 1PC,,,6011.49,16799.0,22
CPT,21142,RCNSTJ MIDFACE LEFORT I 2PCS,,,6011.49,16799.0,22
CPT,21143,RCNSTJ MDFACE LEFORT I 3/>PC,,,6011.49,16799.0,22
CPT,21145,RCNSTJ MDFC LEFORT I 1 W/GRF,,,1424.77,16799.0,22
CPT,21146,RCNSTJ MDFC LEFORT I 2 W/GRF,,,1488.11,16799.0,22
CPT,21147,RCNSTJ MDFC LEFORT I 3/>GRF,,,1564.69,16799.0,22
CPT,21150,RCNSTJ MDFC LEFRTII ANT NTRU,,,6011.49,16799.0,22
CPT,21151,RCNSTJ MDFC LEFRTII W/B1 GRF,,,1633.21,16799.0,22
CPT,21154,RCNSTJ MDFC LEFORT III W/O I,,,1758.57,16799.0,22
CPT,21155,RCNSTJ MDFC LEFORT III W/I,,,1949.37,16799.0,22
CPT,21159,RCNST MDFC LFRTIII ADVM WO I,,,2333.74,16799.0,22
CPT,21160,RCNST MDFC LFRTIII ADVM W/I,,,2529.98,16799.0,22
CPT,21172,RCNST SUPR-LAT ORB RM&LW FHD,,,6011.49,16799.0,22
CPT,21175,RCNST BFRNT SP ORB RM&LW FHD,,,6011.49,16799.0,22
CPT,21179,RCNSTJ FOREHEAD WITH GRAFTS,,,1366.17,16799.0,22
CPT,21180,RCNSTJ FOREHEAD W/AUTOGRAFT,,,1525.01,16799.0,22
CPT,21181,RCNST CNTRG B9 TUM CRNL XTRC,,,5480.0,13936.0,22
CPT,21182,RECONSTRUCT CRANIAL BONE,,,1896.61,16799.0,22
CPT,21183,RECONSTRUCT CRANIAL BONE,,,2061.72,16799.0,22
CPT,21184,RECONSTRUCT CRANIAL BONE,,,2216.23,16799.0,22
CPT,21188,RECONSTRUCTION OF MIDFACE,,,1449.85,16799.0,22
CPT,21193,RECONST LWR JAW W/O GRAFT,,,6011.49,16799.0,22
CPT,21194,RECONST LWR JAW W/GRAFT,,,6011.49,16799.0,22
CPT,21195,RECONST LWR JAW W/O FIXATION,,,6011.49,16799.0,22
CPT,21196,RECONST LWR JAW W/FIXATION,,,6011.49,16799.0,22
CPT,21198,RECONSTR LWR JAW SEGMENT,,,5480.0,13936.0,22
CPT,21199,RECONSTR LWR JAW W/ADVANCE,,,6011.49,29323.0,22
CPT,21206,RECONSTRUCT UPPER JAW BONE,,,6011.49,16799.0,22
CPT,21208,AUGMENTATION OF FACIAL BONES,,,6011.49,16799.0,22
CPT,21209,REDUCTION OF FACIAL BONES,,,6011.49,16799.0,22
CPT,21210,FACE BONE GRAFT,,,6011.49,16799.0,22
CPT,21215,LOWER JAW BONE GRAFT,,,6011.49,16799.0,22
CPT,21230,RIB CARTILAGE GRAFT,,,6011.49,16799.0,22
CPT,21235,EAR CARTILAGE GRAFT,,,3917.0,13936.0,22
CPT,21240,RECONSTRUCTION OF JAW JOINT,,,6011.49,16799.0,22
CPT,21242,RECONSTRUCTION OF JAW JOINT,,,6011.49,16799.0,22
CPT,21243,RECONSTRUCTION OF JAW JOINT,,,9733.0,24394.0,22
CPT,21244,RECONSTRUCTION OF LOWER JAW,,,6011.49,16799.0,22
CPT,21245,RECONSTRUCTION OF JAW,,,6011.49,16799.0,22
CPT,21246,RECONSTRUCTION OF JAW,,,6011.49,16799.0,22
CPT,21247,RECONSTRUCT LOWER JAW BONE,,,1453.86,16799.0,22
CPT,21248,RECONSTRUCTION OF JAW,,,6011.49,16799.0,22
CPT,21249,RECONSTRUCTION OF JAW,,,6011.49,16799.0,22
CPT,21255,RECONSTRUCT LOWER JAW BONE,,,6011.49,16799.0,22
CPT,21256,RECONSTRUCTION OF ORBIT,,,6011.49,16799.0,22
CPT,21260,REVISE EYE SOCKETS,,,6011.49,16799.0,22
CPT,21261,REVISE EYE SOCKETS,,,6011.49,16799.0,22
CPT,21263,REVISE EYE SOCKETS,,,6011.49,16799.0,22
CPT,21267,REVISE EYE SOCKETS,,,6011.49,16799.0,22
CPT,21268,REVISE EYE SOCKETS,,,1811.89,16799.0,22
CPT,21270,AUGMENTATION CHEEK BONE,,,6011.49,16799.0,22
CPT,21275,REVISION ORBITOFACIAL BONES,,,6011.49,16799.0,22
CPT,21280,MEDIAL CANTHOPEXY,,,3295.61,16799.0,22
CPT,21282,LATERAL CANTHOPEXY,,,3295.61,6766.0,22
CPT,21295,REVISION OF JAW MUSCLE/BONE,,,1505.28,6766.0,22
CPT,21296,REVISION OF JAW MUSCLE/BONE,,,3295.61,9469.0,22
CPT,21299,UNLISTED CRANFCL&MAXLFCL PX,,,235.98,29323.0,22
CPT,21315,"HC CLOSED TX OF NASAL BONE FRACTURE W/ MANIPULATION, W/O STABILIZATION",4294.0,2361.7,1288.2,6766.0,106
CPT,21320,HC CLOSED TREATMENT OF NASAL BONE FRACTURE W/ MANIPULATION W/ STABILIZATION,6347.0,3490.85,1904.1,6766.0,106
CPT,21325,OPEN TX NOSE FX UNCOMPLICATD,,,3295.61,9469.0,22
CPT,21330,OPEN TX NOSE FX W/SKELE FIXJ,,,5480.0,13936.0,22
CPT,21335,OPEN TX NOSE & SEPTAL FX,,,3295.61,9469.0,22
CPT,21336,OPEN TX SEPTAL FX W/WO STABJ,,,3297.17,9469.0,22
CPT,21337,HC CLSD TX NASAL SEPTAL FX W WO STABILIZATION,4488.0,2468.4,1346.4,6766.0,53
CPT,21338,OPEN NASOETHMOID FX W/O FIXJ,,,5480.0,13936.0,22
CPT,21339,OPEN NASOETHMOID FX W/ FIXJ,,,5480.0,13936.0,22
CPT,21340,PERQ TX NASOETHMOID FX,,,3295.61,16799.0,22
CPT,21343,OPEN TX DPRSD FRONT SINUS FX,,,993.66,16799.0,22
CPT,21344,OPEN TX COMPL FRONT SINUS FX,,,1265.0,16799.0,22
CPT,21345,CLOSED TX NOSE/JAW FX,,,1505.28,6766.0,22
CPT,21346,OPN TX NASOMAX FX W/FIXJ,,,5480.0,13936.0,22
CPT,21347,OPN TX NASOMAX FX MULTPLE,,,6011.49,16799.0,22
CPT,21348,OPN TX NASOMAX FX W/GRAFT,,,994.46,16799.0,22
CPT,21355,PERQ TX MALAR FRACTURE,,,3295.61,16799.0,22
CPT,21356,OPN TX DPRSD ZYGOMATIC ARCH,,,5480.0,13936.0,22
CPT,21360,OPN TX DPRSD MALAR FRACTURE,,,5480.0,13936.0,22
CPT,21365,OPN TX COMPLX MALAR FX,,,6011.49,16799.0,22
CPT,21366,OPN TX COMPLX MALAR W/GRFT,,,6011.49,16799.0,22
CPT,21385,OPN TX ORBIT FX TRANSANTRAL,,,6011.49,16799.0,22
CPT,21386,OPN TX ORBIT FX PERIORBITAL,,,6011.49,16799.0,22
CPT,21387,OPN TX ORBIT FX COMBINED,,,6011.49,16799.0,22
CPT,21390,OPN TX ORBIT PERIORBTL IMPLT,,,6011.49,16799.0,22
CPT,21395,OPN TX ORBIT PERIORBT W/GRFT,,,6011.49,16799.0,22
CPT,21400,CLOSED TX ORBIT W/O MANIPULJ,,,517.5,4258.0,22
CPT,21401,CLOSED TX ORBIT W/MANIPULJ,,,1505.28,6766.0,22
CPT,21406,OPN TX ORBIT FX W/O IMPLANT,,,6011.49,16799.0,22
CPT,21407,OPN TX ORBIT FX W/IMPLANT,,,6011.49,16799.0,22
CPT,21408,OPN TX ORBIT FX W/BONE GRFT,,,6011.49,16799.0,22
CPT,21421,HC CLSD TX PALATAL OR MAXILLLARY FX W WIRE FIXATION,11798.0,6488.9,3295.61,10205.27,53
CPT,21422,OPTX PALATAL/MAX FRACTURE,,,6011.49,16799.0,22
CPT,21423,OPTX PALATAL/MAX FX COMP,,,720.41,16799.0,22
CPT,21431,CLTX CRANIOFACIAL SEPARATION,,,643.81,16799.0,22
CPT,21432,OPTX CRANFCL SEP W/WIRING,,,649.55,16799.0,22
CPT,21433,OPTX CRANFCL SEP COMP MLT,,,1558.87,16799.0,22
CPT,21435,OPTX CRNFC SEP COMP INT&/XTR,,,1272.07,16799.0,22
CPT,21436,OPTX CRNFCL SEP COMP MLT INT,,,1834.26,16799.0,22
CPT,21440,HC TREAT DENTAL RIDGE FRACTURE,7525.0,4138.75,2257.5,9469.0,106
CPT,21445,OPTX MNDBLR/MAX ALV RIDGE FX,,,6011.49,16799.0,22
CPT,21450,HC CLOSED TX MANDIBULAR FRACTURE W/O MANIPULATION,1486.0,817.3,445.8,4258.0,53
CPT,21451,CLTX MNDBLR FX W/MNPJ,,,1505.28,6766.0,22
CPT,21452,PERQ TX MNDBLR FX XTRNL FIXJ,,,3917.0,13936.0,22
CPT,21453,HC TREAT LOWER JAW FRACTURE,14426.0,7934.3,4327.8,16799.0,53
CPT,21454,OPTX MNDBLR FX XTRNL FIXJ,,,5480.0,13936.0,22
CPT,21461,OPTX MNDBLR FX WO NTRDNTL,,,6011.49,16799.0,22
CPT,21462,OPTX MNDBLR FX W/NTRDNTL,,,6011.49,16799.0,22
CPT,21465,OPTX MNDBLR CNDYLR FX,,,6011.49,16799.0,22
CPT,21470,OPTX COMPLICATED MNDBLR FX,,,6011.49,16799.0,22
CPT,21480,"HC CLOSED TREATMENT TEMPOROMANDIBULAR DISLOCATION, INITIAL OR SUBSEQUENT",524.0,288.2,157.2,4258.0,53
CPT,21485,"HC CLSD TX TEMPOROMANDIBULAR DISLOCATION, COMPLICATED, INITIAL/SUBSEQUENT",2671.0,1469.05,801.3,6766.0,53
CPT,21490,OPTX TMPRMAND DISLOCATION,,,3295.61,16799.0,22
CPT,21497,HC INTERDENTAL WIRING,2199.0,1209.45,659.7,6766.0,53
CPT,21499,UNLISTED MUSCSKEL PX HEAD,,,235.98,29323.0,22
CPT,21501,I&D DP ABSC/HMTMA SFT TS NCK,,,2908.42,9469.0,22
CPT,21502,I&D DP ABS/HMTM NCK RIB OSTC,,,3297.17,9469.0,22
CPT,21510,INC DEEP OPNG B1 CRTX THORAX,,,403.18,16799.0,22
CPT,21550,HC BX NECK OR THORAX SOFT TISSUE,5738.0,3155.9,1646.49,6766.0,530
CPT,21552,EXC NECK LES SC 3 CM/>,,,2908.42,9469.0,22
CPT,21554,EXC NECK TUM DEEP 5 CM/>,,,2908.42,9469.0,22
CPT,21555,EXC NECK LES SC < 3 CM,,,1646.49,6766.0,22
CPT,21556,"HC EXCISION, TUMOR, SOFT TISSUE NECK/ANT THORAX, SUBFASCIAL, LESS THAN 5 CM",10059.0,5532.45,2908.42,9469.0,212
CPT,21557,RESECT NECK THORAX TUMOR<5CM,,,2908.42,8363.0,22
CPT,21558,RESECT NECK TUMOR 5 CM/>,,,2908.42,9469.0,22
CPT,21600,PARTIAL REMOVAL OF RIB,,,7259.46,18485.0,22
CPT,21601,EXC CHEST WALL TUMOR W/RIBS,,,2908.42,9469.0,22
CPT,21602,EXC CH WAL TUM W/O LYMPHADEC,,,1360.73,17804.0,22
CPT,21603,EXC CH WAL TUM W/LYMPHADEC,,,1470.02,17804.0,22
CPT,21610,COSTOTRANSVERSECTOMY,,,3297.17,14658.0,22
CPT,21615,EXCISION 1ST &/CERVICAL RIB,,,544.96,17804.0,22
CPT,21616,EXC 1ST&/CRV RIB W/SYMPTH,,,617.23,17804.0,22
CPT,21620,OSTECTOMY STERNUM PARTIAL,,,447.47,16799.0,22
CPT,21627,STERNAL DEBRIDEMENT,,,492.17,17804.0,22
CPT,21630,RADICAL RESECTION STERNUM,,,1187.22,17804.0,22
CPT,21632,OP Surgery - Grouper Table,,,8363.0,8363.0,1
CPT,21685,HYOID MYOTOMY & SUSPENSION,,,5480.0,13936.0,22
CPT,21700,REVISION OF NECK MUSCLE,,,5480.0,9469.0,22
CPT,21705,REVISION OF NECK MUSCLE/RIB,,,456.89,17804.0,22
CPT,21720,REVISION OF NECK MUSCLE,,,3297.17,9469.0,22
CPT,21725,REVISION OF NECK MUSCLE,,,714.99,4955.0,22
CPT,21740,RECONSTRUCTION OF STERNUM,,,888.43,17804.0,22
CPT,21742,REPAIR STERN/NUSS W/O SCOPE,,,3297.17,16799.0,22
CPT,21743,REPAIR STERNUM/NUSS W/SCOPE,,,3297.17,16799.0,22
CPT,21750,REPAIR OF STERNUM SEPARATION,,,589.99,17804.0,22
CPT,21811,OPTX OF RIB FX W/FIXJ SCOPE,,,5480.0,9469.0,22
CPT,21812,TREATMENT OF RIB FRACTURE,,,5480.0,9469.0,22
CPT,21813,TREATMENT OF RIB FRACTURE,,,1626.34,9469.0,22
CPT,21820,TREAT STERNUM FRACTURE,,,243.77,4258.0,22
CPT,21825,HC OPEN TREATMENT OF STERNUM FRACTURE W OR WO SKELATAL FIXATION,9310.0,5120.5,494.71,17804.0,53
CPT,21899,HC INTERVENTIONAL PROC NECK-THORAX,6038.0,3320.9,235.98,29323.0,53
CPT,21920,"HC BIOPSY, SOFT TISSUE OF BACK OR FLANK, SUPERFICIAL",2819.0,1550.45,845.7,5761.0,159
CPT,21925,"HC BIOPSY, SOFT TISSUE OF BACK OR FLANK, DEEP",6630.0,3646.5,1646.49,9469.0,159
CPT,21930,EXC BACK LES SC < 3 CM,,,1646.49,6766.0,22
CPT,21931,"HC EXCISION, TUMOR, SOFT TISSUE OF BACK/FLANK, SUBCUTANEOUS 3 CM OR GREATER",4116.0,2263.8,1234.8,9469.0,53
CPT,21932,EXC BACK TUM DEEP < 5 CM,,,2908.42,8363.0,22
CPT,21933,EXC BACK TUM DEEP 5 CM/>,,,2908.42,9469.0,22
CPT,21935,RESECT BACK TUM < 5 CM,,,2908.42,8363.0,22
CPT,21936,RESECT BACK TUM 5 CM/>,,,2908.42,9469.0,22
CPT,22010,I&D P-SPINE C/T/CERV-THOR,,,861.17,17804.0,22
CPT,22015,I&D ABSCESS P-SPINE L/S/LS,,,846.09,17804.0,22
CPT,22100,REMOVE PART OF NECK VERTEBRA,,,7259.46,18485.0,22
CPT,22101,REMOVE PART THORAX VERTEBRA,,,7259.46,17804.0,22
CPT,22102,REMOVE PART LUMBAR VERTEBRA,,,7259.46,18485.0,22
CPT,22103,REMOVE EXTRA SPINE SEGMENT,,,115.43,3533.0,21
CPT,22110,REMOVE PART OF NECK VERTEBRA,,,928.16,17804.0,22
CPT,22112,REMOVE PART THORAX VERTEBRA,,,987.22,17804.0,22
CPT,22114,REMOVE PART LUMBAR VERTEBRA,,,987.22,17804.0,22
CPT,22116,REMOVE EXTRA SPINE SEGMENT,,,119.72,8363.0,22
CPT,22206,INCIS SPINE 3 COLUMN THORAC,,,2121.45,18485.0,22
CPT,22207,INCIS SPINE 3 COLUMN LUMBAR,,,2085.6,18485.0,22
CPT,22208,INCIS SPINE 3 COLUMN ADL SEG,,,497.9,18485.0,22
CPT,22210,INCIS 1 VERTEBRAL SEG CERV,,,1564.13,17804.0,22
CPT,22212,INCIS 1 VERTEBRAL SEG THORAC,,,1337.22,17804.0,22
CPT,22214,INCIS 1 VERTEBRAL SEG LUMBAR,,,1336.31,17804.0,22
CPT,22216,INCIS ADDL SPINE SEGMENT,,,309.76,8363.0,22
CPT,22220,OSTEOT DSC ANT 1 VRT SGM CRV,,,1428.35,17804.0,22
CPT,22222,OSTEOT DSC ANT 1VRT SGM THRC,,,1514.65,17804.0,22
CPT,22224,OSTEOT DSC ANT 1VRT SGM LMBR,,,1408.3,17804.0,22
CPT,22226,OSTEOT DSC ANT 1VRT SGM EA,,,308.19,19884.0,22
CPT,22310,CLOSED TX VERT FX W/O MANJ,,,243.77,4258.0,22
CPT,22315,"HC CLSD TX VERTEBRAL FRACTURE/DISLOC REQ CASTING/BRACING, BY MANIP/TRACTION",4310.0,2370.5,1293.0,8363.0,53
CPT,22318,TREAT ODONTOID FX W/O GRAFT,,,1415.99,17804.0,22
CPT,22319,TREAT ODONTOID FX W/GRAFT,,,1562.7,17804.0,22
CPT,22325,TREAT SPINE FRACTURE,,,1293.59,17804.0,22
CPT,22326,TREAT NECK SPINE FRACTURE,,,1311.23,17804.0,22
CPT,22327,TREAT THORAX SPINE FRACTURE,,,1341.93,17804.0,22
CPT,22328,TREAT EACH ADD SPINE FX,,,237.22,8363.0,22
CPT,22505,MANIPULATION OF SPINE,,,1626.34,6766.0,22
CPT,22510,"HC PERC VERTEBROPLASTY, 1 VERTEBRAL BODY, UNILAT/BILAT INJ, CERVICOTHORACIC",9728.0,5350.4,2918.4,14658.0,53
CPT,22511,HC PERCUTAN VERTEBROPLASTY LUMBOSACRAL,9265.0,5095.75,2779.5,14658.0,53
CPT,22512,HC PERCUTAN VERTEBROPLASTY EA ADDL C-T OR L-S,3484.0,1916.2,643.73,3533.0,53
CPT,22513,HC PERCUTAN VERTEBRAL AUGMENT W CAVITY CREATION THORACIC,23709.0,13039.95,7112.7,20508.29,53
CPT,22514,HC PERCUTAN VERTEBRAL AUGMENT W CAVITY CREATION LUMBAR,23709.0,13039.95,7112.7,20508.29,53
CPT,22515,HC PERCUTAN VERTEBRAL AUGMENT W CAVITY CREATION  EA ADDL T-L,23709.0,13039.95,835.0,20508.29,53
CPT,22526,IDET SINGLE LEVEL,,,1724.55,14658.0,23
CPT,22527,IDET 1 OR MORE LEVELS,,,1415.18,14658.0,23
CPT,22532,ARTHRD LAT XTRCVTRY TQ THRC,,,1558.83,21512.0,22
CPT,22533,ARTHRD LAT XTRCVTRY TQ LMBR,,,1468.36,21512.0,22
CPT,22534,ARTHRD LAT XTRCVTRY TQ EA AD,,,307.44,18485.0,22
CPT,22548,ARTHRD ANT TORAL/XORAL C1-C2,,,1676.83,21512.0,22
CPT,22551,ARTHRD ANT NTRBDY CERVICAL,,,10315.0,19884.0,22
CPT,22552,ARTHRD ANT NTRBD CERVICAL EA,,,334.79,16799.0,21
CPT,22554,ARTHRD ANT NTRBD MIN DSC CRV,,,10315.0,19884.0,22
CPT,22556,ARTHRD ANT NTRBD MIN DSC THC,,,1468.39,21512.0,22
CPT,22558,ARTHRD ANT NTRBD MIN DSC LUM,,,1335.57,21512.0,22
CPT,22585,ARTHRD ANT NTRBD MIN DSC EA,,,276.17,17804.0,21
CPT,22586,ARTHRD PRE-SAC NTRBDY L5-S1,,,1733.06,21512.0,22
CPT,22590,ARTHRD PST TQ CRANIOCERVICAL,,,1376.87,21512.0,22
CPT,22595,ARTHRD PST TQ ATLAS-AXIS,,,1317.14,21512.0,22
CPT,22600,ARTHRD PST TQ 1NTRSPC CRV,,,1138.99,21512.0,22
CPT,22610,ARTHRD PST TQ 1NTRSPC THRC,,,1125.6,21512.0,22
CPT,22612,ARTHRD PST TQ 1NTRSPC LUMBAR,,,10315.0,19884.0,22
CPT,22614,ARTHRD PST TQ 1NTRSPC EA ADD,,,331.07,3533.0,21
CPT,22630,ARTHRD PST TQ 1NTRSPC LUM,,,12463.0,21512.0,22
CPT,22632,ARTHRD PST TQ 1NTRSPC LM EA,,,269.22,19884.0,22
CPT,22633,ARTHRD CMBN 1NTRSPC LUMBAR,,,13725.0,23692.0,22
CPT,22634,ARTHRD CMBN 1NTRSPC EA ADDL,,,409.95,3533.0,21
CPT,22800,ARTHRD PST DFRM<6 VRT SGM,,,1206.83,21512.0,22
CPT,22802,ARTHRD PST DFRM 7-12 VRT SGM,,,1846.86,21512.0,22
CPT,22804,ARTHRD PST DFRM 13+ VRT SGM,,,2119.74,21512.0,22
CPT,22808,ARTHRD ANT DFRM 2-3 VRT SGM,,,1581.98,21512.0,22
CPT,22810,ARTHRD ANT DFRM 4-7 VRT SGM,,,1791.8,21512.0,22
CPT,22812,ARTHRD ANT DFRM 8+ VRT SGM,,,1964.44,21512.0,22
CPT,22818,KYPHECTOMY 1-2 SEGMENTS,,,1914.0,21512.0,22
CPT,22819,KYPHECTOMY 3 OR MORE,,,2203.43,21512.0,22
CPT,22830,EXPLORATION OF SPINAL FUSION,,,728.16,17804.0,22
CPT,22836,ANT THRC VRT BODY TETHRG <7,,,1573.01,18485.0,22
CPT,22837,ANT THRC VRT BODY TETHRG 8+,,,1732.7,18485.0,22
CPT,22838,REV RPLC/RMV THRC VRT TETHRG,,,1755.49,18485.0,22
CPT,22840,INSERT SPINE FIXATION DEVICE,,,642.11,3533.0,21
CPT,22841,INSERT SPINE FIXATION DEVICE,,,835.0,5761.0,7
CPT,22842,INSERT SPINE FIXATION DEVICE,,,646.38,3533.0,21
CPT,22843,INSERT SPINE FIXATION DEVICE,,,692.1,5761.0,22
CPT,22844,INSERT SPINE FIXATION DEVICE,,,835.0,5761.0,22
CPT,22845,INSERT SPINE FIXATION DEVICE,,,613.89,17804.0,21
CPT,22846,INSERT SPINE FIXATION DEVICE,,,638.65,17804.0,22
CPT,22847,INSERT SPINE FIXATION DEVICE,,,701.38,17804.0,22
CPT,22848,INSERT PELV FIXATION DEVICE,,,307.51,5761.0,22
CPT,22849,REINSERT SPINAL FIXATION,,,1142.05,21512.0,22
CPT,22850,REMOVE SPINE FIXATION DEVICE,,,652.71,17804.0,22
CPT,22852,REMOVE SPINE FIXATION DEVICE,,,629.22,17804.0,22
CPT,22853,INSJ BIOMECHANICAL DEVICE,,,218.37,3533.0,21
CPT,22854,INSJ BIOMECHANICAL DEVICE,,,283.03,3533.0,21
CPT,22855,REMOVAL ANTERIOR INSTRMJ,,,968.22,17804.0,22
CPT,22856,TOT DISC ARTHRP 1NTRSPC CRV,,,10315.0,24394.0,22
CPT,22857,TOT DISC ARTHRP 1NTRSPC LMBR,,,1560.85,21512.0,22
CPT,22858,TOT DISC ARTHRP 2ND LVL CRV,,,431.3,3533.0,21
CPT,22859,INSJ BIOMECHANICAL DEVICE,,,282.92,3533.0,21
CPT,22860,TOT DISC ARTHRP 2NTRSPC LMBR,,,352.5,24394.0,22
CPT,22861,REV RPLCM ARTHRP 1NTRSPC CRV,,,1960.66,21512.0,22
CPT,22862,REV RPLCM RTHRP 1NTRSPC LMBR,,,1967.05,21512.0,22
CPT,22864,RMVL TOT ARTHRP 1NTRSPC CRV,,,1754.54,18485.0,22
CPT,22865,RMVL TOT ARTHRP 1NTRSPC LMBR,,,1921.53,18485.0,22
CPT,22867,INSJ STABLJ DEV W/DCMPRN,,,10315.0,24394.0,22
CPT,22868,INSJ STABLJ DEV W/DCMPRN,,,204.79,3533.0,21
CPT,22869,INSJ STABLJ DEV W/O DCMPRN,,,10315.0,24394.0,22
CPT,22870,INSJ STABLJ DEV W/O DCMPRN,,,106.83,3533.0,21
CPT,22899,"HC INTERVENTIONAL PERCUNTANEOUS SPINAL PROCEDURE, PEDICLE AUGMENTATION",17005.0,9352.75,243.77,29323.0,53
CPT,22900,EXC ABDL TUM DEEP < 5 CM,,,2908.42,9469.0,22
CPT,22901,EXC ABDL TUM DEEP 5 CM/>,,,2908.42,9469.0,22
CPT,22902,"HC EXC TUMOR SOFT TISSUE ABD WALL SUBQ, LESS THAN 3 CM",5371.0,2954.05,1611.3,6766.0,159
CPT,22903,"HC EXC TUMOR SOFT TISSUE ABD WALL SUBQ, 3 CM OR GREATER",7271.0,3999.05,2181.3,9469.0,53
CPT,22904,RADICAL RESECT ABD TUMOR<5CM,,,2908.42,8363.0,22
CPT,22905,RAD RESECT ABD TUMOR 5 CM/>,,,2908.42,9469.0,22
CPT,22999,UNLISTED PX ABDOMEN MUSCSKEL,,,243.77,29323.0,22
CPT,23000,RMVL SBDLTD CLCREOUS DEP OPN,,,2908.42,8363.0,22
CPT,23020,CAPSULAR CONTRACTURE RELEASE,,,3297.17,14658.0,22
CPT,23030,I&D SHOULDER DEEP ABSC/HMTMA,,,2908.42,9469.0,22
CPT,23031,I&D SHOULDER INFECTED BURSA,,,2908.42,9469.0,22
CPT,23035,INCISION BONE CORTEX SHO,,,1626.34,9469.0,22
CPT,23040,ARTHRT GH JT EXPL/DRG/RMV FB,,,3297.17,14658.0,22
CPT,23044,ARTHRT AC SC JT EXP/RMVL FB,,,3297.17,14658.0,22
CPT,23065,HC BIOPSY SOFT TISSUE SHOULDER AREA SUPERFICIAL,4623.0,2542.65,1386.9,5761.0,159
CPT,23066,"HC BIOPSY, SOFT TISSUE OF SHOULDER AREA; DEEP",8108.0,4459.4,2432.4,9469.0,212
CPT,23071,HC EXCISION TUMOR SOFT TISSUE OF SHOULDER AREA SUBCUTANEOUS 3 CM OR GREATER,2859.0,1572.45,857.7,9469.0,106
CPT,23073,HC EXCISION TUMOR SOFT TISSUE OF SHOULDER AREA SUBFASCIAL 5 CM OR GREATER,10150.0,5582.5,2908.42,9469.0,106
CPT,23075,"HC EXCISION TUMOR SOFT TISSUE OF SHOULDER AREA, SUBCUTANEOUS LESS THAN 3 CM",5870.0,3228.5,1646.49,6766.0,106
CPT,23076,HC EXCISION TUMOR SOFT TISSUE OF SHOULDER AREA SUBFASCIAL LESS THAN 5 CM,10150.0,5582.5,2908.42,8779.75,106
CPT,23077,"HC RADICAL RESECTION OF TUMOR, SOFT TISSUE OF SHOULDER AREA LESS THAN 5 CM",7992.0,4395.6,2397.6,8363.0,106
CPT,23078,HC RADICAL RESECTION OF TUMOR SOFT TISSUE OF SHOULDER AREA 5 CM OR GREATER,7992.0,4395.6,2397.6,9469.0,106
CPT,23100,ARTHROTOMY GLENHUMRL JT W/BX,,,3297.17,9469.0,22
CPT,23101,ARTHRT ACRMCLV/STRNCLAV JT,,,3297.17,14658.0,22
CPT,23105,ARTHROTOMY GLENOHUMERAL JT,,,7259.46,18485.0,22
CPT,23106,ARTHROTOMY STRNCLAV JOINT,,,3297.17,14658.0,22
CPT,23107,ARTHRT GLENHUMRL JT W/EXPL,,,7259.46,18485.0,22
CPT,23120,CLAVICULECTOMY PARTIAL,,,3297.17,14658.0,22
CPT,23125,CLAVICULECTOMY TOTAL,,,3297.17,14658.0,22
CPT,23130,ACROMP/ACROMIONECTOMY PRTL,,,3297.17,16799.0,22
CPT,23140,REMOVAL OF BONE LESION,,,3297.17,9469.0,22
CPT,23145,REMOVAL OF BONE LESION,,,3297.17,14658.0,22
CPT,23146,REMOVAL OF BONE LESION,,,7259.46,18485.0,22
CPT,23150,HC EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF PROXIMAL HUMERUS,8815.0,4848.25,2644.5,14658.0,106
CPT,23155,HC EXCISION/CURETTAGE BONE CYST/BENIGN TUMOR PROXIMAL HUMERUS W / AUTOGRAFT,19154.0,10534.7,5746.2,18485.0,106
CPT,23156,HC EXCISION/CURETTAGE BONE CYST/BENIGN TUMOR PROXIMAL HUMERUS W/ ALLOGRAFT,19154.0,10534.7,5746.2,18485.0,106
CPT,23170,SEQUESTRECTOMY CLAVICLE,,,3297.17,14658.0,22
CPT,23172,SEQUESTRECTOMY SCAPULA,,,3297.17,14658.0,22
CPT,23174,SQSTRCTMY HUMRL HEAD SRG NCK,,,7259.46,14658.0,22
CPT,23180,PRTL EXCISION BONE CLAVICLE,,,7259.46,14658.0,22
CPT,23182,PRTL EXCISION BONE SCAPULA,,,7259.46,14658.0,22
CPT,23184,PRTL EXCISION BONE PROX HUM,,,7259.46,18485.0,22
CPT,23190,OSTECTOMY SCAPULA PARTIAL,,,3297.17,14658.0,22
CPT,23195,RESECTION HUMERAL HEAD,,,7259.46,18485.0,22
CPT,23200,RADICAL RESCJ TUMOR CLAVICLE,,,1350.34,17804.0,22
CPT,23210,RADICAL RESCJ TUMOR SCAPULA,,,1579.74,17804.0,22
CPT,23220,RADICAL RESCJ TUMOR PROX HUM,,,1728.81,17804.0,22
CPT,23330,"HC REMOVAL OF FOREIGN BODY, SHOULDER, SUBCUTANEOUS",1843.0,1013.65,552.9,4955.0,53
CPT,23333,REMOVE SHOULDER FB DEEP,,,2908.42,5761.0,22
CPT,23334,SHOULDER PROSTHESIS REMOVAL,,,2908.42,9469.0,22
CPT,23335,SHOULDER PROSTHESIS REMOVAL,,,1140.42,9469.0,22
CPT,23350,HC INJ PROC SHOULDER ARTHROGRAPHY/ENHANCED CT/MRI SHOULDER ARTHROGRAPHY,435.0,239.25,130.5,3533.0,318
CPT,23350,INJECTION FOR SHOULDER X-RAY,,,254.58,254.58,1
CPT,23395,MUSCLE TRANSFER SHOULDER/ARM,,,7259.46,18485.0,22
CPT,23397,MUSCLE TRANSFERS,,,7259.46,18485.0,22
CPT,23400,FIXATION OF SHOULDER BLADE,,,7259.46,18485.0,22
CPT,23405,INCISION OF TENDON & MUSCLE,,,7259.46,18485.0,22
CPT,23406,INCISE TENDON(S) & MUSCLE(S),,,7259.46,14658.0,22
CPT,23410,"HC REPAIR OF RUPTURED MUSCULOTENDINOUS CUFF OPEN, ACUTE",15144.0,8329.2,4543.2,18485.0,106
CPT,23412,"HC REPAIR OF RUPTURED MUSCULOTENDINOUS CUFF (EG, ROTATOR CUFF) OPEN CHRONIC",19154.0,10534.7,5746.2,18485.0,106
CPT,23415,RELEASE OF SHOULDER LIGAMENT,,,7259.46,18485.0,22
CPT,23420,REPAIR OF SHOULDER,,,7259.46,18485.0,22
CPT,23430,REPAIR BICEPS TENDON,,,7259.46,18485.0,22
CPT,23440,REMOVE/TRANSPLANT TENDON,,,7259.46,14658.0,22
CPT,23450,REPAIR SHOULDER CAPSULE,,,7259.46,18485.0,22
CPT,23455,REPAIR SHOULDER CAPSULE,,,7259.46,18485.0,22
CPT,23460,REPAIR SHOULDER CAPSULE,,,7259.46,18485.0,22
CPT,23462,REPAIR SHOULDER CAPSULE,,,7259.46,18485.0,22
CPT,23465,REPAIR SHOULDER CAPSULE,,,7259.46,18485.0,22
CPT,23466,REPAIR SHOULDER CAPSULE,,,7259.46,18485.0,22
CPT,23470,"HC ARTHROPLASTY, GLENOHUMERAL JOINT HEMIARTHROPLASTY",25135.0,13824.25,7540.5,21741.78,106
CPT,23472,RECONSTRUCT SHOULDER JOINT,,,12463.0,21512.0,22
CPT,23473,REVIS RECONST SHOULDER JOINT,,,9733.0,19884.0,22
CPT,23474,REVIS RECONST SHOULDER JOINT,,,1554.36,19884.0,22
CPT,23480,REVISION OF COLLAR BONE,,,7259.46,18485.0,22
CPT,23485,REVISION OF COLLAR BONE,,,10315.0,19884.0,22
CPT,23490,REINFORCE CLAVICLE,,,7259.46,18485.0,22
CPT,23491,HC PROPHYLACTIC TREATMENT W/WO WITHOUT METHYLMETHACRYLATE PROXIMAL HUMERUS,36006.0,19803.3,10315.0,31145.19,106
CPT,23500,HC TREAT CLAVICLE FRACTURE,714.0,392.7,214.2,4258.0,106
CPT,23505,CLTX CLAVICULAR FX W/MNPJ,,,1626.34,5761.0,22
CPT,23515,"HC IR OPEN TX CLAVICLE FX, INCLUDES INTERNAL FIXATION WHEN PERFORMED",22806.0,12543.3,6841.8,19727.19,53
CPT,23520,CLTX STRNCLAV DISLC W/O MNPJ,,,1626.34,6766.0,22
CPT,23525,CLTX STRNCLAV DISLC W/MNPJ,,,243.77,4258.0,22
CPT,23530,OPTX STRNCLAV DISLC AQT/CHRN,,,7259.46,18485.0,22
CPT,23532,OPTX STRCLV DSLC AQ/CHRN GRF,,,5480.0,18485.0,22
CPT,23540,"HC CLOSED TREATMENT ACROMIOCLAVICULAR DISLOCATION, WITHOUT MANIPULATION",637.0,350.35,191.1,4258.0,106
CPT,23545,CLTX ACROMCLAV DISLC W/MNPJ,,,243.77,4258.0,22
CPT,23550,OPTX ACROMCLV DISLC AQT/CHRN,,,7259.46,18485.0,22
CPT,23552,OPTX ACRCLV DSLC AQ/CHRN GRF,,,7259.46,18485.0,22
CPT,23570,HC CLSD TX SCAPULAR FX WO MANIPULATION,767.0,421.85,230.1,4258.0,106
CPT,23575,CLTX SCAP FX W/MNPJ +-TRACTJ,,,835.0,5761.0,22
CPT,23585,"HC OPEN TX SCAPULAR FX, W INTERNAL FIXATION",20865.0,11475.75,6259.5,18485.0,53
CPT,23600,"HC CLOSED TREATMENT PROXIMAL HUMERAL FRACTURE, WITHOUT MANIPULATION",950.0,522.5,243.77,4258.0,106
CPT,23605,HC CLSD TX PROXIMAL HUMERAL FX W MANIPULATION,6420.0,3531.0,1626.34,9469.0,53
CPT,23615,OPTX PROX HUMRL FX W/INT FIX,,,10315.0,19884.0,22
CPT,23616,HC OPEN TREATMENT PROXIMAL HUMERAL FRACTURE W/ PROX HUM PROSTHETIC RPLCMT,43135.0,23724.25,10315.0,37311.78,106
CPT,23620,HC CLSD TX GREATER HUMERAL TUBEROSITY FRACTURE W/O MANIPULATION,747.0,410.85,224.1,4258.0,106
CPT,23625,HC CLSD TX GREATER HUMERAL TUBEROSITY FX W MANIP,3867.0,2126.85,1160.1,6766.0,53
CPT,23630,OPTX GR HMRL TBRS FX INT FIX,,,7259.46,18485.0,22
CPT,23650,"HC CLSD TX SHOULDER DISLOCATION, W/ MANIPULATION, W/O ANESTHESIA",689.0,378.95,206.7,4258.0,53
CPT,23655,"HC CLSD TX SHOULDER DISLOCATION, WITH MANIPULATION, REQUIRING ANESTHESIA",2880.0,1584.0,864.0,6766.0,53
CPT,23660,OPTX ACUTE SHOULDER DISLC,,,7259.46,18485.0,22
CPT,23665,"HC CLSD TX SHOULDER DISLOC, W/FX OF GREATER HUMERAL TUBEROSITY, W/MANIP",2157.0,1186.35,647.1,5761.0,53
CPT,23670,OPTX SHO DISLC FX,,,7259.46,18485.0,22
CPT,23675,"HC CLSD TX SHOULDER DISLOCATION, W/ SURG OR ANATOMICAL NECK FX, W/ MANIP",1808.0,994.4,542.4,5761.0,53
CPT,23680,OPTX SHO DISLC NECK FX FIXJ,,,10315.0,19884.0,22
CPT,23700,MNPJ ANES SHO JT FIXJ APRATS,,,1626.34,6766.0,22
CPT,23800,ARTHRODESIS GLENOHUMERAL JT,,,7259.46,18485.0,22
CPT,23802,ARTHRD GLENOHUMERAL JT W/GRF,,,10315.0,19884.0,22
CPT,23900,INTERTHORACOSCPLR AMPUTATION,,,1243.52,17804.0,22
CPT,23920,DISARTICULATION SHOULDER,,,1014.85,17804.0,22
CPT,23921,DISARTICULATION SHO SEC CLSR,,,1858.86,6766.0,22
CPT,23929,HC INTERVENTIONAL PROC SHOULDER,4755.0,2615.25,243.77,4258.0,53
CPT,23929,"HC SHOULDER BARBOTAGE, UNLISTED PROCEDURE",17062.0,9384.1,243.77,14758.63,53
CPT,23930,I&D UPR A/E DP ABSC/HMTMA,,,2908.42,9469.0,22
CPT,23931,I&D UPR A/E BURSA,,,1646.49,6766.0,22
CPT,23935,INC DP OPN B1 CRTX HUM/ELBW,,,3297.17,9469.0,22
CPT,24000,ARTHRT ELBW EXPL DRG/RMVL FB,,,3297.17,14658.0,22
CPT,24006,ARTHRT ELBW CAPSL EXC RLS,,,3297.17,14658.0,22
CPT,24065,"HC BIOPSY, SOFT TISSUE OF UPPER ARM OR ELBOW AREA; SUPERFICIAL",4623.0,2542.65,1386.9,6766.0,212
CPT,24066,HC BX SOFT TISSUE OF UPPER ARM/ELBOW AREA DEEP (SUBFASCIAL / INTRAMUSCULAR),7992.0,4395.6,2397.6,8363.0,212
CPT,24071,EXC ARM/ELBOW LES SC 3 CM/>,,,2908.42,9469.0,22
CPT,24073,HC EXCISION TUMOR SOFT TISS UPPER ARM/ELBOW AREA SUBFASCIAL 5 CM OR GREATER,10150.0,5582.5,2908.42,9469.0,106
CPT,24075,HC EXCISION TUMOR SOFT TISSUE UPPER OF ARM OR ELBOW SUBQ LESS THAN 3 CM,3161.0,1738.55,948.3,6766.0,106
CPT,24076,HC EXCISION TUMOR SOFT TISS UPPER ARM/ELBOW AREA SUBFASCIAL LESS THAN 5 CM,6429.0,3535.95,1928.7,8363.0,106
CPT,24077,HC RADICAL RESECTION TUMOR SOFT TISSUE UPPER ARM/ELBOW AREA LESS THAN 5 CM,7992.0,4395.6,2397.6,8363.0,106
CPT,24079,HC RADICAL RESECTION TUMOR  SOFT TISS UPPER ARM/ELBOW AREA 5 CM OR GREATER,10150.0,5582.5,2908.42,9469.0,106
CPT,24100,ARTHRT ELBW SYNOVIAL BX ONLY,,,3297.17,9469.0,22
CPT,24101,ARTHRT ELBW JT EXPL BX RMVL,,,3297.17,14658.0,22
CPT,24102,ARTHRT ELBOW W/SYNOVECTOMY,,,3297.17,14658.0,22
CPT,24105,EXCISION OLECRANON BURSA,,,3297.17,9469.0,22
CPT,24110,"HC EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, HUMERUS",6578.0,3617.9,1973.4,9469.0,106
CPT,24115,HC EXCISION/CURETTAGE OF BONE CYST/BENIGN TUMOR HUMERUS  W/ AUTOGRAFT,19154.0,10534.7,5746.2,18485.0,106
CPT,24116,EXC/CRTG B1 CST/TUM HUM ALGR,,,7259.46,18485.0,22
CPT,24120,HC EXC/CURTG OF BONE CYST/BENIGN TUMOR HEAD/NECK RADIUS/OLECRANON PROCESS,8815.0,4848.25,2644.5,9469.0,106
CPT,24125,HC EXC/CURTG OF BONE CYST/BENIGN TUMOR OF H/N OF RDS/OLECRN W/ AUTOGRAFT,8815.0,4848.25,2644.5,14658.0,106
CPT,24126,HC EXC/CURTG OF BONE CYST/BENIGN TUMOR OF H/N OF RDS/OLECRN W/ ALLOGRAFT,19154.0,10534.7,5746.2,18485.0,106
CPT,24130,EXCISION RADIAL HEAD,,,3297.17,14658.0,22
CPT,24134,SEQUESTRECTOMY SHFT/DSTL HUM,,,7259.46,18485.0,22
CPT,24136,SEQUESTRECTOMY RADIAL H/N,,,3297.17,14658.0,22
CPT,24138,SEQUESTRECTOMY OLECRN PROCES,,,7259.46,18485.0,22
CPT,24140,HC PARTIAL EXCISION BONE HUMERUS,7937.0,4365.35,2381.1,14658.0,106
CPT,24145,HC PARTIAL EXCISION BONE RADIAL HEAD/NECK,19154.0,10534.7,5746.2,18485.0,106
CPT,24147,HC PARTIAL EXCISION BONE OLECRANON PROCESS,6811.0,3746.05,2043.3,14658.0,106
CPT,24149,RADICAL RESECTION OF ELBOW,,,7259.46,18485.0,22
CPT,24150,"HC RADICAL RESECTION OF TUMOR, SHAFT OR DISTAL HUMERUS",19154.0,10534.7,5746.2,18485.0,106
CPT,24152,RAD RESECTION TUM RADIAL H/N,,,7259.46,18485.0,22
CPT,24155,RESECTION OF ELBOW JOINT,,,3297.17,14658.0,22
CPT,24160,RMVL PROSTHHUMRL&ULNAR CMPNT,,,3297.17,14658.0,22
CPT,24164,REMOVAL PROSTH RADIAL HEAD,,,3297.17,14658.0,22
CPT,24200,"HC REMOVE FOREIGN BODY, UPPER ARM OR ELBOW AREA, SUBCUTANEOUS",2314.0,1272.7,694.2,5761.0,106
CPT,24201,RMVL FB UPPER ARM/ELBW DEEP,,,2908.42,8363.0,22
CPT,24220,HC INJ PROC ELBOW ARTHROGRAPHY,314.0,172.7,94.2,3533.0,265
CPT,24220,INJECTION PX FOR ELBOW ARTHG,,,301.41,301.41,1
CPT,24300,MNPJ ELBOW UNDER ANES,,,1626.34,6766.0,22
CPT,24301,MUSC/TDN TRANSFER UPR A/E 1,,,7259.46,18485.0,22
CPT,24305,TENDON LNGTH UPR A/E EA TDN,,,3297.17,14658.0,22
CPT,24310,TNOT OPN ELBW TO SHO EA TDN,,,3297.17,9469.0,22
CPT,24320,TENOPLASTY ELBOW TO SHO 1,,,7259.46,18485.0,22
CPT,24330,FLEXOR-PLASTY ELBOW,,,7259.46,17804.0,22
CPT,24331,FLEXOR-PLASTY ELBW W/ADVMNT,,,7259.46,18485.0,22
CPT,24332,TENOLYSIS TRICEPS,,,3297.17,14658.0,22
CPT,24340,TENODESIS BICEPS TDN AT ELBW,,,7259.46,18485.0,22
CPT,24341,HC REPAIR TENDON/MUSCLE UPPER ARM/ELBOW EA,18247.0,10035.85,5474.1,18485.0,53
CPT,24342,REPAIR OF RUPTURED TENDON,,,7259.46,18485.0,22
CPT,24343,REPR ELBOW LAT LIGMNT W/TISS,,,3297.17,14658.0,22
CPT,24344,RECONSTRUCT ELBOW LAT LIGMNT,,,7259.46,18485.0,22
CPT,24345,REPR ELBW MED LIGMNT W/TISSU,,,7259.46,18485.0,22
CPT,24346,RECONSTRUCT ELBOW MED LIGMNT,,,9733.0,19884.0,22
CPT,24357,REPAIR ELBOW PERC,,,3297.17,9469.0,22
CPT,24358,REPAIR ELBOW W/DEB OPEN,,,3297.17,14658.0,22
CPT,24359,REPAIR ELBOW DEB/ATTCH OPEN,,,3297.17,14658.0,22
CPT,24360,RECONSTRUCT ELBOW JOINT,,,7259.46,18485.0,22
CPT,24361,RECONSTRUCT ELBOW JOINT,,,12463.0,24394.0,22
CPT,24362,RECONSTRUCT ELBOW JOINT,,,9733.0,19884.0,22
CPT,24363,REPLACE ELBOW JOINT,,,12463.0,24394.0,22
CPT,24365,RECONSTRUCT HEAD OF RADIUS,,,9733.0,19884.0,22
CPT,24366,RECONSTRUCT HEAD OF RADIUS,,,12463.0,21512.0,22
CPT,24370,REVISE RECONST ELBOW JOINT,,,12463.0,21512.0,22
CPT,24371,REVISE RECONST ELBOW JOINT,,,12463.0,24394.0,22
CPT,24400,OSTEOT HUMERUS W/WO INT FIXJ,,,7259.46,18485.0,22
CPT,24410,MLT OSTEOT RLGNM IMED RD HUM,,,9733.0,19884.0,22
CPT,24420,OSTEOPLASTY HUMERUS,,,7259.46,18485.0,22
CPT,24430,RPR NON/MAL HUMERUS WO GRAFT,,,10315.0,19884.0,22
CPT,24435,RPR NON/MAL HUM WITH AGRFT,,,10315.0,19884.0,22
CPT,24470,HEMIEPIPHYSEAL ARREST,,,3297.17,16799.0,22
CPT,24495,DECOMPRESSION FASCT FOREARM,,,7259.46,18485.0,22
CPT,24498,"HC PROPHYLACTIC TREATMENT WITH OR WITHOUT METHYLMETHACRYLATE, HUMERAL SHAFT",24618.0,13539.9,7385.4,21294.57,106
CPT,24500,"HC CLOSED TREATMENT HUMERAL SHAFT FRACTURE, WITHOUT MANIPULATION",880.0,484.0,243.77,4258.0,106
CPT,24505,"HC CLOSED TREATMENT HUMERAL SHAFT FX, W/ MANIP, W/ OR W/O SKELETAL TRACTION",2157.0,1186.35,647.1,5761.0,106
CPT,24515,HC OPEN TREATMENT OF HUMERAL SHAFT FRACTURE WITH PLATE/SCREWS W/WO CERCLAGE,36006.0,19803.3,10315.0,31145.19,106
CPT,24516,HC TX OF HUMERAL SHAFT FX W/INSJ IMED IMPLT W/WO CERCLAGE AND/OR LOCK SCREW,24618.0,13539.9,7385.4,21294.57,106
CPT,24530,HC CLSD TX SUPRA/TRANSCONDYLAR HUMERAL FX W/WO INTERCNDYLR EXT W/O MANIP,789.0,433.95,236.7,4258.0,106
CPT,24535,HC CLSD TX SUPRA-TRANSCONDYLAR HUMERAL FX W MANIP,2157.0,1186.35,647.1,5761.0,53
CPT,24538,PRQ SKEL FIX SPRCNDLR HUM FX,,,5480.0,18485.0,22
CPT,24545,HC OPEN TREATMENT OF HUMRAL SUPRACONDYLAR OR TRANSCONDYLAR FRACTURE W/O XTN,45720.0,25146.0,10315.0,39547.8,106
CPT,24546,HC OPEN TREATMENT OF HUMERAL SUPRACONDYLAR OR TRANSCONDYLAR FRACTURE W/ XTN,29493.0,16221.15,8847.9,25511.45,106
CPT,24560,HC CLSD TX HUMERAL EPICOND FX MEDIAL LAT WO MANIP,637.0,350.35,191.1,4258.0,106
CPT,24565,CLTX HUM EPCNDYLR FX W/MNPJ,,,835.0,5761.0,22
CPT,24566,PRQ SKEL FIX EPCNDYLR HUM FX,,,1626.34,9469.0,22
CPT,24575,OPTX HUMERAL EPCNDYLR FX,,,10315.0,19884.0,22
CPT,24576,HC CLSD TX HUMERAL CONDYLAR FX MEDIAL LAT WO MANIP,572.0,314.6,171.6,4258.0,53
CPT,24577,HC CLOSED TREATMENT HUMERAL CONDYLAR FRACTURE MEDIAL/LATERAL W/MANIPULATION,4547.0,2500.85,835.0,5761.0,53
CPT,24579,OPTX HUMRL CNDYLR FRACTURE,,,10315.0,19884.0,22
CPT,24582,PRQ SKEL FIX HUMRL CNDYLR FX,,,5480.0,9469.0,22
CPT,24586,OPTX PARTCLR FX&/DISLC ELBOW,,,10315.0,19884.0,22
CPT,24587,OPTX PARTCLR FX&/DSLC ELBW W,,,10315.0,19884.0,22
CPT,24600,"HC TREATMENT CLOSED ELBOW DISLOCATION, WITHOUT ANESTHESIA",966.0,531.3,243.77,4258.0,106
CPT,24605,HC CLSD TX ELBOW DISLOCATION W ANES,3536.0,1944.8,1060.8,6766.0,53
CPT,24615,OPTX AQT/CHRNC ELBOW DISLC,,,7259.46,18485.0,22
CPT,24620,HC TREAT ELBOW FRACTURE,5056.0,2780.8,1516.8,6766.0,53
CPT,24635,OPTX MONTEGGIA FX DISLC ELBW,,,7259.46,18485.0,22
CPT,24640,"HC CLSD TX RADIAL HEAD SUBLUXATION IN CHILD, NURSEMAID ELBOW W/ MANIP",602.0,331.1,180.6,4258.0,53
CPT,24650,HC CLSD TX RADIAL HEAD NECK FX WO MANIP,749.0,411.95,224.7,4258.0,106
CPT,24655,"HC CLOSED TREATMENT RADIAL HEAD OR NECK FRACTURE, WITH MANIPULATION",2157.0,1186.35,647.1,5761.0,53
CPT,24665,OPTX RADIAL HEAD/NECK FX,,,7259.46,18485.0,22
CPT,24666,OPTX RADIAL HEAD/NCK FX RPLC,,,10315.0,19884.0,22
CPT,24670,HC CLSD TX ULNA FX (OLECRANON PROCESS) WO MANIP,729.0,400.95,218.7,4258.0,106
CPT,24675,"HC CLOSED TREATMENT ULNAR FRACTURE, PROXIMAL END WITH MANIPULATION",1910.0,1050.5,573.0,5761.0,53
CPT,24685,OPTX ULNAR FX PROX END W/FIX,,,7259.46,18485.0,22
CPT,24800,ARTHRODESIS ELBW JOINT LOCAL,,,7259.46,18485.0,22
CPT,24802,ARTHRD ELBOW JT AUTOG GRAFT,,,10315.0,19884.0,22
CPT,24900,AMPUTATION OF UPPER ARM,,,697.24,17804.0,22
CPT,24920,AMPUTATION OF UPPER ARM,,,668.27,17804.0,22
CPT,24925,AMPUTATION FOLLOW-UP SURGERY,,,3297.17,9469.0,22
CPT,24930,AMPUTATION FOLLOW-UP SURGERY,,,703.76,17804.0,22
CPT,24931,AMPUTATE UPPER ARM & IMPLANT,,,842.26,17804.0,22
CPT,24935,REVISION OF AMPUTATION,,,7259.46,18485.0,22
CPT,24940,REVISION OF UPPER ARM,,,8363.0,17804.0,7
CPT,24999,"HC FX REDUCT OF THE DISTAL HUMERUS, UNLISTED PROC",789.0,433.95,236.7,29323.0,53
CPT,25000,INCISION OF TENDON SHEATH,,,1626.34,9469.0,22
CPT,25001,INCISE FLEXOR CARPI RADIALIS,,,3297.17,9469.0,22
CPT,25020,DECOMPRESS FOREARM 1 SPACE,,,1626.34,14658.0,22
CPT,25023,DECOMPRESS FOREARM 1 SPACE,,,3297.17,14658.0,22
CPT,25024,DECOMPRESS FOREARM 2 SPACES,,,3297.17,14658.0,22
CPT,25025,DECOMPRESS FOREARM 2 SPACES,,,1626.34,9469.0,22
CPT,25028,I&D F/ARM&/WRST DP ABSC/HMTM,,,3297.17,9469.0,22
CPT,25031,"HC INCISION AND DRAINAGE , FOREARM AND/OR WRIST, BURSA",4414.0,2427.7,1324.2,9469.0,53
CPT,25035,INC DP BONE CRTX F/ARM&/WRST,,,5480.0,18485.0,22
CPT,25040,ARTHRT RDCRPL/MIDCARPL JT,,,3297.17,14658.0,22
CPT,25065,"HC BIOPSY, SOFT TISSUE OF FOREARM AND/OR WRIST SUPERFICIAL",5114.0,2812.7,1534.2,5761.0,265
CPT,25066,HC BIOPSY SOFT TISSUE OF FOREARM A/OR WRIST DEEP (SUBFASCIAL/INTRAMUSCULAR),6113.0,3362.15,1833.9,9469.0,212
CPT,25071,"HC EXC TUMOR SOFT TISS FOREARM WRIST SUBQ, 3 CM OR GREATER",5870.0,3228.5,1646.49,9469.0,106
CPT,25073,"HC EXCISION, TUMOR, SOFT TISSUE FOREARM/WRIST, SUBFASCIAL 3 CM OR GREATER",8617.0,4739.35,2585.1,9469.0,53
CPT,25075,HC EXC TUMOR SOFT TISS FOREARM WRIST SUBQ LESS THAN 3 CM,3536.0,1944.8,1060.8,6766.0,106
CPT,25076,"HC EXC TUMOR SOFT TISSUE OF FOREARM&/WRIST AREA, SUBFASCIAL LESS THAN 3 CM",3825.0,2103.75,1147.5,6766.0,106
CPT,25077,HC RADICAL RESECTION TUMOR SOFT TISS OF FOREARM/WRIST AREA LESS THAN 3 CM,4623.0,2542.65,1386.9,6766.0,106
CPT,25078,HC RADICAL RESECTION TUMOR SOFT TISS OF FOREARM/WRIST AREA 3 CM OR GREATER,10150.0,5582.5,2908.42,9469.0,106
CPT,25085,INCISION OF WRIST CAPSULE,,,3297.17,9469.0,22
CPT,25100,BIOPSY OF WRIST JOINT,,,3297.17,9469.0,22
CPT,25101,EXPLORE/TREAT WRIST JOINT,,,3297.17,14658.0,22
CPT,25105,REMOVE WRIST JOINT LINING,,,3297.17,14658.0,22
CPT,25107,REMOVE WRIST JOINT CARTILAGE,,,3297.17,14658.0,22
CPT,25109,EXCISE TENDON FOREARM/WRIST,,,3297.17,9469.0,22
CPT,25110,REMOVE WRIST TENDON LESION,,,1626.34,9469.0,22
CPT,25111,REMOVE WRIST TENDON LESION,,,1626.34,9469.0,22
CPT,25112,REREMOVE WRIST TENDON LESION,,,1626.34,9469.0,22
CPT,25115,REMOVE WRIST/FOREARM LESION,,,1626.34,9469.0,22
CPT,25116,REMOVE WRIST/FOREARM LESION,,,3297.17,9469.0,22
CPT,25118,EXCISE WRIST TENDON SHEATH,,,1626.34,9469.0,22
CPT,25119,PARTIAL REMOVAL OF ULNA,,,3297.17,14658.0,22
CPT,25120,HC EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF RADIUS OR ULNA,6027.0,3314.85,1808.1,14658.0,106
CPT,25125,HC EXCISION/CURETTAGE BONE CYST OR BENIGN TUMOR OF RADIUS/ULNA W/ AUTOGRAFT,4414.0,2427.7,1324.2,9469.0,106
CPT,25126,HC EXCISION/CURETTAGE BONE CYST OR BENIGN TUMOR OF RADIUS/ULNA W/ ALLOGRAFT,8815.0,4848.25,2644.5,14658.0,106
CPT,25130,REMOVAL OF WRIST LESION,,,3297.17,14658.0,22
CPT,25135,REMOVE & GRAFT WRIST LESION,,,7259.46,14658.0,22
CPT,25136,REMOVE & GRAFT WRIST LESION,,,7259.46,18485.0,22
CPT,25145,REMOVE FOREARM BONE LESION,,,3297.17,14658.0,22
CPT,25150,PARTIAL REMOVAL OF ULNA,,,3297.17,14658.0,22
CPT,25151,PARTIAL REMOVAL OF RADIUS,,,3297.17,14658.0,22
CPT,25170,"HC RADICAL RESECTION OF TUMOR, RADIUS OR ULNA",19154.0,10534.7,5746.2,18485.0,106
CPT,25210,REMOVAL OF WRIST BONE,,,3297.17,14658.0,22
CPT,25215,REMOVAL OF WRIST BONES,,,3297.17,14658.0,22
CPT,25230,PARTIAL REMOVAL OF RADIUS,,,3297.17,14658.0,22
CPT,25240,PARTIAL REMOVAL OF ULNA,,,3297.17,14658.0,22
CPT,25246,HC INJ PROC WRIST ARTHROGRAPHY,331.0,182.05,99.3,3533.0,265
CPT,25246,INJECTION FOR WRIST X-RAY,,,306.45,306.45,1
CPT,25248,REMOVE FOREARM FOREIGN BODY,,,1626.34,9469.0,22
CPT,25250,REMOVAL OF WRIST PROSTHESIS,,,1626.34,6766.0,22
CPT,25251,REMOVAL OF WRIST PROSTHESIS,,,3297.17,14658.0,22
CPT,25259,MANIPULATE WRIST W/ANESTHES,,,1626.34,6766.0,22
CPT,25260,"HC REPR, TENDON/MUSC, FLEXOR, FOREARM AND/OR WRIST, PRIM, SGL, EA TEND/MUSC",9265.0,5095.75,2779.5,14658.0,53
CPT,25263,REPAIR FOREARM TENDON/MUSCLE,,,7259.46,14658.0,22
CPT,25265,REPAIR FOREARM TENDON/MUSCLE,,,3297.17,14658.0,22
CPT,25270,HC REPR TENDN MUSCL EXTNSR FORARM WRST PRIM SINGL,9265.0,5095.75,2779.5,14658.0,53
CPT,25272,REPAIR FOREARM TENDON/MUSCLE,,,3297.17,14658.0,22
CPT,25274,REPAIR FOREARM TENDON/MUSCLE,,,3297.17,14658.0,22
CPT,25275,REPAIR FOREARM TENDON SHEATH,,,3297.17,14658.0,22
CPT,25280,REVISE WRIST/FOREARM TENDON,,,3297.17,14658.0,22
CPT,25290,INCISE WRIST/FOREARM TENDON,,,3297.17,14658.0,22
CPT,25295,RELEASE WRIST/FOREARM TENDON,,,3297.17,9469.0,22
CPT,25300,FUSION OF TENDONS AT WRIST,,,3297.17,14658.0,22
CPT,25301,FUSION OF TENDONS AT WRIST,,,3297.17,14658.0,22
CPT,25310,TRANSPLANT FOREARM TENDON,,,3297.17,14658.0,22
CPT,25312,TRANSPLANT FOREARM TENDON,,,3297.17,16799.0,22
CPT,25315,REVISE PALSY HAND TENDON(S),,,7259.46,18485.0,22
CPT,25316,REVISE PALSY HAND TENDON(S),,,7259.46,18485.0,22
CPT,25320,REPAIR/REVISE WRIST JOINT,,,7259.46,18485.0,22
CPT,25332,REVISE WRIST JOINT,,,3297.17,16799.0,22
CPT,25335,CENTRALIZATION WRIST ON ULNA,,,3297.17,16799.0,22
CPT,25337,RECONSTRUCT ULNA/RADIOULNAR,,,7259.46,18485.0,22
CPT,25350,REVISION OF RADIUS,,,7259.46,18485.0,22
CPT,25355,REVISION OF RADIUS,,,3297.17,16799.0,22
CPT,25360,REVISION OF ULNA,,,7259.46,18485.0,22
CPT,25365,REVISE RADIUS & ULNA,,,9733.0,19884.0,22
CPT,25370,REVISE RADIUS OR ULNA,,,3297.17,16799.0,22
CPT,25375,REVISE RADIUS & ULNA,,,3297.17,16799.0,22
CPT,25390,SHORTEN RADIUS OR ULNA,,,7259.46,18485.0,22
CPT,25391,LENGTHEN RADIUS OR ULNA,,,9733.0,19884.0,22
CPT,25392,SHORTEN RADIUS & ULNA,,,7259.46,14658.0,22
CPT,25393,LENGTHEN RADIUS & ULNA,,,7259.46,16799.0,22
CPT,25394,REPAIR CARPAL BONE SHORTEN,,,3297.17,16799.0,22
CPT,25400,REPAIR RADIUS OR ULNA,,,7259.46,18485.0,22
CPT,25405,REPAIR/GRAFT RADIUS OR ULNA,,,7259.46,18485.0,22
CPT,25415,REPAIR RADIUS & ULNA,,,7259.46,18485.0,22
CPT,25420,REPAIR/GRAFT RADIUS & ULNA,,,7259.46,18485.0,22
CPT,25425,REPAIR/GRAFT RADIUS OR ULNA,,,7259.46,18485.0,22
CPT,25426,REPAIR/GRAFT RADIUS & ULNA,,,3297.17,16799.0,22
CPT,25430,VASC GRAFT INTO CARPAL BONE,,,3297.17,16799.0,22
CPT,25431,REPAIR NONUNION CARPAL BONE,,,7259.46,18485.0,22
CPT,25440,REPAIR NONU SCPHD CARPL B1,,,7259.46,18485.0,22
CPT,25441,ARTHRP W/PROSTC DSTL RDS,,,12463.0,21512.0,22
CPT,25442,ARTHRP W/PROSTC DSTL ULNA,,,12463.0,24394.0,22
CPT,25443,ARTHRP PROSTC DSTL SCPH CRPL,,,7259.46,18485.0,22
CPT,25444,ARTHRP W/PROSTC LUNATE,,,10315.0,19884.0,22
CPT,25445,ARTHRP W/PROSTC TRAPEZIUM,,,7259.46,18485.0,22
CPT,25446,ARTHRP W/PROSTC DST RDS&CRPS,,,12463.0,24394.0,22
CPT,25447,ARTHRP NTRCRP/CRP/MTCR NTRPS,,,3297.17,16799.0,22
CPT,25448,ARTHRP NTRCRPL/CRP/MTCRP SSP,,,3297.17,14658.0,22
CPT,25449,REVJ ARTHRP WRIST JOINT,,,7259.46,18485.0,22
CPT,25450,EPIPHYSL ARRST DSTL RDS/ULNA,,,3297.17,16799.0,22
CPT,25455,EPIPHYSL ARRST DSTL RDS&ULNA,,,3297.17,16799.0,22
CPT,25490,PROPHYLACTIC TX RADIUS,,,7259.46,18485.0,22
CPT,25491,PROPHYLACTIC TX ULNA,,,9733.0,19884.0,22
CPT,25492,PROPHYLACTIC TX RADIUS&ULNA,,,3297.17,16799.0,22
CPT,25500,HC CLSD TX RADIAL SHAFT FX WO MANIPULATION,685.0,376.75,205.5,4258.0,106
CPT,25505,"HC CLOSED TREATMENT RADIAL SHAFT FRACTURE, WITH MANIPULATION",2077.0,1142.35,623.1,5761.0,53
CPT,25515,OPTX RADIAL SHAFT FRACTURE,,,7259.46,18485.0,22
CPT,25520,HC CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT,4342.0,2388.1,835.0,5761.0,53
CPT,25525,OPTX RDL SHFT FX&CLTX RAD/UL,,,7259.46,18485.0,22
CPT,25526,OPTX RDL SHFT FX&DSTL RAD/UL,,,7259.46,18485.0,22
CPT,25530,HC CLSD TX ULNA SHAFT FX WO MANIPULATION,538.0,295.9,161.4,4258.0,106
CPT,25535,HC CLSD TX ULNA SHAFT FX W MANIPULATION,912.0,501.6,243.77,4258.0,53
CPT,25545,OPTX ULNAR SHFT FX INT FIXJ,,,7259.46,18485.0,22
CPT,25560,"HC CLOSED TREATMENT RADIAL AND ULNAR SHAFT FRACTURES, WITHOUT MANIPULATION",637.0,350.35,191.1,4258.0,106
CPT,25565,"HC CLOSED TREATMENT RADIAL AND ULNAR SHAFT FRACTURES, WITH MANIPULATION",2157.0,1186.35,647.1,5761.0,53
CPT,25574,OPTX RDL&ULN SHFT FX RDS/ULN,,,7259.46,18485.0,22
CPT,25575,OPTX RDL&ULN SHFT FX RDS&ULN,,,7259.46,18485.0,22
CPT,25600,HC CLSD TX DISTAL RADIUS ULNA STYLOID FX WO MANIP,973.0,535.15,243.77,4258.0,106
CPT,25605,HC CLSD TX DISTAL RAD FX/EPIPHYSEAL SEP INCL CLSD TX FX ULNAR STYLD W/MANIP,1885.0,1036.75,565.5,5761.0,106
CPT,25606,PERQ SKEL FIXJ DSTL RDL FX,,,3297.17,9469.0,22
CPT,25607,OPTX DST RD XARTC FX/EPI SEP,,,7259.46,18485.0,22
CPT,25608,OPTX DST RD XART FX/EPI SEP2,,,7259.46,18485.0,22
CPT,25609,OPTX DST RD XART FX/EP SEP3+,,,7259.46,18485.0,22
CPT,25622,HC CLSD TX NAVICULAR FX WO MANIPULATION,841.0,462.55,243.77,4258.0,106
CPT,25624,HC CLSD TX NAVICULAR FX W MANIPULATION,2157.0,1186.35,647.1,5761.0,53
CPT,25628,OPTX CARPL SCPHD FX INT FIXJ,,,7259.46,18485.0,22
CPT,25630,HC CLSD TX CARPAL BONE FX WO MANIPULATN EA BONE,876.0,481.8,243.77,4258.0,106
CPT,25635,HC CLSD TX CARPAL BONE FX W MANIPULATN EA BONE,2740.0,1507.0,822.0,5761.0,53
CPT,25645,OPTX CRPL FX OTH/THN SCPH EA,,,3297.17,17804.0,22
CPT,25650,HC CLSD TX ULNAR STYLOID FRACTURE,626.0,344.3,187.8,4258.0,106
CPT,25651,PERQ SKEL FIX ULNAR STYLD FX,,,3297.17,9469.0,22
CPT,25652,OPTX ULNAR STYLOID FRACTURE,,,7259.46,18485.0,22
CPT,25660,"HC CLOSED TX RADIO OR INTERCARPAL DISLOCATION, 1 OR MORE BONES, W/ MANIP",777.0,427.35,233.1,4258.0,53
CPT,25670,OPTX RDCRPL/NTRCRPL DISLC 1+,,,5480.0,9469.0,22
CPT,25671,PERQ SKEL FIX RAD/ULN DISLC,,,3297.17,9469.0,22
CPT,25675,HC CLOSED TREATMENT DISTAL RADIOULNAR DISLOCATION W MANIPULATION,748.0,411.4,224.4,4258.0,53
CPT,25676,OPTX RAD/ULN DISLC AQT/CHRNC,,,5480.0,18485.0,22
CPT,25680,HC CLOSED TREATMENT TRANS-SACPHOPERILUNAR FX DISLOCATION W MANIPULATION,748.0,411.4,224.4,4258.0,53
CPT,25685,OPTX TRNS-SCPHPRLNR FX DISLC,,,5480.0,9469.0,22
CPT,25690,"HC CLOSED TREATMENT OF LUNATE DISLOCATION, WITH MANIPULATION",2846.0,1565.3,853.8,6766.0,53
CPT,25695,OPTX LUNATE DISLOCATION,,,5480.0,18485.0,22
CPT,25800,ARTHRD WRIST COMPLETE WO GRF,,,7259.46,18485.0,22
CPT,25805,ARTHRD WRIST W/SLIDING GRAFT,,,7259.46,18485.0,22
CPT,25810,ARTHRD WRST ILIAC/OTH AGRFT,,,10315.0,19884.0,22
CPT,25820,ARTHRD WRIST LMTD W/O B1 GRF,,,7259.46,18485.0,22
CPT,25825,ARTHRD WRIST WITH AUTOGRAFT,,,7259.46,18485.0,22
CPT,25830,ARTHRD DST RAD/UL JT SGM RSC,,,7259.46,18485.0,22
CPT,25900,AMPUTATION OF FOREARM,,,660.14,17804.0,22
CPT,25905,AMPUTATION OF FOREARM,,,640.74,17804.0,22
CPT,25907,AMPUTATION FOLLOW-UP SURGERY,,,3297.17,9469.0,22
CPT,25909,AMPUTATION FOLLOW-UP SURGERY,,,5480.0,9469.0,22
CPT,25915,AMPUTATION OF FOREARM,,,1050.08,17804.0,22
CPT,25920,AMPUTATE HAND AT WRIST,,,666.24,17804.0,22
CPT,25922,AMPUTATE HAND AT WRIST,,,1626.34,9469.0,22
CPT,25924,AMPUTATION FOLLOW-UP SURGERY,,,650.64,17804.0,22
CPT,25927,AMPUTATION OF HAND,,,783.75,14658.0,22
CPT,25929,AMPUTATION FOLLOW-UP SURGERY,,,1858.86,6766.0,22
CPT,25931,AMPUTATION FOLLOW-UP SURGERY,,,3297.17,9469.0,22
CPT,25999,UNLISTED PX FOREARM/WRIST,,,243.77,29323.0,22
CPT,26010,"HC DRAIN FINGER ABSCESS, SIMPLE",627.0,344.85,188.1,4258.0,106
CPT,26011,HC DRN FINGER ABSCESS COMPLEX,4602.0,2531.1,1380.6,6766.0,53
CPT,26020,"HC DRAINAGE OF TENDON SHEATH, DIGIT AND/OR PALM, EACH",8256.0,4540.8,2476.8,8363.0,53
CPT,26025,DRAINAGE OF PALM BURSA,,,3297.17,8363.0,22
CPT,26030,DRAINAGE OF PALM BURSAS,,,3297.17,8363.0,22
CPT,26034,TREAT HAND BONE LESION,,,1626.34,6766.0,22
CPT,26035,DECOMPRESS FINGERS/HAND,,,3297.17,8363.0,22
CPT,26037,DECOMPRESS FINGERS/HAND,,,3297.17,8363.0,22
CPT,26040,HC FASCIOTOMY PALMAR PERCUTAN,5563.0,3059.65,1626.34,6766.0,53
CPT,26045,RELEASE PALM CONTRACTURE,,,3297.17,14658.0,22
CPT,26055,INCISE FINGER TENDON SHEATH,,,1626.34,6766.0,22
CPT,26060,INCISION OF FINGER TENDON,,,1626.34,6766.0,22
CPT,26070,EXPLORE/TREAT HAND JOINT,,,1626.34,6766.0,22
CPT,26075,EXPLORE/TREAT FINGER JOINT,,,3297.17,8363.0,22
CPT,26080,EXPLORE/TREAT FINGER JOINT,,,1626.34,6766.0,22
CPT,26100,BIOPSY HAND JOINT LINING,,,3297.17,8363.0,22
CPT,26105,BIOPSY FINGER JOINT LINING,,,3297.17,8363.0,22
CPT,26110,BIOPSY FINGER JOINT LINING,,,1626.34,6766.0,22
CPT,26111,EXC HAND LES SC 1.5 CM/>,,,1646.49,9469.0,22
CPT,26113,EXC HAND TUM DEEP 1.5 CM/>,,,1646.49,9469.0,22
CPT,26115,EXC HAND LES SC < 1.5 CM,,,1646.49,6766.0,22
CPT,26116,EXC HAND TUM DEEP < 1.5 CM,,,1646.49,6766.0,22
CPT,26117,RAD RESECT HAND TUMOR < 3 CM,,,2908.42,8363.0,22
CPT,26118,RAD RESECT HAND TUMOR 3 CM/>,,,2908.42,9469.0,22
CPT,26121,RELEASE PALM CONTRACTURE,,,3297.17,14658.0,22
CPT,26123,RELEASE PALM CONTRACTURE,,,3297.17,14658.0,22
CPT,26125,RELEASE PALM CONTRACTURE,,,238.69,3533.0,21
CPT,26130,REMOVE WRIST JOINT LINING,,,3297.17,8363.0,22
CPT,26135,REVISE FINGER JOINT EACH,,,3297.17,14658.0,22
CPT,26140,REVISE FINGER JOINT EACH,,,1626.34,6766.0,22
CPT,26145,TENDON EXCISION PALM/FINGER,,,1626.34,6766.0,22
CPT,26160,REMOVE TENDON SHEATH LESION,,,1626.34,6766.0,22
CPT,26170,REMOVAL OF PALM TENDON EACH,,,1626.34,6766.0,22
CPT,26180,REMOVAL OF FINGER TENDON,,,1626.34,6766.0,22
CPT,26185,REMOVE FINGER BONE,,,1626.34,6766.0,22
CPT,26200,REMOVE HAND BONE LESION,,,1626.34,6766.0,22
CPT,26205,REMOVE/GRAFT BONE LESION,,,7259.46,18485.0,22
CPT,26210,REMOVAL OF FINGER LESION,,,1626.34,6766.0,22
CPT,26215,REMOVE/GRAFT FINGER LESION,,,3297.17,8363.0,22
CPT,26230,PARTIAL REMOVAL OF HAND BONE,,,3297.17,8363.0,22
CPT,26235,PARTIAL REMOVAL FINGER BONE,,,1626.34,6766.0,22
CPT,26236,HC PARTIAL REMOVAL FINGER BONE,5285.0,2906.75,1585.5,6766.0,53
CPT,26250,EXTENSIVE HAND SURGERY,,,3297.17,8363.0,22
CPT,26260,RESECT PROX FINGER TUMOR,,,3297.17,8363.0,22
CPT,26262,RESECT DISTAL FINGER TUMOR,,,1626.34,6766.0,22
CPT,26320,HC REMOVAL IMPLANT FROM FINGER/HAND,5132.0,2822.6,1539.6,6766.0,53
CPT,26340,MANIPULATE FINGER W/ANESTH,,,835.0,5761.0,22
CPT,26341,HC MANIP PALMAR FASC CORD POST ENZYM INJ SGL CORD,805.0,442.75,241.5,4258.0,53
CPT,26350,HC REPR FINGER HAND TENDON,11228.0,6175.4,3297.17,14658.0,53
CPT,26352,REPAIR/GRAFT HAND TENDON,,,7259.46,14658.0,22
CPT,26356,REPAIR FINGER/HAND TENDON,,,3297.17,14658.0,22
CPT,26357,REPAIR FINGER/HAND TENDON,,,3297.17,14658.0,22
CPT,26358,REPAIR/GRAFT HAND TENDON,,,7259.46,14658.0,22
CPT,26370,REPAIR FINGER/HAND TENDON,,,3297.17,14658.0,22
CPT,26372,REPAIR/GRAFT HAND TENDON,,,7259.46,18485.0,22
CPT,26373,REPAIR FINGER/HAND TENDON,,,3297.17,14658.0,22
CPT,26390,REVISE HAND/FINGER TENDON,,,7259.46,18485.0,22
CPT,26392,REPAIR/GRAFT HAND TENDON,,,7259.46,18485.0,22
CPT,26410,HC REPR HAND TENDON,5358.0,2946.9,1607.4,6766.0,53
CPT,26412,REPAIR/GRAFT HAND TENDON,,,3297.17,14658.0,22
CPT,26415,EXCISION HAND/FINGER TENDON,,,3297.17,14658.0,22
CPT,26416,GRAFT HAND OR FINGER TENDON,,,3297.17,14658.0,22
CPT,26418,"HC REPAIR, EXTENSOR TENDON, FINGER, PRIM/SECOND, W/O FREE GRAFT, EA TENDON",5794.0,3186.7,1626.34,6766.0,53
CPT,26420,REPAIR/GRAFT FINGER TENDON,,,3297.17,14658.0,22
CPT,26426,REPAIR FINGER/HAND TENDON,,,3297.17,14658.0,22
CPT,26428,REPAIR/GRAFT FINGER TENDON,,,3297.17,14658.0,22
CPT,26432,REPAIR FINGER TENDON,,,1626.34,6766.0,22
CPT,26433,REPAIR FINGER TENDON,,,3297.17,8363.0,22
CPT,26434,REPAIR/GRAFT FINGER TENDON,,,3297.17,14658.0,22
CPT,26437,REALIGNMENT OF TENDONS,,,3297.17,8363.0,22
CPT,26440,RELEASE PALM/FINGER TENDON,,,1626.34,6766.0,22
CPT,26442,RELEASE PALM & FINGER TENDON,,,3297.17,14658.0,22
CPT,26445,RELEASE HAND/FINGER TENDON,,,3297.17,8363.0,22
CPT,26449,RELEASE FOREARM/HAND TENDON,,,3297.17,14658.0,22
CPT,26450,INCISION OF PALM TENDON,,,3297.17,8363.0,22
CPT,26455,INCISION OF FINGER TENDON,,,1626.34,6766.0,22
CPT,26460,INCISE HAND/FINGER TENDON,,,1626.34,6766.0,22
CPT,26471,FUSION OF FINGER TENDONS,,,3297.17,8363.0,22
CPT,26474,FUSION OF FINGER TENDONS,,,1626.34,6766.0,22
CPT,26476,TENDON LENGTHENING,,,3297.17,8363.0,22
CPT,26477,TENDON SHORTENING,,,3297.17,8363.0,22
CPT,26478,LENGTHENING OF HAND TENDON,,,3297.17,8363.0,22
CPT,26479,SHORTENING OF HAND TENDON,,,3297.17,8363.0,22
CPT,26480,TRANSPLANT HAND TENDON,,,3297.17,14658.0,22
CPT,26483,TRANSPLANT/GRAFT HAND TENDON,,,3297.17,14658.0,22
CPT,26485,TRANSPLANT PALM TENDON,,,3297.17,14658.0,22
CPT,26489,TRANSPLANT/GRAFT PALM TENDON,,,3297.17,14658.0,22
CPT,26490,REVISE THUMB TENDON,,,3297.17,14658.0,22
CPT,26492,TENDON TRANSFER WITH GRAFT,,,3297.17,14658.0,22
CPT,26494,HAND TENDON/MUSCLE TRANSFER,,,3297.17,14658.0,22
CPT,26496,REVISE THUMB TENDON,,,3297.17,14658.0,22
CPT,26497,FINGER TENDON TRANSFER,,,3297.17,14658.0,22
CPT,26498,FINGER TENDON TRANSFER,,,3297.17,14658.0,22
CPT,26499,CORRECTION CLAW FINGER OTHER,,,3297.17,9469.0,22
CPT,26500,HAND TENDON RECONSTRUCTION,,,3917.0,18485.0,22
CPT,26502,HAND TENDON RECONSTRUCTION,,,3297.17,14658.0,22
CPT,26508,RELEASE THUMB CONTRACTURE,,,3297.17,8363.0,22
CPT,26510,THUMB TENDON TRANSFER,,,3297.17,14658.0,22
CPT,26516,FUSION OF KNUCKLE JOINT,,,3297.17,14658.0,22
CPT,26517,FUSION OF KNUCKLE JOINTS,,,3297.17,14658.0,22
CPT,26518,FUSION OF KNUCKLE JOINTS,,,7259.46,14658.0,22
CPT,26520,RELEASE KNUCKLE CONTRACTURE,,,3297.17,8363.0,22
CPT,26525,RELEASE FINGER CONTRACTURE,,,1626.34,6766.0,22
CPT,26530,REVISE KNUCKLE JOINT,,,7259.46,16799.0,22
CPT,26531,REVISE KNUCKLE WITH IMPLANT,,,7259.46,18485.0,22
CPT,26535,REVISE FINGER JOINT,,,3297.17,16799.0,22
CPT,26536,REVISE/IMPLANT FINGER JOINT,,,7259.46,18485.0,22
CPT,26540,HC REPR COLLAT LIGAMENT METACARP-INTERPHALANGEAL JT,10188.0,5603.4,3056.4,8812.62,53
CPT,26541,REPAIR HAND JOINT WITH GRAFT,,,3297.17,14658.0,22
CPT,26542,REPAIR HAND JOINT WITH GRAFT,,,3297.17,8363.0,22
CPT,26545,RECONSTRUCT FINGER JOINT,,,3297.17,14658.0,22
CPT,26546,REPAIR NONUNION HAND,,,7259.46,18485.0,22
CPT,26548,RECONSTRUCT FINGER JOINT,,,3297.17,14658.0,22
CPT,26550,POLLICIZATION DIGIT,,,3297.17,14658.0,22
CPT,26551,GREAT TOE-HAND TRANSFER,,,2935.5,16799.0,22
CPT,26553,SINGLE TRANSFER TOE-HAND,,,2915.65,16799.0,22
CPT,26554,DOUBLE TRANSFER TOE-HAND,,,3391.84,16799.0,22
CPT,26555,POSITIONAL CHANGE OF FINGER,,,7259.46,18485.0,22
CPT,26556,TOE JOINT TRANSFER,,,3035.08,17804.0,22
CPT,26560,REPAIR OF WEB FINGER,,,1626.34,6766.0,22
CPT,26561,REPAIR OF WEB FINGER,,,3297.17,14658.0,22
CPT,26562,REPAIR OF WEB FINGER,,,3297.17,14658.0,22
CPT,26565,CORRECT METACARPAL FLAW,,,3297.17,14658.0,22
CPT,26567,CORRECT FINGER DEFORMITY,,,3297.17,14658.0,22
CPT,26568,LENGTHEN METACARPAL/FINGER,,,7259.46,18485.0,22
CPT,26580,REPAIR CLEFT HAND,,,3297.17,8363.0,22
CPT,26587,RECONSTRUCT EXTRA FINGER,,,3297.17,8363.0,22
CPT,26590,REPAIR FINGER DEFORMITY,,,1626.34,6766.0,22
CPT,26591,REPAIR MUSCLES OF HAND,,,3297.17,9469.0,22
CPT,26593,RELEASE MUSCLES OF HAND,,,3297.17,8363.0,22
CPT,26596,EXCISION CONSTRICTING TISSUE,,,3297.17,8363.0,22
CPT,26600,HC CLSD TX METACARPAL FX SGL WO MANIP EA BONE,637.0,350.35,191.1,4258.0,106
CPT,26605,"HC CLSD TX METACARPAL FRACTURE, SINGLE W/ MANIPULATION, EA BONE",1025.0,563.75,243.77,4258.0,106
CPT,26607,TREAT METACARPAL FRACTURE,,,3297.17,8363.0,22
CPT,26608,TREAT METACARPAL FRACTURE,,,3297.17,9469.0,22
CPT,26615,HC OPEN TX METACARPAL FRACTURE SINGLE EA BONE,8745.0,4809.75,2623.5,17804.0,53
CPT,26641,HC TREAT THUMB DISLOCATION,748.0,411.4,224.4,4258.0,53
CPT,26645,"HC CLSD TX CARPOMETACARPAL FRACTURE DISLOCATION, THUMB, WITH MANIPULATION",4164.0,2290.2,835.0,5761.0,53
CPT,26650,TREAT THUMB FRACTURE,,,3297.17,9469.0,22
CPT,26665,TREAT THUMB FRACTURE,,,3297.17,17804.0,22
CPT,26670,"HC CLSD TX CARPOMETACARPAL DISLOC, OTH THN THUMB, W/ MANIP, EA JT, W/O ANES",808.0,444.4,242.4,4258.0,53
CPT,26675,TREAT HAND DISLOCATION,,,835.0,5761.0,22
CPT,26676,PIN HAND DISLOCATION,,,3297.17,9469.0,22
CPT,26685,TREAT HAND DISLOCATION,,,3297.17,9469.0,22
CPT,26686,TREAT HAND DISLOCATION,,,3297.17,17804.0,22
CPT,26700,"HC CLSD TX METACARPOPHALANGEAL DISLOCATION, SINGLE, W/O MANIP, W/O ANES",823.0,452.65,243.77,4258.0,53
CPT,26705,TREAT KNUCKLE DISLOCATION,,,835.0,5761.0,22
CPT,26706,PIN KNUCKLE DISLOCATION,,,3297.17,8363.0,22
CPT,26715,TREAT KNUCKLE DISLOCATION,,,3297.17,9469.0,22
CPT,26720,HC CLSD TX PHALANGEAL SHAFT FX WO MANIPULATION EA,547.0,300.85,164.1,4258.0,106
CPT,26725,"HC CLSD TX PHLNG SHFT FX, PROX/MID PHLNX, FGR/THB W/MANIP W/WO SKN/SKLT, EA",893.0,491.15,243.77,4258.0,106
CPT,26727,TREAT FINGER FRACTURE EACH,,,3297.17,9469.0,22
CPT,26735,TREAT FINGER FRACTURE EACH,,,3297.17,9469.0,22
CPT,26740,HC CLSD TX ARTICULAR FX WO MANIPULATION,704.0,387.2,211.2,4258.0,53
CPT,26742,"HC CLSD TX ARTICULAR FX, METACARPOPHALANGEAL/INTERPHALANG JT, W/ MANIP, EA",2157.0,1186.35,647.1,5761.0,53
CPT,26746,TREAT FINGER FRACTURE EACH,,,3297.17,9469.0,22
CPT,26750,"HC CLSD TX DISTAL PHALANGEAL FRACTURE, FINGER/THUMB W/O MANIPULATION, EA",557.0,306.35,167.1,4258.0,106
CPT,26755,"HC CLSD TX DISTAL PHALANGEAL FX, FINGER OR THUMB, W/ MANIP, EACH",833.0,458.15,243.77,4258.0,53
CPT,26756,PIN FINGER FRACTURE EACH,,,3297.17,9469.0,22
CPT,26765,"HC OPEN TX DISTAL PHALANGEAL FX, FINGER/THUMB, INCL INTERNAL FIX, EA",9087.0,4997.85,2726.1,9469.0,53
CPT,26770,"HC CLSD TX INTERPHALANGEAL JOINT DISLOCATION, SINGLE, W/ MANIP, W/O ANESTH",742.0,408.1,222.6,4258.0,106
CPT,26775,TREAT FINGER DISLOCATION,,,269.88,4258.0,22
CPT,26776,PIN FINGER DISLOCATION,,,3297.17,9469.0,22
CPT,26785,TREAT FINGER DISLOCATION,,,3297.17,9469.0,22
CPT,26820,THUMB FUSION WITH GRAFT,,,7259.46,18485.0,22
CPT,26841,FUSION OF THUMB,,,7259.46,18485.0,22
CPT,26842,THUMB FUSION WITH GRAFT,,,7259.46,18485.0,22
CPT,26843,FUSION OF HAND JOINT,,,7259.46,18485.0,22
CPT,26844,FUSION/GRAFT OF HAND JOINT,,,7259.46,18485.0,22
CPT,26850,FUSION OF KNUCKLE,,,7259.46,18485.0,22
CPT,26852,FUSION OF KNUCKLE WITH GRAFT,,,7259.46,18485.0,22
CPT,26860,FUSION OF FINGER JOINT,,,3297.17,14658.0,22
CPT,26861,FUSION OF FINGER JNT ADD-ON,,,90.15,3533.0,21
CPT,26862,FUSION/GRAFT OF FINGER JOINT,,,3297.17,14658.0,22
CPT,26863,FUSE/GRAFT ADDED JOINT,,,201.02,3533.0,21
CPT,26910,AMPUTATE METACARPAL BONE,,,3297.17,14658.0,22
CPT,26951,"HC AMPUT, FGR/THUMB, PRIM/SECOND, ANY JT,SGL,INCL NEURECTOM,W/ DIR CLOS",4563.0,2509.65,1368.9,8363.0,53
CPT,26952,"HC AMPUT, FGR/THUMB, PRIM/SECOND, ANY JT,SGL,INCL NEURECTOM,W/ LOCAL ADV FL",5794.0,3186.7,1738.2,8363.0,53
CPT,26989,UNLISTED PX HANDS/FINGERS,,,243.77,4258.0,22
CPT,26990,DRAINAGE OF PELVIS LESION,,,3297.17,9469.0,22
CPT,26991,DRAINAGE OF PELVIS BURSA,,,1626.34,9469.0,22
CPT,26992,DRAINAGE OF BONE LESION,,,908.85,16799.0,22
CPT,27000,TENOTOMY ADDUCTOR HIP PERQ,,,1626.34,9469.0,22
CPT,27001,TENOTOMY ADDUCTOR HIP OPEN,,,3297.17,14658.0,22
CPT,27003,TNOT ADDUCTR SUBQ OPN NEURCT,,,7259.46,18485.0,22
CPT,27005,TENOTOMY HIP FLEXOR OPEN,,,659.07,17804.0,22
CPT,27006,TENOTOMY ABDUCTOR&/XTNSR HIP,,,3297.17,14658.0,22
CPT,27025,FASCIOTOMY HIP/THIGH ANY TYP,,,851.03,17804.0,22
CPT,27027,DCMPRN FASCT PEL COMPARTMENT,,,7259.46,18485.0,22
CPT,27030,ARTHROTOMY HIP W/DRAINAGE,,,845.75,16799.0,22
CPT,27033,ARTHRT HIP EXPL/RMV LOOSE/FB,,,7259.46,16799.0,22
CPT,27035,DENERVATION OF HIP JOINT,,,3297.17,14658.0,22
CPT,27036,CAPSULECTOMY/CAPSULOTOMY HIP,,,923.07,16799.0,22
CPT,27040,HC BIOPSY SOFT TISSUE OF PELVIS AND HIP AREA SUPERFICIAL,4623.0,2542.65,1386.9,5761.0,106
CPT,27041,"HC BIOPSY, SOFT TISSUE OF PELVIS AND HIP AREA, DEEP, SUBFASCIAL/IM",5620.5,3091.275,1611.3,5761.0,265
CPT,27043,"HC EXC TUMOR SOFT TISS PELVIS HIP SUBQ, 3 CM OR GREATER",10150.0,5582.5,2908.42,9469.0,106
CPT,27045,HC EXCISION TUMOR SOFT TISS OF PELVIS & HIP AREA SUBFASCIAL 5 CM OR GREATER,10150.0,5582.5,2908.42,9469.0,106
CPT,27047,HC EXCISION TUMOR SOFT TISSUE OF PELVIS AND HIP AREA SUBQ LESS THAN 3 CM,5465.0,3005.75,1639.5,8363.0,106
CPT,27048,HC EXCISION TUMOR SOFT TISS OF PELVIS & HIP AREA SUBFASCIAL LESS THAN 5 CM,7992.0,4395.6,2397.6,8363.0,106
CPT,27049,HC RADICAL RESECTION OF TUMOR SOFT TISS OF PELVIS & HIP AREA LESS THAN 5 CM,10150.0,5582.5,2908.42,8779.75,106
CPT,27050,BIOPSY OF SACROILIAC JOINT,,,1626.34,9469.0,22
CPT,27052,BIOPSY OF HIP JOINT,,,1626.34,9469.0,22
CPT,27054,REMOVAL OF HIP JOINT LINING,,,629.25,14658.0,22
CPT,27057,BUTTOCK FASCIOTOMY W/DBRDMT,,,1626.34,9469.0,22
CPT,27059,HC RADICAL RESECT OF TUMOR SOFT TISSUE OF PELVIS & HIP AREA 5 CM OR GREATER,10150.0,5582.5,2908.42,9469.0,106
CPT,27060,REMOVAL OF ISCHIAL BURSA,,,5480.0,9469.0,22
CPT,27062,REMOVE FEMUR LESION/BURSA,,,3297.17,9469.0,22
CPT,27065,REMOVE HIP BONE LES SUPER,,,5480.0,9469.0,22
CPT,27066,REMOVE HIP BONE LES DEEP,,,3297.17,14658.0,22
CPT,27067,REMOVE/GRAFT HIP BONE LESION,,,7259.46,18485.0,22
CPT,27070,PART REMOVE HIP BONE SUPER,,,794.87,17804.0,22
CPT,27071,HC PARTIAL EXCISION WING ILIUM SYMPHYSIS PUBIS/GREATER TROCHANTER OF FEMUR,10010.0,5505.5,877.11,17804.0,106
CPT,27075,RESECT HIP TUMOR,,,1855.59,17804.0,22
CPT,27076,RESECT HIP TUM INCL ACETABUL,,,2237.05,17804.0,22
CPT,27077,RESECT HIP TUM W/INNOM BONE,,,2491.95,17804.0,22
CPT,27078,RSECT HIP TUM INCL FEMUR,,,1830.1,17804.0,22
CPT,27080,REMOVAL OF TAIL BONE,,,3297.17,14658.0,22
CPT,27086,"HC REMOVAL OF FOREIGN BODY, PELVIS OR HIP; SUBCUTANEOUS TISSUE",7247.0,3985.85,2174.1,6766.0,53
CPT,27087,REMOVE HIP FOREIGN BODY,,,3297.17,9469.0,22
CPT,27090,REMOVAL OF HIP PROSTHESIS,,,751.45,9469.0,22
CPT,27091,REMOVAL OF HIP PROSTHESIS,,,1426.22,9469.0,22
CPT,27093,"HC INJ PROC HIP ARTHROGRAPHY, WO ANES",511.0,281.05,153.3,3533.0,424
CPT,27093,INJECTION FOR HIP X-RAY,,,360.45,360.45,1
CPT,27095,HC INJ PROC FOR HIP ARTHROGRAPHY; W/ ANESTH,5061.0,2783.55,275.92,4377.77,53
CPT,27095,INJECTION FOR HIP X-RAY,,,482.86,482.86,1
CPT,27096,"HC INJ PROC SAC-IL JT, ANES/STEROID, IMG GUID INCL ARTHROGRAPHY",2145.0,1179.75,151.32,4258.0,212
CPT,27096,INJECT SACROILIAC JOINT,,,264.81,264.81,1
CPT,27097,REVISION OF HIP TENDON,,,3297.17,14658.0,22
CPT,27098,TRANSFER TENDON TO PELVIS,,,3297.17,9469.0,22
CPT,27100,TRANSFER OF ABDOMINAL MUSCLE,,,7259.46,18485.0,22
CPT,27105,TRANSFER OF SPINAL MUSCLE,,,3297.17,16799.0,22
CPT,27110,TRANSFER OF ILIOPSOAS MUSCLE,,,7259.46,18485.0,22
CPT,27111,TRANSFER OF ILIOPSOAS MUSCLE,,,3297.17,16799.0,22
CPT,27120,RECONSTRUCTION OF HIP SOCKET,,,1167.67,17804.0,22
CPT,27122,RECONSTRUCTION OF HIP SOCKET,,,994.21,17804.0,22
CPT,27125,PARTIAL HIP REPLACEMENT,,,1019.89,17804.0,22
CPT,27130,TOTAL HIP ARTHROPLASTY,,,12463.0,21512.0,22
CPT,27132,TOTAL HIP ARTHROPLASTY,,,1494.43,21512.0,22
CPT,27134,REVISE HIP JOINT REPLACEMENT,,,1695.89,21512.0,22
CPT,27137,REVISE HIP JOINT REPLACEMENT,,,1310.39,21512.0,22
CPT,27138,REVISE HIP JOINT REPLACEMENT,,,1360.67,21512.0,22
CPT,27140,TRANSPLANT FEMUR RIDGE,,,812.91,17804.0,22
CPT,27146,INCISION OF HIP BONE,,,1151.4,17804.0,22
CPT,27147,REVISION OF HIP BONE,,,1311.95,17804.0,22
CPT,27151,INCISION OF HIP BONES,,,1416.19,17804.0,22
CPT,27156,REVISION OF HIP BONES,,,1523.92,17804.0,22
CPT,27158,REVISION OF PELVIS,,,1255.44,17804.0,22
CPT,27161,INCISION OF NECK OF FEMUR,,,1099.12,17804.0,22
CPT,27165,INCISION/FIXATION OF FEMUR,,,1231.92,17804.0,22
CPT,27170,REPAIR/GRAFT FEMUR HEAD/NECK,,,1052.07,17804.0,22
CPT,27175,TREAT SLIPPED EPIPHYSIS,,,607.1,17804.0,22
CPT,27176,TREAT SLIPPED EPIPHYSIS,,,836.64,17804.0,22
CPT,27177,TREAT SLIPPED EPIPHYSIS,,,1007.63,17804.0,22
CPT,27178,TREAT SLIPPED EPIPHYSIS,,,836.64,17804.0,22
CPT,27179,REVISE HEAD/NECK OF FEMUR,,,7259.46,18485.0,22
CPT,27181,TREAT SLIPPED EPIPHYSIS,,,1011.89,17804.0,22
CPT,27185,REVISION OF FEMUR EPIPHYSIS,,,656.0,17804.0,22
CPT,27187,"HC PROPHYLACTIC TX W OR WO METHYLMETHACRYLATE, FEMORAL NECK PROX FEMUR",10010.0,5505.5,901.7,17804.0,53
CPT,27197,"HC CLSD TX POSTERIOR PELVIC RING FX, DISLOC, UNILAT OR BILAT, W/O MANIP",748.0,411.4,224.4,4258.0,106
CPT,27198,CLSD TX PELVIC RING FX,,,243.77,4258.0,22
CPT,27200,TREAT TAIL BONE FRACTURE,,,243.77,4258.0,22
CPT,27202,TREAT TAIL BONE FRACTURE,,,3297.17,17804.0,22
CPT,27215,"HC OPEN TX ILIAC SPINE(S), TUBEROSITY AVULSION/ILIAC WING FX(S), UNILAT",13518.0,7434.9,556.67,11693.07,53
CPT,27216,"HC PERCU SKELETAL FIXATION POSTERIOR PELVIC BONE FX AND/OR DISLOC, UNILAT",8798.0,4838.9,823.01,14658.0,53
CPT,27217,"HC OPEN TX ANTERIOR PELV BONE FX/DISLOC, UNILAT, INCL INTERNAL FIX",16396.0,9017.8,773.48,14182.54,53
CPT,27218,"HC OPEN TX POSTERIOR PELVIC FX OR DISLOC, UNILAT, INCLUDE INTERNAL FIXATION",17117.0,9414.35,1059.83,14806.21,53
CPT,27220,"HC CLOSED TX ACETABULUM (HIP SOCKET) FRACTURE(S), W/O MANIP",697.0,383.35,209.1,4258.0,53
CPT,27222,HC CLSD TX HIP SOCKET FX W MANIPULATION,2582.0,1420.1,774.6,4258.0,53
CPT,27226,"HC OPEN TX OF POSTERIOR/ANTERIOR ACETABULAR WALL FX, W FIXATION",17486.0,9617.3,948.67,16799.0,53
CPT,27227,"HC OPEN TX ACETABLR FX ANT-POST-TRANS FX, 1 COLUMN, W INTERNAL FIXATION",15612.0,8586.6,1478.13,16799.0,53
CPT,27228,"HC OPEN TX ACETABLR ANT-POST-TRANS FX, 2 COLUMN, W INTERNAL FIXATION",15612.0,8586.6,1675.62,16799.0,53
CPT,27230,"HC CLOSED TREATMENT OF FEM FRACTURE, PROXIMAL END, NECK; W/O MANIPULATION",748.0,411.4,224.4,4258.0,53
CPT,27232,TREAT THIGH FRACTURE,,,655.64,6766.0,22
CPT,27235,"HC PERCUTANEOUS SKELETAL FIXATION FEMORAL FRACT, PROXIMAL END, NECK",24321.0,13376.55,7259.46,21037.67,106
CPT,27236,TREAT THIGH FRACTURE,,,1074.95,17804.0,22
CPT,27238,TREAT THIGH FRACTURE,,,835.0,5761.0,22
CPT,27240,TREAT THIGH FRACTURE,,,863.85,6766.0,22
CPT,27244,TREAT THIGH FRACTURE,,,1105.41,17804.0,22
CPT,27245,TREAT THIGH FRACTURE,,,1104.27,16799.0,22
CPT,27246,"HC CLOSED TREATMENT OF GREATER TROCHANTERIC FRACTURE, WITHOUT MANIPULATION",697.0,383.35,209.1,4258.0,53
CPT,27248,TREAT THIGH FRACTURE,,,674.16,17804.0,22
CPT,27250,HC CLSD TX HIP DISLOCATION WO ANES,1459.0,802.45,243.77,4258.0,53
CPT,27252,TREAT HIP DISLOCATION,,,1626.34,5761.0,22
CPT,27253,TREAT HIP DISLOCATION,,,848.86,14658.0,22
CPT,27254,TREAT HIP DISLOCATION,,,1142.76,14658.0,22
CPT,27256,TREAT HIP DISLOCATION,,,243.77,4258.0,22
CPT,27257,TREAT HIP DISLOCATION,,,1626.34,5761.0,22
CPT,27258,TREAT HIP DISLOCATION,,,1002.6,14658.0,22
CPT,27259,TREAT HIP DISLOCATION,,,1384.89,14658.0,22
CPT,27265,HC CLSD TX HIP PRSTH DISLOC WO ANES,1063.0,584.65,243.77,4258.0,53
CPT,27266,HC CLSD TX POST HIP ARTHROPLASTY DISLOC W ANES,4099.0,2254.45,1229.7,6766.0,53
CPT,27267,CLTX THIGH FX,,,3297.17,8363.0,22
CPT,27268,CLTX THIGH FX W/MNPJ,,,500.81,14658.0,22
CPT,27269,OPTX THIGH FX,,,1112.97,8363.0,22
CPT,27275,MANIPULATION OF HIP JOINT,,,1626.34,6766.0,22
CPT,27278,ARTHRD SI JT PLMT IARTIC DEV,,,12463.0,24394.0,22
CPT,27279,"HC ARTHRODESIS, SAC-IL JOINT, PERC OR MIN INV, W IMG GUID",46454.0,25549.7,12463.0,40182.71,53
CPT,27280,ARTHR SI JT OPN B1GRF INSTRM,,,1192.82,21512.0,22
CPT,27282,ARTHRODESIS SYMPHYSIS PUBIS,,,781.81,17804.0,22
CPT,27284,ARTHRODESIS HIP JOINT,,,1431.6,21512.0,22
CPT,27286,ARTHRD HIP JT SBTRCHC OSTEOT,,,1469.73,21512.0,22
CPT,27290,AMPUTATION OF LEG AT HIP,,,1455.0,21512.0,22
CPT,27295,AMPUTATION OF LEG AT HIP,,,1119.11,21512.0,22
CPT,27299,HC INTERVENTIONAL PROC PELVIS,4755.0,2615.25,243.77,29323.0,53
CPT,27299,HC PERCUTANEOUS FIXATION ACETABULUM,16378.0,9007.9,243.77,29323.0,53
CPT,27299,HC PERCUTANEOUS FIXATION ANTERIOR PELVIS,17200.0,9460.0,243.77,29323.0,53
CPT,27299,"HC US GUIDED TRANSVAGINAL PELVIC CORE BIOPSY, UNLISTED PROCEDURE",2819.0,1550.45,243.77,29323.0,53
CPT,27301,DRAIN THIGH/KNEE LESION,,,2908.42,9469.0,22
CPT,27303,DRAINAGE OF BONE LESION,,,586.3,16799.0,22
CPT,27305,INCISE THIGH TENDON & FASCIA,,,3297.17,9469.0,22
CPT,27306,INCISION OF THIGH TENDON,,,3297.17,9469.0,22
CPT,27307,INCISION OF THIGH TENDONS,,,3297.17,14658.0,22
CPT,27310,EXPLORATION OF KNEE JOINT,,,3297.17,14658.0,22
CPT,27323,HC BX SOFT TISSUE THIGH OR KNEE AREA SUPERFICIAL,5786.5,3182.5750000000003,1074.3,6913.08,318
CPT,27324,HC BX SOFT TISSUE OF THIGH OR KNEE AREA DEEP (SUBFASCIAL OR INTRAMUSCULAR),8083.0,4445.65,2424.9,9469.0,212
CPT,27325,NEURECTOMY HAMSTRING,,,1984.4,6766.0,22
CPT,27326,NEURECTOMY POPLITEAL,,,1984.4,6766.0,22
CPT,27327,HC EXCISION TUMOR SOFT TISSUE OF THIGH/KNEE SUBQ LESS THAN 3 CM,5870.0,3228.5,1646.49,9469.0,106
CPT,27328,HC EXCISION TUMOR SOFT TISSUE OF THIGH/KNEE AREA SUBFASCIAL LESS THAN 5 CM,10150.0,5582.5,2908.42,8779.75,106
CPT,27329,HC RADICAL RESECTION OF TUMOR SOFT TISSUE OF THIGH/KNEE AREA LESS THAN 5 CM,6038.0,3320.9,1811.4,8363.0,106
CPT,27330,BIOPSY KNEE JOINT LINING,,,3297.17,14658.0,22
CPT,27331,EXPLORE/TREAT KNEE JOINT,,,3297.17,14658.0,22
CPT,27332,REMOVAL OF KNEE CARTILAGE,,,3297.17,14658.0,22
CPT,27333,REMOVAL OF KNEE CARTILAGE,,,3297.17,14658.0,22
CPT,27334,REMOVE KNEE JOINT LINING,,,3297.17,14658.0,22
CPT,27335,REMOVE KNEE JOINT LINING,,,7259.46,18485.0,22
CPT,27337,HC EXCISION TUMOR SOFT TISSUE OF THIGH/KNEE SUBQ 3 CM OR GREATER,9038.0,4970.9,2377.8,9469.0,159
CPT,27339,HC EXCISION TUMOR SOFT TISSUE OF THIGH/KNEE AREA SUBFASCIAL 5 CM OR GREATER,10150.0,5582.5,2908.42,9469.0,106
CPT,27340,REMOVAL OF KNEECAP BURSA,,,3297.17,9469.0,22
CPT,27345,REMOVAL OF KNEE CYST,,,3297.17,9469.0,22
CPT,27347,REMOVE KNEE CYST,,,3297.17,9469.0,22
CPT,27350,REMOVAL OF KNEECAP,,,7259.46,14658.0,22
CPT,27355,HC EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF FEMUR,8815.0,4848.25,2644.5,14658.0,106
CPT,27356,HC EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF FEMUR W/ ALLOGRAFT,36005.0,19802.75,8488.0,31144.33,106
CPT,27357,HC EXCISION/CURETTAGE OF BONE CYST OR BENIGN TUMOR OF FEMUR W/ AUTOGRAFT,19154.0,10534.7,5746.2,18485.0,106
CPT,27358,HC EXCISION/CURETTAGE BONE CYST/BENIGN TUMOR OF FEMUR W/ INT FIX (ADD ON),7633.0,4198.15,240.77,6602.55,106
CPT,27360,"HC PARTIAL EXCISION BONE, FEMUR, PROXIMAL TIBIA AND/OR FIBULA",7674.0,4220.7,2302.2,14658.0,106
CPT,27364,HC RADICAL RESECTION TUMOR  SOFT TISSUE OF THIGH/KNEE AREA 5 CM OR GREATER,10150.0,5582.5,2908.42,9469.0,106
CPT,27365,RESECT FEMUR/KNEE TUMOR,,,1830.62,17804.0,22
CPT,27369,HC INJ PROC CONTR KNEE ARTHROGRAPHY/CONTR ENHANCED CT/MRI KNEE ARTHROGRAPHY,834.0,458.7,158.47,3533.0,265
CPT,27369,NJX CNTRST KNE ARTHG/CT/MRI,,,277.32,277.32,1
CPT,27372,"HC REMOVAL OF FOREIGN BODY, DEEP, THIGH REGION OR KNEE AREA",7247.0,3985.85,2174.1,9469.0,53
CPT,27380,REPAIR OF KNEECAP TENDON,,,7259.46,18485.0,22
CPT,27381,REPAIR/GRAFT KNEECAP TENDON,,,7259.46,18485.0,22
CPT,27385,REPAIR OF THIGH MUSCLE,,,7259.46,18485.0,22
CPT,27386,REPAIR/GRAFT OF THIGH MUSCLE,,,7259.46,18485.0,22
CPT,27390,INCISION OF THIGH TENDON,,,3297.17,9469.0,22
CPT,27391,INCISION OF THIGH TENDONS,,,3297.17,9469.0,22
CPT,27392,INCISION OF THIGH TENDONS,,,3297.17,14658.0,22
CPT,27393,LENGTHENING OF THIGH TENDON,,,7259.46,14658.0,22
CPT,27394,LENGTHENING OF THIGH TENDONS,,,7259.46,18485.0,22
CPT,27395,LENGTHENING OF THIGH TENDONS,,,3297.17,16799.0,22
CPT,27396,TRANSPLANT OF THIGH TENDON,,,7259.46,18485.0,22
CPT,27397,TRANSPLANTS OF THIGH TENDONS,,,7259.46,18485.0,22
CPT,27400,REVISE THIGH MUSCLES/TENDONS,,,7259.46,18485.0,22
CPT,27403,REPAIR OF KNEE CARTILAGE,,,7259.46,14658.0,22
CPT,27405,REPAIR OF KNEE LIGAMENT,,,7259.46,18485.0,22
CPT,27407,REPAIR OF KNEE LIGAMENT,,,7259.46,18485.0,22
CPT,27409,REPAIR OF KNEE LIGAMENTS,,,7259.46,18485.0,22
CPT,27412,AUTOCHONDROCYTE IMPLANT KNEE,,,7259.46,18485.0,22
CPT,27415,OSTEOCHONDRAL KNEE ALLOGRAFT,,,10315.0,19884.0,22
CPT,27416,OSTEOCHONDRAL KNEE AUTOGRAFT,,,7259.46,18485.0,22
CPT,27418,REPAIR DEGENERATED KNEECAP,,,7259.46,18485.0,22
CPT,27420,REVISION OF UNSTABLE KNEECAP,,,7259.46,18485.0,22
CPT,27422,REVISION OF UNSTABLE KNEECAP,,,7259.46,18485.0,22
CPT,27424,REVISION/REMOVAL OF KNEECAP,,,7259.46,18485.0,22
CPT,27425,LAT RETINACULAR RELEASE OPEN,,,3297.17,14658.0,22
CPT,27427,RECONSTRUCTION KNEE,,,7259.46,18485.0,22
CPT,27428,RECONSTRUCTION KNEE,,,10315.0,19884.0,22
CPT,27429,RECONSTRUCTION KNEE,,,10315.0,19884.0,22
CPT,27430,REVISION OF THIGH MUSCLES,,,7259.46,18485.0,22
CPT,27435,INCISION OF KNEE JOINT,,,3297.17,14658.0,22
CPT,27437,REVISE KNEECAP,,,7259.46,18485.0,22
CPT,27438,REVISE KNEECAP WITH IMPLANT,,,10315.0,19884.0,22
CPT,27440,REVISION OF KNEE JOINT,,,9733.0,19884.0,22
CPT,27441,REVISION OF KNEE JOINT,,,9733.0,19884.0,22
CPT,27442,REVISION OF KNEE JOINT,,,9733.0,19884.0,22
CPT,27443,REVISION OF KNEE JOINT,,,9733.0,19884.0,22
CPT,27445,APC,,,1127.9,1161.74,15
CPT,27445,OP Surgery - Grouper Table,,,10315.0,18485.0,7
CPT,27446,REVISION OF KNEE JOINT,,,12463.0,21512.0,22
CPT,27447,TOTAL KNEE ARTHROPLASTY,,,12463.0,21512.0,22
CPT,27448,INCISION OF THIGH,,,752.56,17804.0,22
CPT,27450,INCISION OF THIGH,,,910.6,17804.0,22
CPT,27454,REALIGNMENT OF THIGH BONE,,,1164.05,17804.0,22
CPT,27455,REALIGNMENT OF KNEE,,,869.48,17804.0,22
CPT,27457,REALIGNMENT OF KNEE,,,862.82,16799.0,22
CPT,27465,SHORTENING OF THIGH BONE,,,1122.14,17804.0,22
CPT,27466,LENGTHENING OF THIGH BONE,,,1068.09,17804.0,22
CPT,27468,APC,,,1205.16,1241.32,15
CPT,27468,OP Surgery - Grouper Table,,,8363.0,17804.0,7
CPT,27470,REPAIR OF THIGH,,,1064.17,17804.0,22
CPT,27472,REPAIR/GRAFT OF THIGH,,,1138.2,17804.0,22
CPT,27475,SURGERY TO STOP LEG GROWTH,,,7259.46,18485.0,22
CPT,27477,SURGERY TO STOP LEG GROWTH,,,7259.46,14658.0,22
CPT,27479,SURGERY TO STOP LEG GROWTH,,,7259.46,18485.0,22
CPT,27485,SURGERY TO STOP LEG GROWTH,,,7259.46,14658.0,22
CPT,27486,REVISE/REPLACE KNEE JOINT,,,1261.01,21512.0,22
CPT,27487,REVISE/REPLACE KNEE JOINT,,,1566.58,21512.0,22
CPT,27488,REMOVAL OF KNEE PROSTHESIS,,,1082.07,18485.0,22
CPT,27495,REINFORCE THIGH,,,1018.91,17804.0,22
CPT,27496,DECOMPRESSION OF THIGH/KNEE,,,3297.17,14658.0,22
CPT,27497,DECOMPRESSION OF THIGH/KNEE,,,3297.17,9469.0,22
CPT,27498,DECOMPRESSION OF THIGH/KNEE,,,1626.34,14658.0,22
CPT,27499,DECOMPRESSION OF THIGH/KNEE,,,7259.46,29323.0,22
CPT,27500,TREATMENT OF THIGH FRACTURE,,,243.77,4258.0,22
CPT,27501,HC CLSD TX SUPRA-TRANSCONDYLAR FEMUR FX WO MANIP,1515.0,833.25,243.77,4258.0,106
CPT,27502,HC CLSD TX FEMUR SHAFT FX W MANIP W OR WO TRACTION,4626.0,2544.3,1387.8,6766.0,53
CPT,27503,TREATMENT OF THIGH FRACTURE,,,835.0,5761.0,22
CPT,27506,TREATMENT OF THIGH FRACTURE,,,1205.4,16799.0,22
CPT,27507,TREATMENT OF THIGH FRACTURE,,,871.32,16799.0,22
CPT,27508,"HC CLSD TX FEMORAL FX, DISTAL END, MEDIAL/LATERAL CONDYLE, W/O MANIP",996.0,547.8,243.77,4258.0,106
CPT,27509,TREATMENT OF THIGH FRACTURE,,,5480.0,18485.0,22
CPT,27510,HC CLSD TX DISTAL FEMUR FX W MANIPULATION,2157.0,1186.35,647.1,5761.0,53
CPT,27511,TREATMENT OF THIGH FRACTURE,,,893.19,16799.0,22
CPT,27513,TREATMENT OF THIGH FRACTURE,,,1103.58,16799.0,22
CPT,27514,TREATMENT OF THIGH FRACTURE,,,867.79,16799.0,22
CPT,27516,TREAT THIGH FX GROWTH PLATE,,,243.77,4258.0,22
CPT,27517,TREAT THIGH FX GROWTH PLATE,,,835.0,5761.0,22
CPT,27519,TREAT THIGH FX GROWTH PLATE,,,801.12,16799.0,22
CPT,27520,HC CLSD TX KNEECAP FX WO MANIPULATION,895.0,492.25,243.77,4258.0,106
CPT,27524,TREAT KNEECAP FRACTURE,,,7259.46,18485.0,22
CPT,27530,HC CLSD TX TIBIAL FX PROXIMAL WO MANIP,904.0,497.2,243.77,4258.0,106
CPT,27532,HC CLSD TX TIBIA FX PROXIM W WO MANIP W SKEL TRACT,5831.0,3207.05,1749.3,8363.0,53
CPT,27535,TREAT KNEE FRACTURE,,,806.6,16799.0,22
CPT,27536,TREAT KNEE FRACTURE,,,1071.34,16799.0,22
CPT,27538,TREAT KNEE FRACTURE(S),,,243.77,4258.0,22
CPT,27540,TREAT KNEE FRACTURE,,,741.49,16799.0,22
CPT,27550,HC CLSD TX KNEE DISLOC WO ANES,1003.0,551.65,243.77,4258.0,53
CPT,27552,TREAT KNEE DISLOCATION,,,1626.34,6766.0,22
CPT,27556,TREAT KNEE DISLOCATION,,,787.84,16799.0,22
CPT,27557,TREAT KNEE DISLOCATION,,,935.94,16799.0,22
CPT,27558,TREAT KNEE DISLOCATION,,,1062.61,16799.0,22
CPT,27560,HC CLSD TX PATELLAR DISLOC WO ANES,950.0,522.5,243.77,4258.0,53
CPT,27562,TREAT KNEECAP DISLOCATION,,,243.77,4258.0,22
CPT,27566,TREAT KNEECAP DISLOCATION,,,7259.46,18485.0,22
CPT,27570,FIXATION OF KNEE JOINT,,,1626.34,6766.0,22
CPT,27580,FUSION OF KNEE,,,1324.86,17804.0,22
CPT,27590,AMPUTATE LEG AT THIGH,,,678.93,21512.0,22
CPT,27591,AMPUTATE LEG AT THIGH,,,872.08,21512.0,22
CPT,27592,AMPUTATE LEG AT THIGH,,,591.54,21512.0,22
CPT,27594,AMPUTATION FOLLOW-UP SURGERY,,,3297.17,9469.0,22
CPT,27596,AMPUTATION FOLLOW-UP SURGERY,,,625.21,17804.0,22
CPT,27598,AMPUTATE LOWER LEG AT KNEE,,,612.2,17804.0,22
CPT,27599,HC INTERVENTIONAL PROC LEG THIGH,4755.0,2615.25,243.77,29323.0,53
CPT,27600,DECOMPRESSION OF LOWER LEG,,,3297.17,9469.0,22
CPT,27601,DECOMPRESSION OF LOWER LEG,,,3297.17,9469.0,22
CPT,27602,"HC DECOMPRESSION FASCIOTOMY, LEG, ANT/LATERAL, AND POSTERIOR COMPARTMENT",8023.0,4412.65,2406.9,14658.0,53
CPT,27603,DRAIN LOWER LEG LESION,,,2908.42,9469.0,22
CPT,27604,DRAIN LOWER LEG BURSA,,,3297.17,9469.0,22
CPT,27605,INCISION OF ACHILLES TENDON,,,1626.34,9469.0,22
CPT,27606,INCISION OF ACHILLES TENDON,,,3297.17,9469.0,22
CPT,27607,TREAT LOWER LEG BONE LESION,,,3297.17,9469.0,22
CPT,27610,EXPLORE/TREAT ANKLE JOINT,,,3297.17,14658.0,22
CPT,27612,EXPLORATION OF ANKLE JOINT,,,3297.17,14658.0,22
CPT,27613,HC BX SOFT TISSUE LEG ANKLE SUPERFICIAL,4099.5,2254.725,1072.8,5761.0,265
CPT,27614,HC BX SOFT TISSUE OF LEG OR ANKLE AREA DEEP (SUBFASCIAL OR INTRAMUSCULAR),6778.0,3727.9,2033.4,9469.0,212
CPT,27615,HC RADICAL RESECTION OF TUMOR SOFT TISSUE OF LEG/ANKLE AREA LESS THAN 5 CM,7992.0,4395.6,2397.6,8363.0,106
CPT,27616,HC RADICAL RESECTION OF TUMOR SOFT TISSUE OF LEG/ANKLE AREA 5 CM OR GREATER,10150.0,5582.5,2908.42,9469.0,106
CPT,27618,"HC EXC, TUMOR, SOFT TISSUE LEG/ANKLE AREA, SUBCUT, LESS THAN 3 CM",3161.0,1738.55,948.3,6766.0,106
CPT,27619,"HC EXCISION TUMOR SOFT TISSUE OF LEG/ANKLE AREA, SUBFASCIAL LESS THAN 5 CM",10150.0,5582.5,2908.42,8779.75,106
CPT,27620,EXPLORE/TREAT ANKLE JOINT,,,3297.17,14658.0,22
CPT,27625,REMOVE ANKLE JOINT LINING,,,3297.17,14658.0,22
CPT,27626,REMOVE ANKLE JOINT LINING,,,3297.17,14658.0,22
CPT,27630,REMOVAL OF TENDON LESION,,,3297.17,9469.0,22
CPT,27632,"HC EXC TUMOR SOFT TISSUE LEG OR ANKLE SUBQ, 3 CM OR GREATER",8178.0,4497.9,2453.4,9469.0,106
CPT,27634,"HC EXCISION TUMOR SOFT TISSUE OF LEG/ANKLE AREA, SUBFASCIAL 5 CM OR GREATER",8368.0,4602.4,2510.4,9469.0,106
CPT,27635,"HC EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TIBIA OR FIBULA",9235.0,5079.25,2770.5,14658.0,106
CPT,27637,HC EXCISION/CURETTAGE OF BONE CYST OR BENIGN TUMOR TIBIA/FIBULA W/ AUTOGRFT,19154.0,10534.7,5746.2,18485.0,106
CPT,27638,HC EXCISION/CURETTAGE OF BONE CYST/BENIGN TUMOR TIBIA/FIBULA W/ ALLOGRAFT,23620.0,12991.0,7086.0,20431.3,106
CPT,27640,HC PARTIAL EXCISION (CRATERIZATION/SAUCERIZATION/DIAPHYSECTOMY) BONE; TIBIA,11194.0,6156.7,3297.17,14658.0,106
CPT,27641,PARTIAL REMOVAL OF FIBULA,,,3297.17,14658.0,22
CPT,27645,RESECT TIBIA TUMOR,,,1579.74,17804.0,22
CPT,27646,RESECT FIBULA TUMOR,,,1375.85,17804.0,22
CPT,27647,RESECT TALUS/CALCANEUS TUM,,,3297.17,14658.0,22
CPT,27648,HC INJ PROC ANKLE ARTHROGRAPHY,98.0,53.9,29.4,3533.0,371
CPT,27648,INJECTION FOR ANKLE X-RAY,,,329.1,329.1,1
CPT,27650,REPAIR ACHILLES TENDON,,,7259.46,16799.0,22
CPT,27652,REPAIR/GRAFT ACHILLES TENDON,,,7259.46,18485.0,22
CPT,27654,REPAIR OF ACHILLES TENDON,,,7259.46,18485.0,22
CPT,27656,REPAIR LEG FASCIA DEFECT,,,3297.17,9469.0,22
CPT,27658,REPAIR OF LEG TENDON EACH,,,3297.17,9469.0,22
CPT,27659,REPAIR OF LEG TENDON EACH,,,5480.0,18485.0,22
CPT,27664,REPAIR OF LEG TENDON EACH,,,7259.46,18485.0,22
CPT,27665,REPAIR OF LEG TENDON EACH,,,7259.46,18485.0,22
CPT,27675,REPAIR LOWER LEG TENDONS,,,3297.17,9469.0,22
CPT,27676,REPAIR LOWER LEG TENDONS,,,7259.46,18485.0,22
CPT,27680,RELEASE OF LOWER LEG TENDON,,,3297.17,14658.0,22
CPT,27681,RELEASE OF LOWER LEG TENDONS,,,3297.17,14658.0,22
CPT,27685,REVISION OF LOWER LEG TENDON,,,3297.17,14658.0,22
CPT,27686,REVISE LOWER LEG TENDONS,,,3297.17,14658.0,22
CPT,27687,REVISION OF CALF TENDON,,,3297.17,14658.0,22
CPT,27690,REVISE LOWER LEG TENDON,,,7259.46,18485.0,22
CPT,27691,REVISE LOWER LEG TENDON,,,7259.46,18485.0,22
CPT,27692,REVISE ADDITIONAL LEG TENDON,,,90.95,3533.0,21
CPT,27695,REPAIR OF ANKLE LIGAMENT,,,7259.46,18485.0,22
CPT,27696,REPAIR OF ANKLE LIGAMENTS,,,7259.46,18485.0,22
CPT,27698,REPAIR OF ANKLE LIGAMENT,,,7259.46,18485.0,22
CPT,27700,REVISION OF ANKLE JOINT,,,7259.46,18485.0,22
CPT,27702,RECONSTRUCT ANKLE JOINT,,,8363.0,19248.61,22
CPT,27703,RECONSTRUCTION ANKLE JOINT,,,1007.51,18485.0,22
CPT,27704,REMOVAL OF ANKLE IMPLANT,,,3297.17,14658.0,22
CPT,27705,OSTEOTOMY TIBIA,,,7259.46,18485.0,22
CPT,27707,OSTEOTOMY FIBULA,,,3297.17,14658.0,22
CPT,27709,OSTEOTOMY TIBIA & FIBULA,,,8488.0,19884.0,22
CPT,27712,OSTEOT MLT RELIGNMT IMED ROD,,,996.47,17804.0,22
CPT,27715,OSTPL TIBFIB LNGTH/SHRT,,,967.86,17804.0,22
CPT,27720,REPAIR OF TIBIA,,,7259.46,18485.0,22
CPT,27722,REPAIR/GRAFT OF TIBIA,,,7259.46,18485.0,22
CPT,27724,REPAIR/GRAFT OF TIBIA,,,1124.4,17804.0,22
CPT,27725,REPAIR OF LOWER LEG,,,1099.44,17804.0,22
CPT,27726,REPAIR FIBULA NONUNION,,,7259.46,18485.0,22
CPT,27727,REPAIR OF LOWER LEG,,,939.65,17804.0,22
CPT,27730,REPAIR OF TIBIA EPIPHYSIS,,,3297.17,14658.0,22
CPT,27732,REPAIR OF FIBULA EPIPHYSIS,,,3297.17,14658.0,22
CPT,27734,REPAIR LOWER LEG EPIPHYSES,,,3297.17,14658.0,22
CPT,27740,REPAIR OF LEG EPIPHYSES,,,3297.17,14658.0,22
CPT,27742,REPAIR OF LEG EPIPHYSES,,,3297.17,16799.0,22
CPT,27745,"HC PROPHYLACTIC TREATMENT WITH OR WITHOUT METHYLMETHACRYLATE, TIBIA",19154.0,10534.7,5746.2,18485.0,106
CPT,27750,HC CLSD TX TIBIA SHAFT FX W WO FIBULA FX WO MANIP,868.0,477.4,243.77,4258.0,106
CPT,27752,HC CLSD TX TIBIA SHAFT FX W WO FIBULA FX W MANIP,5056.0,2780.8,1516.8,6766.0,106
CPT,27756,TREATMENT OF TIBIA FRACTURE,,,5480.0,18485.0,22
CPT,27758,"HC OPEN TX OF TIBIAL SHAFT FX (W/WO FIBULAR FX) W/ PLT/SCREWS, W/WO CERCLGE",24618.0,13539.9,7385.4,21294.57,106
CPT,27759,HC TREATMENT OF TIBIAL SHAFT FX IMED IMPLT W/WO INTERLOCK SCREWS/CERCLAGE,36006.0,19803.3,10315.0,31145.19,106
CPT,27760,HC CLSD TX MEDIAL MALLEOLUS FX WO MANIPULATION,637.0,350.35,191.1,4258.0,106
CPT,27762,HC CLSD TX MEDIAL MALLEOLUS FX W MANIPULATION,5056.0,2780.8,1516.8,6766.0,53
CPT,27766,HC OPEN TREATMENT OF MEDIAL MALLEOLUS FRACTURE INCLUDES INTERNAL FIXATION,21190.0,11654.5,6357.0,18485.0,106
CPT,27767,HC CLSD TX POSTERIOR MALLEOLUS FX WO MANIPULATION,950.0,522.5,243.77,4258.0,53
CPT,27768,HC CLSD TX POSTERIOR MALLEOLUS FX W MANIPULATION,2157.0,1186.35,647.1,5761.0,53
CPT,27769,OPTX POST ANKLE FX,,,7259.46,18485.0,22
CPT,27780,HC CLSD TX PROXIMAL FIBULA SHAFT FX WO MANIP,775.0,426.25,232.5,4258.0,106
CPT,27781,HC CLSD TX PROXIMAL FIBULA SHAFT FX W MANIP,5056.0,2780.8,1516.8,5761.0,53
CPT,27784,TREATMENT OF FIBULA FRACTURE,,,7259.46,18485.0,22
CPT,27786,HC CLSD TX DISTL FIBULAR FX LAT MALLEOLUS WO MANIP,635.0,349.25,190.5,4258.0,106
CPT,27788,HC CLSD TX DISTAL FIBULAR FX LAT MALLEOLUS W MANIP,950.0,522.5,243.77,4258.0,106
CPT,27792,HC OPEN TX OF DISTAL FIBULAR FX (LATERAL MALLEOLUS) INCLD INTERNAL FIXATION,14131.0,7772.05,4239.3,18485.0,106
CPT,27808,HC CLSD TX BIMALLEOLAR ANKLE FX WO MANIPULATION,975.0,536.25,243.77,4258.0,106
CPT,27810,HC CLSD TX BIMALLEOLAR ANKLE FX W MANIPULATION,1890.0,1039.5,567.0,5761.0,106
CPT,27814,"HC OPEN TX BIMALLEOLAR ANKLE FX, INCL INT FIX",24165.0,13290.75,7249.5,20902.73,106
CPT,27816,HC CLSD TX TRIMALLEOLAR ANKLE FX WO MANIPULATION,812.0,446.6,243.6,4258.0,106
CPT,27818,HC CLSD TX TRIMALLEOLAR ANKLE FX W MANIPULATION,2740.0,1507.0,822.0,5761.0,106
CPT,27822,HC OPEN TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE W/O FIXJ OF POSTERIOR LIP,20224.0,11123.2,6067.2,18485.0,106
CPT,27823,HC OPEN TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE W/FIXJ OF POSTERIOR LIP,24137.0,13275.35,7241.1,20878.51,106
CPT,27824,HC CLSD TX FX WT BEAR ARTCLR DSTL TIBIA WO MANIP,833.0,458.15,243.77,4258.0,106
CPT,27825,HC CLSD TX FX WT BEAR ARTCLR DSTL TIBIA W SKEL TRAC,5056.0,2780.8,1516.8,6766.0,53
CPT,27826,HC OPEN TREATMENT OF FRACTURE DISTAL TIBIA  W/ FIXATION; OF FIBULA ONLY,14997.0,8248.35,4499.1,18485.0,106
CPT,27827,TREAT LOWER LEG FRACTURE,,,10315.0,19884.0,22
CPT,27828,TREAT LOWER LEG FRACTURE,,,10315.0,19884.0,22
CPT,27829,TREAT LOWER LEG JOINT,,,7259.46,18485.0,22
CPT,27830,"HC CLOSED TX OF PROXIMAL TIBIOFIBULAR JOINT DISLOCATION, W/O ANESTHESIA",685.0,376.75,205.5,4258.0,53
CPT,27831,TREAT LOWER LEG DISLOCATION,,,2932.0,8363.0,22
CPT,27832,TREAT LOWER LEG DISLOCATION,,,7259.46,18485.0,22
CPT,27840,HC TREAT ANKLE DISLOCATION,710.0,390.5,213.0,4258.0,53
CPT,27842,TREAT ANKLE DISLOCATION,,,1626.34,6766.0,22
CPT,27846,TREAT ANKLE DISLOCATION,,,7259.46,18485.0,22
CPT,27848,TREAT ANKLE DISLOCATION,,,7259.46,18485.0,22
CPT,27860,FIXATION OF ANKLE JOINT,,,3297.17,8363.0,22
CPT,27870,FUSION OF ANKLE JOINT OPEN,,,10315.0,19884.0,22
CPT,27871,FUSION OF TIBIOFIBULAR JOINT,,,10315.0,19884.0,22
CPT,27880,AMPUTATION OF LOWER LEG,,,780.78,21512.0,22
CPT,27881,AMPUTATION OF LOWER LEG,,,727.77,17804.0,22
CPT,27882,AMPUTATION OF LOWER LEG,,,515.7,17804.0,22
CPT,27884,AMPUTATION FOLLOW-UP SURGERY,,,3297.17,9469.0,22
CPT,27886,AMPUTATION FOLLOW-UP SURGERY,,,572.25,17804.0,22
CPT,27888,AMPUTATION OF FOOT AT ANKLE,,,494.71,17804.0,22
CPT,27889,ANKLE DISARTICULATION,,,7259.46,18485.0,22
CPT,27892,DECOMPRESSION OF LEG,,,3297.17,14658.0,22
CPT,27893,DECOMPRESSION OF LEG,,,7259.46,18485.0,22
CPT,27894,DECOMPRESSION OF LEG,,,3297.17,14658.0,22
CPT,27899,UNLISTED PX LEG/ANKLE,,,243.77,29323.0,22
CPT,28001,DRAINAGE OF BURSA OF FOOT,,,1646.49,6766.0,22
CPT,28002,TREATMENT OF FOOT INFECTION,,,1626.34,9469.0,22
CPT,28003,TREATMENT OF FOOT INFECTION,,,3297.17,9469.0,22
CPT,28005,TREAT FOOT BONE LESION,,,3297.17,9469.0,22
CPT,28008,INCISION OF FOOT FASCIA,,,3297.17,9469.0,22
CPT,28010,INCISION OF TOE TENDON,,,1626.34,9469.0,22
CPT,28011,INCISION OF TOE TENDONS,,,1626.34,9469.0,22
CPT,28020,EXPLORATION OF FOOT JOINT,,,3297.17,9469.0,22
CPT,28022,EXPLORATION OF FOOT JOINT,,,3297.17,9469.0,22
CPT,28024,EXPLORATION OF TOE JOINT,,,1626.34,9469.0,22
CPT,28035,DECOMPRESSION OF TIBIA NERVE,,,1984.4,9469.0,22
CPT,28039,EXC FOOT/TOE TUM SC 1.5 CM/>,,,2908.42,9469.0,22
CPT,28041,EXC FOOT/TOE TUM DEP 1.5CM/>,,,2908.42,9469.0,22
CPT,28043,EXC FOOT/TOE TUM SC < 1.5 CM,,,1646.49,6766.0,22
CPT,28045,EXC FOOT/TOE TUM DEEP <1.5CM,,,2908.42,8363.0,22
CPT,28046,RESECT FOOT/TOE TUMOR < 3 CM,,,2908.42,8363.0,22
CPT,28047,RESECT FOOT/TOE TUMOR 3 CM/>,,,2908.42,9469.0,22
CPT,28050,BIOPSY OF FOOT JOINT LINING,,,3297.17,9469.0,22
CPT,28052,BIOPSY OF FOOT JOINT LINING,,,3297.17,9469.0,22
CPT,28054,BIOPSY OF TOE JOINT LINING,,,3297.17,9469.0,22
CPT,28055,NEURECTOMY FOOT,,,1984.4,9469.0,22
CPT,28060,PARTIAL REMOVAL FOOT FASCIA,,,3297.17,9469.0,22
CPT,28062,REMOVAL OF FOOT FASCIA,,,3297.17,9469.0,22
CPT,28070,REMOVAL OF FOOT JOINT LINING,,,5480.0,9469.0,22
CPT,28072,REMOVAL OF FOOT JOINT LINING,,,3297.17,9469.0,22
CPT,28080,REMOVAL OF FOOT LESION,,,1626.34,9469.0,22
CPT,28086,EXCISE FOOT TENDON SHEATH,,,3297.17,9469.0,22
CPT,28088,EXCISE FOOT TENDON SHEATH,,,3297.17,9469.0,22
CPT,28090,REMOVAL OF FOOT LESION,,,1626.34,9469.0,22
CPT,28092,REMOVAL OF TOE LESIONS,,,1626.34,9469.0,22
CPT,28100,REMOVAL OF ANKLE/HEEL LESION,,,3297.17,9469.0,22
CPT,28102,REMOVE/GRAFT FOOT LESION,,,7259.46,18485.0,22
CPT,28103,REMOVE/GRAFT FOOT LESION,,,7259.46,18485.0,22
CPT,28104,REMOVAL OF FOOT LESION,,,3297.17,9469.0,22
CPT,28106,REMOVE/GRAFT FOOT LESION,,,7259.46,18485.0,22
CPT,28107,REMOVE/GRAFT FOOT LESION,,,7259.46,18485.0,22
CPT,28108,REMOVAL OF TOE LESIONS,,,1626.34,9469.0,22
CPT,28110,PART REMOVAL OF METATARSAL,,,3297.17,9469.0,22
CPT,28111,PART REMOVAL OF METATARSAL,,,3297.17,9469.0,22
CPT,28112,PART REMOVAL OF METATARSAL,,,3297.17,9469.0,22
CPT,28113,PART REMOVAL OF METATARSAL,,,3297.17,9469.0,22
CPT,28114,REMOVAL OF METATARSAL HEADS,,,3297.17,9469.0,22
CPT,28116,REVISION OF FOOT,,,3297.17,9469.0,22
CPT,28118,REMOVAL OF HEEL BONE,,,3297.17,9469.0,22
CPT,28119,REMOVAL OF HEEL SPUR,,,3297.17,9469.0,22
CPT,28120,PART REMOVAL OF ANKLE/HEEL,,,3297.17,9469.0,22
CPT,28122,PARTIAL REMOVAL OF FOOT BONE,,,3297.17,9469.0,22
CPT,28124,PARTIAL REMOVAL OF TOE,,,3297.17,9469.0,22
CPT,28126,PARTIAL REMOVAL OF TOE,,,3297.17,9469.0,22
CPT,28130,REMOVAL OF ANKLE BONE,,,5480.0,9469.0,22
CPT,28140,REMOVAL OF METATARSAL,,,3297.17,9469.0,22
CPT,28150,REMOVAL OF TOE,,,3297.17,9469.0,22
CPT,28153,PARTIAL REMOVAL OF TOE,,,3297.17,9469.0,22
CPT,28160,PARTIAL REMOVAL OF TOE,,,3297.17,9469.0,22
CPT,28171,RESECT TARSAL TUMOR,,,3297.17,9469.0,22
CPT,28173,RESECT METATARSAL TUMOR,,,3297.17,9469.0,22
CPT,28175,RESECT PHALANX OF TOE TUMOR,,,1626.34,9469.0,22
CPT,28190,"HC REMOVAL FOREIGN BODY, FOOT, SUBCUTANEOUS",2868.0,1577.4,714.99,4955.0,53
CPT,28192,REMOVAL OF FOOT FOREIGN BODY,,,1646.49,6766.0,22
CPT,28193,REMOVAL OF FOOT FOREIGN BODY,,,1646.49,5761.0,22
CPT,28200,REPAIR OF FOOT TENDON,,,3297.17,9469.0,22
CPT,28202,REPAIR/GRAFT OF FOOT TENDON,,,5480.0,18485.0,22
CPT,28208,HC REPR OF FOOT TENDON,6681.0,3674.55,2004.3,9469.0,53
CPT,28210,REPAIR/GRAFT OF FOOT TENDON,,,7259.46,18485.0,22
CPT,28220,RELEASE OF FOOT TENDON,,,1626.34,9469.0,22
CPT,28222,RELEASE OF FOOT TENDONS,,,3297.17,9469.0,22
CPT,28225,RELEASE OF FOOT TENDON,,,3297.17,9469.0,22
CPT,28226,RELEASE OF FOOT TENDONS,,,3297.17,9469.0,22
CPT,28230,INCISION OF FOOT TENDON(S),,,1626.34,9469.0,22
CPT,28232,"HC TENOTOMY, OPEN, TENDON, FLEXOR; TOE, SINGLE TENDON (SEPARATE PROCEDURE)",4547.0,2500.85,1364.1,9469.0,53
CPT,28234,INCISION OF FOOT TENDON,,,1626.34,9469.0,22
CPT,28238,REVISION OF FOOT TENDON,,,7259.46,18485.0,22
CPT,28240,RELEASE OF BIG TOE,,,3297.17,9469.0,22
CPT,28250,REVISION OF FOOT FASCIA,,,3297.17,9469.0,22
CPT,28260,RELEASE OF MIDFOOT JOINT,,,3297.17,9469.0,22
CPT,28261,REVISION OF FOOT TENDON,,,1626.34,9469.0,22
CPT,28262,REVISION OF FOOT AND ANKLE,,,5480.0,18485.0,22
CPT,28264,RELEASE OF MIDFOOT JOINT,,,1626.34,16799.0,22
CPT,28270,RELEASE OF FOOT CONTRACTURE,,,3297.17,9469.0,22
CPT,28272,RELEASE OF TOE JOINT EACH,,,1626.34,9469.0,22
CPT,28280,FUSION OF TOES,,,3297.17,9469.0,22
CPT,28285,REPAIR OF HAMMERTOE,,,3297.17,9469.0,22
CPT,28286,REPAIR OF HAMMERTOE,,,3297.17,9469.0,22
CPT,28288,PARTIAL REMOVAL OF FOOT BONE,,,3297.17,9469.0,22
CPT,28289,CORRJ HALUX RIGDUS W/O IMPLT,,,3297.17,9469.0,22
CPT,28291,CORRJ HALUX RIGDUS W/IMPLT,,,7259.46,18485.0,22
CPT,28292,COR HLX VLGS RSC PRX PHLX BS,,,3297.17,14658.0,22
CPT,28295,COR HLX VLGS PRX MTAR OSTEOT,,,3297.17,14658.0,22
CPT,28296,COR HLX VLGS DSTL MTAR OSTEO,,,3297.17,14658.0,22
CPT,28297,COR HLX VLGS JT ARTHRD,,,8488.0,18485.0,22
CPT,28298,COR HLX VLGS PRX PHLX OSTEOT,,,7259.46,18485.0,22
CPT,28299,COR HLX VLGS DOUBLE OSTEOT,,,7259.46,29323.0,22
CPT,28300,INCISION OF HEEL BONE,,,7259.46,18485.0,22
CPT,28302,INCISION OF ANKLE BONE,,,5480.0,18485.0,22
CPT,28304,INCISION OF MIDFOOT BONES,,,7259.46,18485.0,22
CPT,28305,INCISE/GRAFT MIDFOOT BONES,,,7259.46,18485.0,22
CPT,28306,INCISION OF METATARSAL,,,5480.0,18485.0,22
CPT,28307,INCISION OF METATARSAL,,,5480.0,9469.0,22
CPT,28308,INCISION OF METATARSAL,,,3297.17,9469.0,22
CPT,28309,INCISION OF METATARSALS,,,7259.46,18485.0,22
CPT,28310,REVISION OF BIG TOE,,,5480.0,9469.0,22
CPT,28312,REVISION OF TOE,,,3297.17,9469.0,22
CPT,28313,REPAIR DEFORMITY OF TOE,,,3297.17,9469.0,22
CPT,28315,REMOVAL OF SESAMOID BONE,,,3297.17,9469.0,22
CPT,28320,REPAIR OF FOOT BONES,,,10315.0,19884.0,22
CPT,28322,REPAIR OF METATARSALS,,,5480.0,18485.0,22
CPT,28340,RESECT ENLARGED TOE TISSUE,,,3297.17,9469.0,22
CPT,28341,RESECT ENLARGED TOE,,,3297.17,9469.0,22
CPT,28344,REPAIR EXTRA TOE(S),,,3297.17,9469.0,22
CPT,28345,REPAIR WEBBED TOE(S),,,1626.34,9469.0,22
CPT,28360,RECONSTRUCT CLEFT FOOT,,,7259.46,18485.0,22
CPT,28400,HC CLSD TX CALCANEAL FX WO MANIP,1027.0,564.85,243.77,4258.0,106
CPT,28405,HC CLSD TX CALCANEAL FX W MANIP,4474.0,2460.7,243.77,4258.0,53
CPT,28406,PRQ SKEL FIX CLCNL FX W/MNPJ,,,5480.0,18485.0,22
CPT,28415,OPTX CALCANEAL FRACTURE,,,7259.46,18485.0,22
CPT,28420,OPTX CALCANEAL FX W/BONE GRF,,,10315.0,19884.0,22
CPT,28430,HC CLSD TX TALUS FX WO MANIPULATION,754.0,414.7,226.2,4258.0,106
CPT,28435,HC CLSD TX TALUS FX W MANIPULATION,2939.0,1616.45,881.7,6766.0,53
CPT,28436,PRQ SKEL FIX TALUS FX W/MNPJ,,,5480.0,18485.0,22
CPT,28445,OPTX TALUS FRACTURE,,,7259.46,18485.0,22
CPT,28446,OPN OSTEOCHONDRL AGRFT TALUS,,,7259.46,18485.0,22
CPT,28450,HC TX TARSAL BONE FRACTURE WO MANIPULATION EACH,684.0,376.2,205.2,4258.0,106
CPT,28455,"HC TX TARSAL BONE FRACTURE, W/ MANIPULATION, EACH",4381.0,2409.55,835.0,5761.0,53
CPT,28456,PRQ SKEL FIX TARSL FX W/MNPJ,,,5480.0,18485.0,22
CPT,28465,OPTX TARSAL BONE FX EACH,,,7259.46,18485.0,22
CPT,28470,HC CLSD TX METATARSAL FX WO MANIP EA,628.0,345.4,188.4,4258.0,106
CPT,28475,HC CLSD TX METATARSAL FX W MANIP EA,950.0,522.5,243.77,4258.0,106
CPT,28476,PRQ SKEL FIX METAR FX W/MNPJ,,,3297.17,9469.0,22
CPT,28485,OPTX METATARSAL FX EACH,,,7259.46,18485.0,22
CPT,28490,HC CLSD TX FX GREAT TOE PHALANX PHALANGES WO MANIP,596.0,327.8,178.8,4258.0,106
CPT,28495,HC CLSD TX FX GREAT TOE PHALANX PHALANGES W MANIPULATION,950.0,522.5,243.77,4258.0,53
CPT,28496,TREAT BIG TOE FRACTURE,,,3297.17,9469.0,22
CPT,28505,TREAT BIG TOE FRACTURE,,,3297.17,9469.0,22
CPT,28510,HC CLSD TX FX PHLNX PHLNG OTH THN GRT TOE WO MANIP,538.0,295.9,161.4,4258.0,106
CPT,28515,HC CLSD TX FX PHLNX PHLNG OTH THN GRT TOE W MANIP,803.0,441.65,240.9,4258.0,106
CPT,28525,TREAT TOE FRACTURE,,,3297.17,9469.0,22
CPT,28530,TREAT SESAMOID BONE FRACTURE,,,243.77,4258.0,22
CPT,28531,TREAT SESAMOID BONE FRACTURE,,,5480.0,18485.0,22
CPT,28540,TREAT FOOT DISLOCATION,,,243.77,4258.0,22
CPT,28545,TREAT FOOT DISLOCATION,,,3297.17,9469.0,22
CPT,28546,TREAT FOOT DISLOCATION,,,1626.34,9469.0,22
CPT,28555,REPAIR FOOT DISLOCATION,,,7259.46,18485.0,22
CPT,28570,HC CLSD TX TALOTARSAL JT DISLOC WO ANES,744.0,409.2,223.2,4258.0,106
CPT,28575,TREAT FOOT DISLOCATION,,,3297.17,8363.0,22
CPT,28576,TREAT FOOT DISLOCATION,,,5480.0,9469.0,22
CPT,28585,REPAIR FOOT DISLOCATION,,,5480.0,18485.0,22
CPT,28600,HC CLSD TX TARSOMETATARSAL DISLOC WO ANES,748.0,411.4,224.4,4258.0,106
CPT,28605,TREAT FOOT DISLOCATION,,,243.77,4258.0,22
CPT,28606,TREAT FOOT DISLOCATION,,,3297.17,9469.0,22
CPT,28615,REPAIR FOOT DISLOCATION,,,7259.46,18485.0,22
CPT,28630,HC CLSD TX METATARSOPHALANGEAL JT DISLOC WO ANES,637.0,350.35,191.1,4258.0,53
CPT,28635,TREAT TOE DISLOCATION,,,1626.34,6766.0,22
CPT,28636,TREAT TOE DISLOCATION,,,3297.17,9469.0,22
CPT,28645,REPAIR TOE DISLOCATION,,,3297.17,9469.0,22
CPT,28660,HC CLSD TX INTERPHALANGEAL JT DISLOC WO ANES,637.0,350.35,191.1,4258.0,53
CPT,28665,HC CLSD TX INTERPHALANGEAL JT DISLOC W ANES,792.0,435.6,237.6,4258.0,106
CPT,28666,TREAT TOE DISLOCATION,,,3297.17,9469.0,22
CPT,28675,REPAIR OF TOE DISLOCATION,,,3297.17,9469.0,22
CPT,28705,ARTHRODESIS PANTALAR,,,10315.0,24394.0,22
CPT,28715,ARTHRODESIS TRIPLE,,,10315.0,19884.0,22
CPT,28725,ARTHRODESIS SUBTALAR,,,10315.0,19884.0,22
CPT,28730,FUSION OF FOOT BONES,,,10315.0,19884.0,22
CPT,28735,FUSION OF FOOT BONES,,,10315.0,19884.0,22
CPT,28737,REVISION OF FOOT BONES,,,10315.0,19884.0,22
CPT,28740,FUSION OF FOOT BONES,,,7259.46,18485.0,22
CPT,28750,FUSION OF BIG TOE JOINT,,,7259.46,18485.0,22
CPT,28755,FUSION OF BIG TOE JOINT,,,5480.0,18485.0,22
CPT,28760,FUSION OF BIG TOE JOINT,,,7259.46,18485.0,22
CPT,28800,AMPUTATION OF MIDFOOT,,,487.36,18485.0,22
CPT,28805,AMPUTATION THRU METATARSAL,,,3297.17,9469.0,22
CPT,28810,AMPUTATION TOE & METATARSAL,,,3297.17,9469.0,22
CPT,28820,"HC AMPUTATION, TOE, METATARSOPHALANGEAL JOINT",8243.0,4533.65,2472.9,9469.0,53
CPT,28825,HC PARTIAL AMPUTATION OF TOE,6611.0,3636.05,1983.3,9469.0,53
CPT,28890,HI ENRGY ESWT PLANTAR FASCIA,,,1626.34,14658.0,22
CPT,28899,HC CRYOABLATION OF SOFT TISSUE FOOT,8677.0,4772.35,243.77,29323.0,53
CPT,29000,APPL HALO TYPE BODY CAST,,,269.88,4258.0,22
CPT,29010,APPL RISSER JACKET BODY ONLY,,,269.88,4258.0,22
CPT,29015,APPL RISSR JACKET BDY W/HEAD,,,269.88,4258.0,22
CPT,29035,APPL BODY CAST SHO TO HIPS,,,269.88,4258.0,22
CPT,29040,APPL BDY CST SHO TO HIP HEAD,,,269.88,4258.0,22
CPT,29044,APPL BDY CST SHO TO HIP 1THI,,,160.35,4258.0,22
CPT,29046,APPL BDY CST SHO TO HIP B TH,,,269.88,4258.0,22
CPT,29049,APPL CAST FIGURE-OF-EIGHT,,,269.88,4258.0,22
CPT,29055,APPL CAST SHOULDER SPICA,,,269.88,4258.0,22
CPT,29058,APPL CAST PLASTER VELPEAU,,,269.88,4258.0,22
CPT,29065,HC APPL OF LONG ARM CAST,866.0,476.3,259.8,4258.0,106
CPT,29065,"HC OT, APPL, CAST, SHOULDER TO HAND (LONG ARM)",866.0,476.3,237.0,749.09,318
CPT,29065,"HC PT, APPL, CAST, SHOULDER TO HAND (LONG ARM)",866.0,476.3,237.0,749.09,212
CPT,29065,HC RE-APPL OF LONG ARM CAST,866.0,476.3,259.8,4258.0,53
CPT,29075,HC APPL ELBOW TO FINGER SHORT ARM CAST,661.0,363.55,198.3,4258.0,106
CPT,29075,"HC OT, APPL, CAST, ELBOW TO FINGER (SHORT ARM)",661.0,363.55,198.3,571.77,318
CPT,29075,"HC PT, APPL, CAST, ELBOW TO FINGER (SHORT ARM)",661.0,363.55,198.3,571.77,212
CPT,29075,HC RE-APPL ELBOW TO FINGER SHORT ARM CAST,661.0,363.55,198.3,4258.0,53
CPT,29085,HC APPL HAND LWR FOREARM GAUNTLET CAST,592.0,325.6,160.35,4258.0,53
CPT,29085,"HC OT, APPL, CAST, HAND AND LOWER FOREARM (GAUNTLET)",592.0,325.6,160.35,512.08,318
CPT,29086,APPLICATION CAST FINGER,,,160.35,4258.0,22
CPT,29105,HC APPLICATION LONG ARM SPLINT (SHOULDER TO HAND),589.0,323.95,160.35,4258.0,53
CPT,29105,HC APPLICATION LONG ARM SPLINT SHOULDER TO HAND,517.0,284.35,155.1,4258.0,53
CPT,29105,HC RE-APPLICATION LONG ARM SPLINT SHOULDER TO HAND,517.0,284.35,155.1,4258.0,53
CPT,29125,"HC APPLICATION SHORT ARM SPLINT (FOREARM TO HAND), STATIC",608.0,334.4,130.99,4258.0,53
CPT,29125,"HC APPLICATION SHORT ARM SPLINT FOREARM TO HAND, STATIC",554.0,304.7,130.99,4258.0,53
CPT,29126,APPL SHORT ARM SPLINT DYN,,,130.99,4258.0,22
CPT,29130,"HC APPLICATION FINGER SPLINT, STATIC",267.0,146.85,80.1,4258.0,53
CPT,29131,APPL FINGER SPLINT DYNAMIC,,,60.36,4258.0,22
CPT,29200,STRAPPING THORAX,,,160.35,4258.0,22
CPT,29240,STRAPPING OF SHOULDER,,,130.99,4258.0,22
CPT,29260,STRAPPING OF ELBOW OR WRIST,,,60.36,4258.0,22
CPT,29280,STRAPPING OF HAND OR FINGER,,,60.36,4258.0,22
CPT,29305,APPL HIP SPICA CAST 1 LEG,,,269.88,4258.0,22
CPT,29325,APPL HIP SPICA CAST1&1/2,,,269.88,4258.0,22
CPT,29345,HC APPL LONG LEG CAST,981.0,539.55,269.88,4258.0,106
CPT,29345,HC RE-APPL LONG LEG CAST,981.0,539.55,269.88,4258.0,106
CPT,29355,HC APPL LONG LEG CAST WALKER OR AMBULATORY TYPE,859.0,472.45,257.7,4258.0,106
CPT,29358,APPL LONG LEG CAST BRACE,,,269.88,4258.0,22
CPT,29365,HC APPL CYLINDER CAST,874.0,480.7,262.2,4258.0,53
CPT,29365,HC RE-APPL CYLINDER CAST,874.0,480.7,262.2,4258.0,53
CPT,29405,HC APPL SHORT LEG CAST,700.0,385.0,210.0,4258.0,106
CPT,29405,HC APPLICATION SHORT LEG CAST (BELOW KNEE TO TOES),768.0,422.4,230.4,4258.0,53
CPT,29405,"HC OT, APPL SHORT LEG CAST (BELOW KNEE TO TOES)",700.0,385.0,210.0,605.5,212
CPT,29405,"HC PT, APPL SHORT LEG CAST (BELOW KNEE TO TOES)",700.0,385.0,210.0,605.5,265
CPT,29405,HC RE-APPL SHORT LEG CAST,700.0,385.0,210.0,4258.0,53
CPT,29425,HC APPL SHORT LEG CAST WALKER OR AMBULATORY TYPE,950.0,522.5,269.88,4258.0,53
CPT,29435,HC APPL PTB CAST,874.0,480.7,262.2,4258.0,53
CPT,29435,HC REAPPL PTB CAST,874.0,480.7,262.2,4258.0,53
CPT,29440,ADDING WALKER TO PREV CAST,,,160.35,4258.0,22
CPT,29445,HC APPL RIGID TOTAL CONTACT LEG CAST,740.0,407.0,222.0,4258.0,159
CPT,29450,APPLICATION CLUBFOOT CAST,,,160.35,4258.0,22
CPT,29505,HC APPL LONG LEG SPLINT,695.0,382.25,160.35,4258.0,53
CPT,29505,HC APPLICATION LONG LEG SPLINT (THIGH TO ANKLE OR TOES),763.0,419.65,160.35,4258.0,53
CPT,29505,HC RE-APPL LONG LEG SPLINT,695.0,382.25,160.35,4258.0,53
CPT,29515,HC APPL LOWER LEG SPLINT,476.0,261.8,142.8,4258.0,53
CPT,29515,HC APPLICATION SHORT LEG SPLINT (CALF TO FOOT),609.0,334.95,160.35,4258.0,53
CPT,29515,HC RE-APPL LOWER LEG SPLINT,476.0,261.8,142.8,4258.0,53
CPT,29520,"HC STRAPPING, HIP",326.0,179.3,97.8,4258.0,53
CPT,29530,STRAPPING OF KNEE,,,130.99,4258.0,22
CPT,29540,STRAPPING ANKLE &/FOOT,,,160.35,4258.0,22
CPT,29550,HC STRAPPING TOES,253.0,139.15,60.36,4258.0,53
CPT,29580,"HC STRAPPING, UNNA BOOT",409.0,224.95,122.7,4258.0,159
CPT,29581,"HC APPL MULTI-LAYER COMPRESSION SYS, LEG (BELOW KNEE), INCL ANKLE AND FOOT",683.0,375.65,160.35,4258.0,212
CPT,29584,"HC APPL MULTI-LAYER COMPRESSION SYS, UPR ARM, FOREARM, HAND, AND FINGERS",308.0,169.4,92.4,4258.0,106
CPT,29700,"HC REMOVAL OR BIVALVING, GAUNTLET, BOOT OR BODY CAST",661.0,363.55,198.3,4258.0,106
CPT,29705,"HC REMOVAL OR BIVALVING, FULL ARM OR FULL LEG CAST",661.0,363.55,198.3,4258.0,106
CPT,29710,RMVL/BIVLV SHO/HIP SPICA,,,269.88,4258.0,22
CPT,29720,REPAIR SPICA BODY CST/JACKET,,,160.35,4258.0,22
CPT,29730,HC WINDOWING OF CAST,406.0,223.3,121.8,4258.0,53
CPT,29740,WEDGING OF CAST,,,269.88,4258.0,22
CPT,29750,WEDGING OF CLUBFOOT CAST,,,269.88,4258.0,22
CPT,29799,UNLISTED PX CASTING/STRPG,,,160.35,29323.0,22
CPT,29800,JAW ARTHROSCOPY/SURGERY,,,3297.17,14658.0,22
CPT,29804,JAW ARTHROSCOPY/SURGERY,,,3297.17,14658.0,22
CPT,29805,SHO ARTHRS DX +- SYNOVIAL BX,,,3297.17,14658.0,22
CPT,29806,SHO ARTHRS SRG CAPSULORRAPHY,,,7259.46,18485.0,22
CPT,29807,SHO ARTHRS SRG RPR SLAP LES,,,7259.46,18485.0,22
CPT,29819,SHO ARTHRS SRG RMVL LOOSE/FB,,,3297.17,17804.0,22
CPT,29820,SHO ARTHRS SRG PRTL SYNVCT,,,7259.46,18485.0,22
CPT,29821,SHO ARTHRS SRG COMPL SYNVCT,,,3297.17,17804.0,22
CPT,29822,SHO ARTHRS SRG LMTD DBRDMT,,,3297.17,14658.0,22
CPT,29823,SHO ARTHRS SRG XTNSV DBRDMT,,,3297.17,17804.0,22
CPT,29824,SHO ARTHRS SRG DSTL CLAVICLC,,,3297.17,17804.0,22
CPT,29825,SHO ARTHRS SRG LSS&RESCJ ADS,,,3297.17,17804.0,22
CPT,29826,SHO ARTHRS SRG DECOMPRESSION,,,151.65,3533.0,21
CPT,29827,SHO ARTHRS SRG RT8TR CUF RPR,,,7259.46,18485.0,22
CPT,29828,SHO ARTHRS SRG BICP TENODSIS,,,7259.46,18485.0,22
CPT,29830,ELBOW ARTHROSCOPY,,,3297.17,17804.0,22
CPT,29834,ELBOW ARTHROSCOPY/SURGERY,,,3297.17,14658.0,22
CPT,29835,ELBOW ARTHROSCOPY/SURGERY,,,3297.17,17804.0,22
CPT,29836,ELBOW ARTHROSCOPY/SURGERY,,,7259.46,18485.0,22
CPT,29837,ELBOW ARTHROSCOPY/SURGERY,,,3297.17,14658.0,22
CPT,29838,ELBOW ARTHROSCOPY/SURGERY,,,3297.17,14658.0,22
CPT,29840,WRIST ARTHROSCOPY,,,3297.17,14658.0,22
CPT,29843,WRIST ARTHROSCOPY/SURGERY,,,3297.17,14658.0,22
CPT,29844,WRIST ARTHROSCOPY/SURGERY,,,3297.17,14658.0,22
CPT,29845,WRIST ARTHROSCOPY/SURGERY,,,3297.17,14658.0,22
CPT,29846,WRIST ARTHROSCOPY/SURGERY,,,3297.17,14658.0,22
CPT,29847,WRIST ARTHROSCOPY/SURGERY,,,7259.46,18485.0,22
CPT,29848,WRIST ENDOSCOPY/SURGERY,,,1626.34,14658.0,22
CPT,29850,KNEE ARTHROSCOPY/SURGERY,,,1626.34,14658.0,22
CPT,29851,KNEE ARTHROSCOPY/SURGERY,,,1626.34,16799.0,22
CPT,29855,TIBIAL ARTHROSCOPY/SURGERY,,,7259.46,18485.0,22
CPT,29856,TIBIAL ARTHROSCOPY/SURGERY,,,10315.0,19884.0,22
CPT,29860,HIP ARTHROSCOPY DX,,,7259.46,18485.0,22
CPT,29861,HIP ARTHRO W/FB REMOVAL,,,7259.46,17804.0,22
CPT,29862,HIP ARTHR0 W/DEBRIDEMENT,,,7259.46,18485.0,22
CPT,29863,HIP ARTHR0 W/SYNOVECTOMY,,,3297.17,17804.0,22
CPT,29866,AUTGRFT IMPLNT KNEE W/SCOPE,,,7259.46,18485.0,22
CPT,29867,ALLGRFT IMPLNT KNEE W/SCOPE,,,10315.0,19884.0,22
CPT,29868,MENISCAL TRNSPL KNEE W/SCPE,,,7259.46,18485.0,22
CPT,29870,ARTHRS KNEE DX W/WO SYN BX,,,3297.17,14658.0,22
CPT,29871,ARTHRS KNEE SURG FOR INFCTJ,,,3297.17,14658.0,22
CPT,29873,ARTHRS KNEE SURG W/LAT RLS,,,3297.17,14658.0,22
CPT,29874,ARTHRS KNEE SURG RMV LOOS/FB,,,3297.17,14658.0,22
CPT,29875,ARTHRS KNEE SURG SYNVCT LMTD,,,3297.17,14658.0,22
CPT,29876,ARTHRS KNEE SURG SYNVCT MAJ,,,3297.17,14658.0,22
CPT,29877,ARTHRS KNEE SURG DBRDMT/SHVG,,,3297.17,14658.0,22
CPT,29879,ARTHRS KNE SRG ABRASJ ARTHRP,,,3297.17,14658.0,22
CPT,29880,ARTHRS KNE SRG MNISECTMY M&L,,,3297.17,14658.0,22
CPT,29881,ARTHRS KNE SRG MNISECTMY M/L,,,3297.17,14658.0,22
CPT,29882,ARTHRS KNE SRG MNISC RPR M/L,,,3297.17,14658.0,22
CPT,29883,ARTHRS KNE SRG MNISC RPR M&L,,,3297.17,14658.0,22
CPT,29884,ARTHRS KNEE SURG LYSIS ADS,,,3297.17,14658.0,22
CPT,29885,ARTHRS KNE SRG DRLG OST DISS,,,7259.46,18485.0,22
CPT,29886,ARTHRS KNEE SURG DRLG OD LES,,,3297.17,14658.0,22
CPT,29887,ARTHRS KNEE SRG DRLG OD FIXJ,,,7259.46,18485.0,22
CPT,29888,ARTHRS AID ACL RPR/AGMNTJ,,,7259.46,18485.0,22
CPT,29889,ARTHRS AID PCL RPR/AGMNTJ,,,10315.0,19884.0,22
CPT,29891,ARTHR ANK OSTCHN DF TAL&/TIB,,,3297.17,17804.0,22
CPT,29892,ARTHRS AID RPR OD LES/TIB FX,,,7259.46,18485.0,22
CPT,29893,ENDOSCOPIC PLANTR FASCIOTOMY,,,3297.17,9469.0,22
CPT,29894,ANKLE ARTHROSCOPY/SURGERY,,,3297.17,14658.0,22
CPT,29895,ANKLE ARTHROSCOPY/SURGERY,,,3297.17,14658.0,22
CPT,29897,ANKLE ARTHROSCOPY/SURGERY,,,3297.17,14658.0,22
CPT,29898,ANKLE ARTHROSCOPY/SURGERY,,,3297.17,14658.0,22
CPT,29899,ANKLE ARTHROSCOPY/SURGERY,,,7259.46,29323.0,22
CPT,29900,MCP JOINT ARTHROSCOPY DX,,,3297.17,14658.0,22
CPT,29901,MCP JOINT ARTHROSCOPY SURG,,,3297.17,17804.0,22
CPT,29902,MCP JOINT ARTHROSCOPY SURG,,,1626.34,14658.0,22
CPT,29904,SUBTALAR ARTHRO W/FB RMVL,,,3297.17,14658.0,22
CPT,29905,SUBTALAR ARTHRO W/EXC,,,7259.46,14658.0,22
CPT,29906,SUBTALAR ARTHRO W/DEB,,,3297.17,14658.0,22
CPT,29907,SUBTALAR ARTHRO W/FUSION,,,10315.0,19884.0,22
CPT,29914,HIP ARTHRO W/FEMOROPLASTY,,,7259.46,18485.0,22
CPT,29915,HIP ARTHRO ACETABULOPLASTY,,,7259.46,18485.0,22
CPT,29916,HIP ARTHRO W/LABRAL REPAIR,,,7259.46,18485.0,22
CPT,29999,UNLISTED PX ARTHROSCOPY,,,243.77,29323.0,22
CPT,30000,"HC DRAINAGE ABSCESS OR HEMATOMA, NASAL, INTERNAL APPROACH",660.0,363.0,198.0,4258.0,53
CPT,30020,"HC DRAIN ABSCESS OR HEMATOMA, NASAL SEPTUM",1486.0,817.3,445.8,4258.0,53
CPT,30100,HC BX INTRANASAL,3220.0,1771.0,840.0,6766.0,212
CPT,30110,HC EXC NASAL POLYP SIMPLE,3708.0,2039.4,1112.4,6766.0,53
CPT,30115,REMOVAL OF NOSE POLYP(S),,,3295.61,9469.0,22
CPT,30117,REMOVAL OF INTRANASAL LESION,,,3295.61,6766.0,22
CPT,30118,REMOVAL OF INTRANASAL LESION,,,3295.61,9469.0,22
CPT,30120,REVISION OF NOSE,,,3295.61,9469.0,22
CPT,30124,REMOVAL OF NOSE LESION,,,1505.28,6766.0,22
CPT,30125,REMOVAL OF NOSE LESION,,,6011.49,16799.0,22
CPT,30130,EXCISE INFERIOR TURBINATE,,,3295.61,9469.0,22
CPT,30140,RESECT INFERIOR TURBINATE,,,3295.61,9469.0,22
CPT,30150,RHINECTOMY PARTIAL,,,6011.49,16799.0,22
CPT,30160,RHINECTOMY TOTAL,,,6011.49,16799.0,22
CPT,30200,INJECTION TREATMENT OF NOSE,,,517.5,4258.0,22
CPT,30210,NASAL SINUS THERAPY,,,1505.28,6766.0,22
CPT,30220,"HC INSERTION, NASAL SEPTAL PROSTHESIS (BUTTON)",3708.0,2039.4,1112.4,6766.0,53
CPT,30300,"HC REMOVAL FOREIGN BODY, INTRANASAL",262.0,144.1,78.6,4258.0,212
CPT,30310,REMOVE NASAL FOREIGN BODY,,,3295.61,6766.0,22
CPT,30320,REMOVE NASAL FOREIGN BODY,,,1505.28,6766.0,22
CPT,30400,RECONSTRUCTION OF NOSE,,,5480.0,13936.0,22
CPT,30410,RECONSTRUCTION OF NOSE,,,6011.49,16799.0,22
CPT,30420,RECONSTRUCTION OF NOSE,,,6011.49,16799.0,22
CPT,30430,REVISION OF NOSE,,,5480.0,13936.0,22
CPT,30435,REVISION OF NOSE,,,6011.49,16799.0,22
CPT,30450,REVISION OF NOSE,,,6011.49,16799.0,22
CPT,30460,REVISION OF NOSE,,,6011.49,16799.0,22
CPT,30462,REVISION OF NOSE,,,6011.49,16799.0,22
CPT,30465,REPAIR NASAL STENOSIS,,,6011.49,16799.0,22
CPT,30468,RPR NSL VLV COLLAPSE W/IMPLT,,,6011.49,16799.0,22
CPT,30469,RPR NSL VLV COLLAPSE W/RMDLG,,,6011.49,16799.0,22
CPT,30520,REPAIR OF NASAL SEPTUM,,,3295.61,9469.0,22
CPT,30540,RPR CHOANAL ATRESIA NTRANASL,,,6011.49,16799.0,22
CPT,30545,RPR CHOANAL ATRESIA TRSNPLTN,,,6011.49,16799.0,22
CPT,30560,LYSIS INTRANASAL SYNECHIA,,,517.5,4258.0,22
CPT,30580,REPAIR UPPER JAW FISTULA,,,6011.49,16799.0,22
CPT,30600,"HC REPAIR FISTULA, ORONASAL",17588.0,9673.4,5276.4,16799.0,53
CPT,30620,INTRANASAL RECONSTRUCTION,,,6011.49,16799.0,22
CPT,30630,REPAIR NASAL SEPTUM DEFECT,,,3295.61,9469.0,22
CPT,30801,HC ABLAT SOFT TIS INFERIOR TURBINATES UNI/BI SUPFC,3708.0,2039.4,1112.4,6766.0,53
CPT,30802,HC ABLAT SFT TIS INF TURBS UNI-BILAT SUPRFC INTMRL,3708.0,2039.4,1112.4,6766.0,53
CPT,30901,"HC CONTROL NASAL HEMORRHAGE, ANTERIOR, SIMPLE, ANY METHOD",813.0,447.15,130.99,4258.0,212
CPT,30903,"HC CONTROL NASAL HEMORRHAGE, ANTERIOR, COMPLEX, ANY METHOD",998.0,548.9,130.99,4258.0,106
CPT,30905,"HC CONTROL NASAL HEMORRHAGE, POSTERIOR, W/ PST NASAL PACKS/CAUTERY, INITIAL",893.0,491.15,130.99,4258.0,106
CPT,30906,HC CONTROL NASAL HEMORRHAGE POSTERIOR SUBSEQ,598.0,328.9,179.4,4258.0,106
CPT,30915,LIGATION NASAL SINUS ARTERY,,,3198.49,14658.0,22
CPT,30920,LIGATION UPPER JAW ARTERY,,,3198.49,14658.0,22
CPT,30930,THER FX NASAL INF TURBINATE,,,3295.61,9469.0,22
CPT,30999,UNLISTED PROCEDURE NOSE,,,235.98,29323.0,22
CPT,31000,IRRIGATION MAXILLARY SINUS,,,235.98,4258.0,22
CPT,31002,IRRIGATION SPHENOID SINUS,,,1505.28,6766.0,22
CPT,31020,EXPLORATION MAXILLARY SINUS,,,3295.61,9469.0,22
CPT,31030,EXPLORATION MAXILLARY SINUS,,,6011.49,16799.0,22
CPT,31032,EXPLORE SINUS REMOVE POLYPS,,,6011.49,16799.0,22
CPT,31040,EXPLORATION BEHIND UPPER JAW,,,5480.0,13936.0,22
CPT,31050,EXPLORATION SPHENOID SINUS,,,6011.49,16799.0,22
CPT,31051,SPHENOID SINUS SURGERY,,,6011.49,16799.0,22
CPT,31070,EXPLORATION OF FRONTAL SINUS,,,5480.0,13936.0,22
CPT,31075,EXPLORATION OF FRONTAL SINUS,,,6011.49,16799.0,22
CPT,31080,REMOVAL OF FRONTAL SINUS,,,6011.49,16799.0,22
CPT,31081,REMOVAL OF FRONTAL SINUS,,,6011.49,16799.0,22
CPT,31084,REMOVAL OF FRONTAL SINUS,,,6011.49,16799.0,22
CPT,31085,REMOVAL OF FRONTAL SINUS,,,6011.49,16799.0,22
CPT,31086,REMOVAL OF FRONTAL SINUS,,,6011.49,16799.0,22
CPT,31087,REMOVAL OF FRONTAL SINUS,,,6011.49,16799.0,22
CPT,31090,EXPLORATION OF SINUSES,,,6011.49,16799.0,22
CPT,31200,REMOVAL OF ETHMOID SINUS,,,6011.49,16799.0,22
CPT,31201,REMOVAL OF ETHMOID SINUS,,,1505.28,6766.0,22
CPT,31205,REMOVAL OF ETHMOID SINUS,,,3295.61,9469.0,22
CPT,31225,REMOVAL OF UPPER JAW,,,1633.96,13936.0,22
CPT,31230,REMOVAL OF UPPER JAW,,,1819.18,13936.0,22
CPT,31231,"HC NASAL ENDOSCOPY, DIAGNOSTIC, UNILAT OR BILAT",800.0,440.0,197.29,4258.0,371
CPT,31233,NSL/SINS NDSC DX MAX SINUSC,,,394.6,4258.0,22
CPT,31235,NSL/SINS NDSC DX SPHN SINUSC,,,1752.41,6766.0,22
CPT,31237,HC NASAL SINUS ENDOSCOP SURG W BX POLYPECT DEBRIDE,4346.0,2390.3,1238.1,6766.0,159
CPT,31238,"HC NASAL/SINUS ENDOSCOPY, SURGICAL, WITH CONTROL OF NASAL HEMORRHAGE",7017.0,3859.35,1752.41,6766.0,106
CPT,31239,NSL/SINUS ENDOSCOPY SURG DCR,,,3746.68,9469.0,22
CPT,31240,NSL/SNS NDSC CNCH BULL RESCJ,,,1752.41,9469.0,22
CPT,31241,NSL/SNS NDSC LIG SPHNPTN ART,,,1752.41,9469.0,22
CPT,31242,HC NASAL/SINUS NDSC DSTRJ RF ABLATION PST NSL NRV,15821.0,8701.55,4746.3,16799.0,53
CPT,31243,"HC NASAL/SINUS ENDOSCOPY, SURG, W/ DESTR BY CRYOABLAT, POST NASAL NERVE",14238.0,7830.9,4271.4,16799.0,53
CPT,31253,NSL/SINS NDSC TOTAL,,,7034.61,17386.0,22
CPT,31254,NSL/SINS NDSC W/PRTL ETHMDCT,,,5480.0,17386.0,22
CPT,31255,NSL/SINS NDSC W/TOT ETHMDCT,,,7034.61,17386.0,22
CPT,31256,EXPLORATION MAXILLARY SINUS,,,3746.68,9469.0,22
CPT,31257,NSL/SINS NDSC TOT W/SPHENDT,,,7034.61,17386.0,22
CPT,31259,NSL/SINS NDSC SPHN TISS RMVL,,,7034.61,17386.0,22
CPT,31267,ENDOSCOPY MAXILLARY SINUS,,,5480.0,17386.0,22
CPT,31276,NSL/SINS NDSC FRNT TISS RMVL,,,7034.61,17386.0,22
CPT,31287,NASAL/SINUS ENDOSCOPY SURG,,,7034.61,17386.0,22
CPT,31288,NASAL/SINUS ENDOSCOPY SURG,,,7034.61,17386.0,22
CPT,31290,NASAL/SINUS ENDOSCOPY SURG,,,1031.56,17386.0,22
CPT,31291,NASAL/SINUS ENDOSCOPY SURG,,,1093.73,17386.0,22
CPT,31292,NSL/SINS NDSC MED/INF DCMPRN,,,7034.61,17386.0,22
CPT,31293,NSL/SINS NDSC MED&INF DCMPRN,,,7034.61,17386.0,22
CPT,31294,NSL/SINS NDSC SURG ON DCMPRN,,,7034.61,17386.0,22
CPT,31295,NSL/SINS NDSC SURG MAX SINS,,,7034.61,17386.0,22
CPT,31296,NSL/SINS NDSC SURG FRNT SINS,,,7034.61,17386.0,22
CPT,31297,NSL/SINS NDSC SURG SPHN SINS,,,5480.0,17386.0,22
CPT,31298,NSL/SINS NDSC SURG FRNT&SPHN,,,7034.61,17386.0,22
CPT,31299,UNLISTED PX ACCESSORY SINUS,,,235.98,29323.0,22
CPT,31300,REMOVAL OF LARYNX LESION,,,3295.61,9469.0,22
CPT,31360,REMOVAL OF LARYNX,,,1861.53,13936.0,22
CPT,31365,REMOVAL OF LARYNX,,,2296.01,13936.0,22
CPT,31367,PARTIAL REMOVAL OF LARYNX,,,1971.42,13936.0,22
CPT,31368,PARTIAL REMOVAL OF LARYNX,,,2176.84,13936.0,22
CPT,31370,PARTIAL REMOVAL OF LARYNX,,,1850.69,13936.0,22
CPT,31375,PARTIAL REMOVAL OF LARYNX,,,1760.5,13936.0,22
CPT,31380,PARTIAL REMOVAL OF LARYNX,,,1736.15,13936.0,22
CPT,31382,PARTIAL REMOVAL OF LARYNX,,,1899.19,13936.0,22
CPT,31390,REMOVAL OF LARYNX & PHARYNX,,,2453.0,13936.0,22
CPT,31395,RECONSTRUCT LARYNX & PHARYNX,,,2453.0,13936.0,22
CPT,31400,REVISION OF LARYNX,,,6011.49,16799.0,22
CPT,31420,EPIGLOTTIDECTOMY,,,6011.49,16799.0,22
CPT,31500,HC INSERT EMERGENCY AIRWAY,910.0,500.5,235.98,4258.0,106
CPT,31502,HC TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT,660.0,363.0,198.0,4258.0,371
CPT,31505,HC DIAGNOSTIC LARYNGOSCOPY INDIRECT,443.0,243.65,115.5,4258.0,159
CPT,31510,LARYNGOSCOPY WITH BIOPSY,,,3746.68,8363.0,22
CPT,31511,HC LARYNGOSCOPY INDIRECT W/REMOVAL FOREIGN BODY,453.0,249.15,135.9,4258.0,53
CPT,31512,REMOVAL OF LARYNX LESION,,,3746.68,9469.0,22
CPT,31513,INJECTION INTO VOCAL CORD,,,394.6,4258.0,22
CPT,31515,LARYNGOSCOPY FOR ASPIRATION,,,394.6,4258.0,22
CPT,31520,DX LARYNGOSCOPY NEWBORN,,,394.6,4258.0,22
CPT,31525,HC LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN,6127.0,3369.85,1752.41,6766.0,53
CPT,31526,DX LARYNGOSCOPY W/OPER SCOPE,,,1752.41,6766.0,22
CPT,31527,LARYNGOSCOPY FOR TREATMENT,,,3746.68,9469.0,22
CPT,31528,LARYNGOSCOPY AND DILATION,,,3746.68,9469.0,22
CPT,31529,LARYNGOSCOPY AND DILATION,,,3746.68,9469.0,22
CPT,31530,"HC LARYNGOSCOPY, DIRECT, OPERATIVE, WITH FOREIGN BODY REMOVAL",4127.0,2269.85,1238.1,6766.0,106
CPT,31531,LARYNGOSCOPY W/FB & OP SCOPE,,,3746.68,8363.0,22
CPT,31535,LARYNGOSCOPY W/BIOPSY,,,3746.68,9469.0,22
CPT,31536,LARYNGOSCOPY W/BX & OP SCOPE,,,3746.68,9469.0,22
CPT,31540,LARYNGOSCOPY W/EXC OF TUMOR,,,3746.68,9469.0,22
CPT,31541,HC LARYNGOSCOPY EXC TUM STRIP CORDS EPIGL MICROSCP,9105.0,5007.75,2731.5,9469.0,53
CPT,31545,REMOVE VC LESION W/SCOPE,,,3746.68,9469.0,22
CPT,31546,REMOVE VC LESION SCOPE/GRAFT,,,7034.61,17386.0,22
CPT,31551,LARYNGOPLASTY LARYNGEAL STEN,,,6011.49,16799.0,22
CPT,31552,LARYNGOPLASTY LARYNGEAL STEN,,,6011.49,16799.0,22
CPT,31553,LARYNGOPLASTY LARYNGEAL STEN,,,6011.49,16799.0,22
CPT,31554,LARYNGOPLASTY LARYNGEAL STEN,,,6011.49,16799.0,22
CPT,31560,LARYNGOSCOP W/ARYTENOIDECTOM,,,7034.61,17386.0,22
CPT,31561,LARYNSCOP REMVE CART + SCOP,,,5480.0,17386.0,22
CPT,31570,LARYNGOSCOPE W/VC INJ,,,3746.68,8363.0,22
CPT,31571,LARYNGOSCOP W/VC INJ + SCOPE,,,3746.68,9469.0,22
CPT,31572,"HC LARYNGOSCOPY, FLEXIBLE, W/ ABLATION/DESTRUCT LESION(S) W/ LASER, UNILAT",9105.0,5007.75,2731.5,9469.0,53
CPT,31573,"HC LARYNGOSCOPY, FLEXIBLE, W/ THERAPEUTIC INJECTION(S), UNILATERAL",4127.0,2269.85,1238.1,6766.0,53
CPT,31574,"HC LARYNGOSCOPY, FLEXIBLE, W/ INJECTION(S) FOR AUGMENTATION, UNILATERAL",4127.0,2269.85,1238.1,6766.0,53
CPT,31575,"HC LARYNGOSCOPY, FLEXIBLE, DIAGNOSTIC",736.5,405.07500000000005,197.29,4258.0,636
CPT,31575,"HC LARYNGOSCOPY, FLEXIBLE, DIAGNOSTIC WITH VIDEO",771.0,424.05,197.29,4258.0,212
CPT,31576,"HC LARYNGOSCOPY, FLEXIBLE, WITH BIOPSY(IES)",4597.0,2528.35,1238.1,6766.0,371
CPT,31577,"HC LARYNGOSCOPY, FLEXIBLE, WITH REMOVAL OF FOREIGN BODY(S)",1327.5,730.125,384.0,4258.0,212
CPT,31578,"HC LARYNGOSCOPY, FLEXIBLE, WITH REMOVAL OF LESION(S), NON-LASER",9105.0,5007.75,2731.5,8363.0,53
CPT,31579,"HC LARYNGOSCOPY, FLEXIBLE OR RIGID TELESCOPIC, WITH STROBOSCOPY",993.0,546.15,297.9,4258.0,53
CPT,31580,LARYNGOPLASTY LARYNGEAL WEB,,,6011.49,16799.0,22
CPT,31584,LARYNGOPLASTY FX RDCTJ FIXJ,,,6011.49,14658.0,22
CPT,31587,LARYNGOPLASTY CRICOID SPLIT,,,6011.49,16799.0,22
CPT,31590,REINNERVATE LARYNX,,,6011.49,16799.0,22
CPT,31591,LARYNGOPLASTY MEDIALIZATION,,,6011.49,16799.0,22
CPT,31592,CRICOTRACHEAL RESECTION,,,6011.49,16799.0,22
CPT,31599,"HC TRACHEOESOPHAGEAL FISTULA TRACT INJECTION, UNLISTED PROCEDURE",2497.0,1373.35,235.98,29323.0,53
CPT,31600,"HC TRACHEOSTOMY, PLANNED (SEPARATE PROCEDURE)",8239.0,4531.45,2471.7,9469.0,53
CPT,31601,PLANNED TRACHEOSTOMY<2 YRS,,,5480.0,13936.0,22
CPT,31603,HC TRACHEOSTOMY EMERGENCY PROC TRANSTRACHEAL,2102.0,1156.1,630.6,6766.0,53
CPT,31605,HC TRACHEOSTOMY EMERG PROC CRICOTHYROID MEMBRANE,1219.0,670.45,235.98,4258.0,53
CPT,31610,TRACHEOSTOMY FENEST SKIN FLP,,,5480.0,13936.0,22
CPT,31611,HC CONST TRACHESOPHGL FSTL & SUBSEQ INS SP PROSTH,6297.0,3463.35,1889.1,9469.0,159
CPT,31612,HC TRACHIAL PUNCT PERCUTAN W TRANSTR ASPIR OR INJ,7828.0,4305.4,2348.4,9469.0,53
CPT,31613,TRACHEOSTOMA REVJ SIMPLE,,,3295.61,9469.0,22
CPT,31614,TRACHEOSTOMA REVJ COMPLEX,,,6011.49,16799.0,22
CPT,31615,HC TRACHEOBRONCHOSCOPY THRU EST TRACH INCISION,2147.5,1181.125,492.9,4258.0,212
CPT,31622,HC DX BRONCHOSCOPY W CELL WASHING INCL FLUORO GUID,4813.0,2647.15,1443.9,6766.0,159
CPT,31623,HC BRONCHOSCOPY W BRUSHING INCL FLUORO,4304.0,2367.2,1291.2,6766.0,53
CPT,31624,HC BRONCHOSCOPY W BRONCHIAL ALVEOLAR LAVAGE,5114.0,2812.7,1534.2,6766.0,53
CPT,31625,HC BRONCHSC W BRONCH ENDOBRONCH BX SGL MULT SITES,5346.0,2940.3,1603.8,6766.0,53
CPT,31626,HC DX BRONCHOSCOPY WITH FIDUCIAL MARKERS,23228.0,12775.4,6968.4,20092.22,53
CPT,31627,"HC  BRONCHOSCOPY,  COMPUTER ASSISTED/IMAGE NAVIGATION ADD ON",5461.0,3003.55,835.0,4723.77,53
CPT,31628,"HC BRONCH, RIGID/FLEX, INCL FLUORO GUID, W/ TRANSBRONCH LUNG BX, SGL LOBE",5476.0,3011.8,1642.8,8363.0,53
CPT,31629,HC DX BRONCHOSCOPY W/NDL ASP BX,6736.0,3704.8,2020.8,14658.0,159
CPT,31630,HC BRONCHOSCOPY INCLD FLUOROSCOPIC GUID W/TRACH/BRONCH DILAT/CLSD REDUCT FX,8438.0,4640.9,2531.4,14658.0,53
CPT,31631,BRONCHOSCOPY DILATE W/STENT,,,7034.61,17386.0,22
CPT,31632,HC TRANSBRONCIAL LUNG BX EA ADDL LOBE,8528.0,4690.4,59.25,7376.72,53
CPT,31633,HC DX BRONCHOSCOPY W/NDL ASP BX EA ADDL LOBE- ADD ON,5831.0,3207.05,73.81,5043.82,53
CPT,31634,BRONCH W/BALLOON OCCLUSION,,,7034.61,17386.0,22
CPT,31635,HC BRONCHOSCOPY W/REMOVAL FOREIGN BODY,5459.0,3002.45,1637.7,6766.0,53
CPT,31636,BRONCHOSCOPY BRONCH STENTS,,,7034.61,17386.0,22
CPT,31637,BRONCHOSCOPY STENT ADD-ON,,,67.99,3533.0,21
CPT,31638,BRONCHOSCOPY REVISE STENT,,,7034.61,17386.0,22
CPT,31640,BRONCHOSCOPY W/TUMOR EXCISE,,,3746.68,14658.0,22
CPT,31641,"HC BRONCHOSCOPY, INCLD FLUOROSCOPIC GUID W/ DESTRUCT TUMOR/RELIEF STENOSIS",8402.0,4621.1,2520.6,14658.0,53
CPT,31643,DIAG BRONCHOSCOPE/CATHETER,,,1752.41,6766.0,22
CPT,31645,"HC BRONCHOSCOPY W/ THERAPEUTIC ASPIRATION OF TRACHEOBRONCHIAL TREE, INITIAL",4076.0,2241.8,1222.8,6766.0,106
CPT,31646,BRNCHSC W/THER ASPIR SBSQ,,,394.6,4258.0,22
CPT,31647,BRONCHIAL VALVE INIT INSERT,,,7034.61,17386.0,22
CPT,31648,BRONCHIAL VALVE REMOV INIT,,,3746.68,14658.0,22
CPT,31649,BRONCHIAL VALVE REMOV ADDL,,,1752.41,6766.0,22
CPT,31651,BRONCHIAL VALVE ADDL INSERT,,,67.88,3533.0,21
CPT,31652,HC DX BRONCHOSCOPY W EBUS 1-2 ASP/BX,7644.0,4204.2,2293.2,9469.0,53
CPT,31653,HC DX BRONCHOSCOPY W/EBUS 3 OR MORE ASP/BX,8698.0,4783.9,2609.4,9469.0,53
CPT,31654,HC DX BRONCHOSCOPY W/EBUS- ADD ON,5512.0,3031.6,109.83,4767.88,53
CPT,31660,BRONCH THERMOPLSTY 1 LOBE,,,7034.61,17386.0,22
CPT,31661,BRONCH THERMOPLSTY 2/> LOBES,,,7034.61,17386.0,22
CPT,31717,BRONCHIAL BRUSH BIOPSY,,,394.6,4258.0,22
CPT,31720,HC NASOTRACHEAL SUCTIONING,314.0,172.7,94.2,4258.0,159
CPT,31725,CLEARANCE OF AIRWAYS,,,71.47,5761.0,22
CPT,31730,INTRO WINDPIPE WIRE/TUBE,,,1752.41,6766.0,22
CPT,31750,TRACHEOPLASTY CERVICAL,,,6011.49,16799.0,22
CPT,31755,TRACHPLSTY TRCHPHRYNGL FSTLJ,,,6011.49,16799.0,22
CPT,31760,TRACHEOPLASTY INTRATHORACIC,,,1183.13,13936.0,22
CPT,31766,CARINAL RECONSTRUCTION,,,1515.08,13936.0,22
CPT,31770,REPAIR/GRAFT OF BRONCHUS,,,1135.03,13936.0,22
CPT,31775,RECONSTRUCT BRONCHUS,,,1196.24,13936.0,22
CPT,31780,RECONSTRUCT WINDPIPE,,,1086.98,13936.0,22
CPT,31781,RECONSTRUCT WINDPIPE,,,1299.15,13936.0,22
CPT,31785,REMOVE WINDPIPE LESION,,,5480.0,13936.0,22
CPT,31786,REMOVE WINDPIPE LESION,,,1232.87,13936.0,22
CPT,31800,REPAIR OF WINDPIPE INJURY,,,643.95,8363.0,22
CPT,31805,REPAIR OF WINDPIPE INJURY,,,709.11,8363.0,22
CPT,31820,HC SURG CLOSR TRACHEOSTOMY FISTULA WO PLASTIC REPR,8175.5,4496.525,2225.1,9469.0,265
CPT,31825,REPAIR OF WINDPIPE DEFECT,,,3295.61,9469.0,22
CPT,31830,REVISE WINDPIPE SCAR,,,3295.61,9469.0,22
CPT,31899,UNLISTED PX TRACHEA BRONCHI,,,197.29,29323.0,22
CPT,32035,THORACOSTOMY W/RIB RESECTION,,,641.26,16786.0,22
CPT,32036,THORACOSTOMY W/FLAP DRAINAGE,,,684.44,16786.0,22
CPT,32096,OPEN WEDGE/BX LUNG INFILTR,,,694.08,16786.0,22
CPT,32097,OPEN WEDGE/BX LUNG NODULE,,,693.38,16786.0,22
CPT,32098,OPEN BIOPSY OF LUNG PLEURA,,,653.94,16786.0,22
CPT,32100,"HC THORACOTOMY, WITH EXPLORATION",4416.0,2428.8,704.5,17386.0,53
CPT,32110,HC EXPLORE REPR CHEST,7067.0,3886.85,1279.95,17386.0,53
CPT,32120,RE-EXPLORATION OF CHEST,,,758.93,17386.0,22
CPT,32124,EXPLORE CHEST FREE ADHESIONS,,,801.03,17386.0,22
CPT,32140,REMOVAL OF LUNG LESION(S),,,855.4,17386.0,22
CPT,32141,REMOVE/TREAT LUNG LESIONS,,,1302.92,17386.0,22
CPT,32150,REMOVAL OF LUNG LESION(S),,,882.12,17386.0,22
CPT,32151,REMOVE LUNG FOREIGN BODY,,,867.47,17386.0,22
CPT,32160,HC OPEN CHEST HEART MASSAGE,2496.0,1372.8,699.79,17386.0,53
CPT,32200,DRAIN OPEN LUNG LESION,,,987.99,16786.0,22
CPT,32215,TREAT CHEST LINING,,,697.0,16786.0,22
CPT,32220,RELEASE OF LUNG,,,1381.79,16786.0,22
CPT,32225,PARTIAL RELEASE OF LUNG,,,860.86,16786.0,22
CPT,32310,REMOVAL OF CHEST LINING,,,794.63,16786.0,22
CPT,32320,FREE/REMOVE CHEST LINING,,,1383.0,16786.0,22
CPT,32400,"HC BIOPSY, PLEURA, PERCUTANEOUS NEEDLE",2761.0,1518.55,828.3,6766.0,159
CPT,32408,"HC CORE NEED BIOPSY, LUNG OR MEDIASTINUM, PERC, INCL IMG GUID",4032.0,2217.6,1209.6,6766.0,159
CPT,32440,REMOVE LUNG PNEUMONECTOMY,,,1347.24,19884.0,22
CPT,32442,SLEEVE PNEUMONECTOMY,,,2453.0,19884.0,22
CPT,32445,REMOVAL OF LUNG EXTRAPLEURAL,,,2453.0,19884.0,22
CPT,32480,PARTIAL REMOVAL OF LUNG,,,1269.33,19884.0,22
CPT,32482,BILOBECTOMY,,,1358.73,19884.0,22
CPT,32484,SEGMENTECTOMY,,,1228.34,19884.0,22
CPT,32486,SLEEVE LOBECTOMY,,,1985.75,19884.0,22
CPT,32488,COMPLETION PNEUMONECTOMY,,,2035.65,19884.0,22
CPT,32491,LUNG VOLUME REDUCTION,,,1266.34,19884.0,22
CPT,32501,REPAIR BRONCHUS ADD-ON,,,204.25,19884.0,22
CPT,32503,RESECT APICAL LUNG TUMOR,,,1532.92,19884.0,22
CPT,32504,RESECT APICAL LUNG TUM/CHEST,,,1742.5,19884.0,22
CPT,32505,WEDGE RESECT OF LUNG INITIAL,,,804.38,19884.0,22
CPT,32506,WEDGE RESECT OF LUNG ADD-ON,,,131.26,19884.0,22
CPT,32507,WEDGE RESECT OF LUNG DIAG,,,131.26,19884.0,22
CPT,32540,REMOVAL OF LUNG LESION,,,1477.61,19884.0,22
CPT,32550,HC INSERT INDWELLING TUNNELED PLEURAL CATH W CUFF,8303.5,4566.924999999999,2300.7,14658.0,371
CPT,32551,"HC TUBE THORACOSTOMY, INCL CONNECTION TO DRAINAGE SYSTEM, OPEN",2298.0,1263.9,570.9,5761.0,159
CPT,32552,HC REM INDWELLING TUNNELED PLEURAL CATH W CUFF,1626.0,894.3,487.8,4955.0,371
CPT,32553,INS MARK THOR FOR RT PERQ,,,1390.43,6766.0,22
CPT,32554,"HC THORACENTESIS, NEEDLE/CATH, ASPIR PLEURAL SPACE, WO IMG GUID",2091.5,1150.3249999999998,582.6,4955.0,477
CPT,32555,ASPIRATE PLEURA W/ IMAGING,,,1099.48,1099.48,1
CPT,32555,"HC THORACENTESIS, NEEDLE/CATH, ASPIR PLEURAL SPACE, W IMG GUID",2383.0,1310.65,628.28,4955.0,636
CPT,32556,"HC PLEURAL DRAINAGE, PERC, W INSERT INDWELL CATH, WO IMG GUID",3026.0,1664.3,906.0,6766.0,318
CPT,32557,"HC PLEURAL DRAINAGE, PERC, W INSERT INDWELL CATH, W IMG GUID",2675.0,1471.25,802.5,5761.0,530
CPT,32557,INSERT CATH PLEURA W/ IMAGE,,,2762.56,2762.56,1
CPT,32560,TREAT PLEURODESIS W/AGENT,,,628.28,4955.0,22
CPT,32561,"HC INSTILLATION(S) VIA CHEST TUBE/CATH, AGENT FOR FIBRINOLYSIS, INITIAL DAY",1761.0,968.55,528.3,4955.0,265
CPT,32562,"HC INSTILLATION(S) VIA CHEST TUBE/CATH, AGENT FOR FIBRINOLYSIS, SUBSEQ DAY",1831.5,1007.325,509.1,4955.0,159
CPT,32601,THORACOSCOPY DIAGNOSTIC,,,5928.88,16799.0,22
CPT,32604,THORACOSCOPY WBX SAC,,,9733.0,16799.0,22
CPT,32606,THORACOSCOPY W/BX MED SPACE,,,5928.88,16799.0,22
CPT,32607,THORACOSCOPY W/BX INFILTRATE,,,9733.0,16799.0,22
CPT,32608,THORACOSCOPY W/BX NODULE,,,9733.0,16799.0,22
CPT,32609,THORACOSCOPY W/BX PLEURA,,,5928.88,16799.0,22
CPT,32650,THORACOSCOPY W/PLEURODESIS,,,582.33,21512.0,22
CPT,32651,THORACOSCOPY REMOVE CORTEX,,,943.13,21512.0,22
CPT,32652,THORACOSCOPY REM TOTL CORTEX,,,1424.28,21512.0,22
CPT,32653,THORACOSCOPY REMOV FB/FIBRIN,,,916.88,17804.0,22
CPT,32654,THORACOSCOPY CONTRL BLEEDING,,,1032.07,16786.0,22
CPT,32655,THORACOSCOPY RESECT BULLAE,,,825.24,21512.0,22
CPT,32656,THORACOSCOPY W/PLEURECTOMY,,,696.69,21512.0,22
CPT,32658,THORACOSCOPY W/SAC FB REMOVE,,,619.59,16786.0,22
CPT,32659,THORACOSCOPY W/SAC DRAINAGE,,,637.25,16786.0,22
CPT,32661,THORACOSCOPY W/PERICARD EXC,,,689.78,16786.0,22
CPT,32662,THORACOSCOPY W/MEDIAST EXC,,,771.91,16786.0,22
CPT,32663,THORACOSCOPY W/LOBECTOMY,,,1195.78,16786.0,22
CPT,32664,THORACOSCOPY W/ TH NRV EXC,,,731.44,16786.0,22
CPT,32665,THORACOSCOP W/ESOPH MUSC EXC,,,1054.66,16786.0,22
CPT,32666,THORACOSCOPY W/WEDGE RESECT,,,752.08,19884.0,22
CPT,32667,THORACOSCOPY W/W RESECT ADDL,,,131.37,16786.0,22
CPT,32668,THORACOSCOPY W/W RESECT DIAG,,,131.68,16786.0,22
CPT,32669,THORACOSCOPY REMOVE SEGMENT,,,1148.73,16786.0,22
CPT,32670,THORACOSCOPY BILOBECTOMY,,,1367.23,16786.0,22
CPT,32671,THORACOSCOPY PNEUMONECTOMY,,,1508.84,16786.0,22
CPT,32672,THORACOSCOPY FOR LVRS,,,1294.34,16786.0,22
CPT,32673,THORACOSCOPY W/THYMUS RESECT,,,1041.57,16786.0,22
CPT,32674,THORACOSCOPY LYMPH NODE EXC,,,180.61,16786.0,22
CPT,32701,THORAX STEREO RAD TARGETW/TX,,,180.8,4258.0,16
CPT,32800,REPAIR LUNG HERNIA,,,823.19,16786.0,22
CPT,32810,CLOSE CHEST AFTER DRAINAGE,,,779.9,16786.0,22
CPT,32815,CLOSE BRONCHIAL FISTULA,,,2386.92,16786.0,22
CPT,32820,RECONSTRUCT INJURED CHEST,,,1211.67,16786.0,22
CPT,32850,DONOR PNEUMONECTOMY,,,2453.0,16786.0,7
CPT,32851,LUNG TRANSPLANT SINGLE,,,2453.0,24394.0,22
CPT,32852,LUNG TRANSPLANT WITH BYPASS,,,2453.0,24394.0,22
CPT,32853,LUNG TRANSPLANT DOUBLE,,,2453.0,24394.0,22
CPT,32854,LUNG TRANSPLANT WITH BYPASS,,,2453.0,24394.0,22
CPT,32855,PREPARE DONOR LUNG SINGLE,,,2453.0,16786.0,7
CPT,32856,PREPARE DONOR LUNG DOUBLE,,,2453.0,16786.0,7
CPT,32900,REMOVAL OF RIB(S),,,1272.86,8363.0,22
CPT,32905,REVISE & REPAIR CHEST WALL,,,1143.64,19884.0,22
CPT,32906,REVISE & REPAIR CHEST WALL,,,1406.09,19884.0,22
CPT,32940,REVISION OF LUNG,,,1058.81,19884.0,22
CPT,32960,THERAPEUTIC PNEUMOTHORAX,,,628.28,4955.0,22
CPT,32994,"HC ABLAT THER REDUCT/ERAD 1 OR MORE PULMONARY TUMOR, UNILAT, CRYOABLATION",15954.0,8774.7,4786.2,17804.0,106
CPT,32997,TOTAL LUNG LAVAGE,,,304.57,8363.0,22
CPT,32998,"HC ABLAT THER REDUCT/ERADICAT 1/MORE PULM TUM(S), PERC, UNILAT, RADFREQ",14717.0,8094.35,4415.1,17804.0,53
CPT,32999,"HC CT GUIDED LUNG MARKING, UNLISTED PX LUNGS & PLEURA",2497.0,1373.35,628.28,29323.0,53
CPT,33016,HC PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED,3491.0,1920.05,1047.3,5761.0,159
CPT,33016,PERICARDIOCENTESIS W/IMAGING,,,2762.56,2762.56,1
CPT,33017,HC PERQ PRCRD DRG INCLD FLUOR AND/OR US 6YR OR OLDER W/O CONGEN CAR ANOMALY,5353.0,2944.15,210.2,5761.0,106
CPT,33018,HC PERQ PRCRD DRG INCLUD FLUOR AND/OR US 0-5YR/ANY AGE W/CONGEN CAR ANOMALY,5353.0,2944.15,245.63,5761.0,53
CPT,33019,"HC IR PERICARDIAL DRAIN PLACE, PERC, INCLD CT GUID",5353.0,2944.15,186.22,5761.0,53
CPT,33020,INCISION OF HEART SAC,,,713.7,17386.0,22
CPT,33025,HC CREATION OF PERICARDIAL WINDOW OR PARTIAL RESECTION FOR DRAINAGE,6520.0,3586.0,664.59,17386.0,53
CPT,33030,PARTIAL REMOVAL OF HEART SAC,,,1706.55,17386.0,22
CPT,33031,PARTIAL REMOVAL OF HEART SAC,,,2104.26,17386.0,22
CPT,33050,RESECT HEART SAC LESION,,,868.24,17386.0,22
CPT,33120,EXC ICAR TUM RESC W/CARD BYP,,,1778.66,19884.0,22
CPT,33130,RESCJ EXTERNAL CARDIAC TUMOR,,,1172.25,17386.0,22
CPT,33140,HEART REVASCULARIZE (TMR),,,1327.94,17386.0,22
CPT,33141,HEART TMR W/OTHER PROCEDURE,,,110.88,17386.0,22
CPT,33202,INSERT EPICARD ELTRD OPEN,,,663.96,19884.0,22
CPT,33203,INSERT EPICARD ELTRD ENDO,,,695.28,19884.0,22
CPT,33206,HC INSERT REPL PERM PM W TRANSVEN ELCTRD ATRIAL,25823.0,14202.65,7746.9,22336.9,53
CPT,33207,HC INSERT REPL PERM PM W TRANSVEN ELCTRD VENTR,28462.0,15654.1,8538.6,24619.63,53
CPT,33208,HC INSERT REPL PERM PM W TRANSVEN ELCTRD ATR VENTR,24959.0,13727.45,7487.7,23692.0,53
CPT,33210,HC INSERT REPL TEMP TRNVEN SGL CHMBR ELCTR PM CATH,14565.0,8010.75,4369.5,19884.0,106
CPT,33211,INSERT CARD ELECTRODES DUAL,,,8410.05,19884.0,22
CPT,33212,INSERT PULSE GEN SNGL LEAD,,,8410.05,21512.0,22
CPT,33213,HC INSERT REPL PM PLSE GEN DUAL CHMBR ATRIAL VENTR,21630.0,11896.5,6489.0,21512.0,53
CPT,33214,HC UPGRADE OF IMPLANTED PACEMAKER SYSTEM,22531.0,12392.05,6759.3,23692.0,53
CPT,33215,HC REPOSITION PREV IMPL TRANSVEN PM OR IMPL DEFIB ELECTRODE,8593.0,4726.15,2577.9,14658.0,53
CPT,33216,HC INSERT 1 TRANSVEN ELECTRODE PERM PM OR IMPL DEFIB,13905.0,7647.75,4171.5,19884.0,53
CPT,33217,HC INSERT 2 TRANSVEN ELECTRODE PERM PM OR IMPL DEFIB,12585.0,6921.75,3775.5,19884.0,53
CPT,33218,REPAIR LEAD PACE-DEFIB ONE,,,3698.26,14658.0,22
CPT,33220,REPAIR LEAD PACE-DEFIB DUAL,,,3698.26,14658.0,22
CPT,33221,HC INSERT PERM PM PLSE GEN ONLY W EXIST MULT LEAD,24537.0,13495.35,7361.1,24394.0,53
CPT,33222,HC RELOCATION OF SKIN POCKET FOR PACEMAKER,6722.0,3697.1,1858.86,6766.0,53
CPT,33223,HC RELOCATION OF SKIN POCKET FOR IMPL DEFIB,6722.0,3697.1,1858.86,6766.0,53
CPT,33224,HC INSERT PAC ELCTRD LT VENTR W PREV PLACE PM IMPL DEFIB PLS GN,22009.0,12104.95,6602.7,23692.0,53
CPT,33225,HC INSERT PAC ELCTRD LT VENTR AT INSERT IMPL DEFIB OR PM PLS GN,33900.0,18645.0,393.07,29323.5,53
CPT,33226,REPOSITION L VENTRIC LEAD,,,3198.49,14658.0,22
CPT,33227,HC REM PERM PM PLSE GEN W REPL PLSE GEN SGL LEAD,29603.0,16281.65,8410.05,25606.6,53
CPT,33228,HC REM PERM PM PLSE GEN W REPL PLSE GEN DUAL LEAD,23029.0,12665.95,6908.7,21512.0,53
CPT,33229,HC REM PERM PM PLSE GEN W REPL PLSE GEN MULT LEAD,34655.0,19060.25,10396.5,29976.58,53
CPT,33230,INSRT PULSE GEN W/DUAL LEADS,,,19979.0,34485.0,22
CPT,33231,INSRT PULSE GEN W/MULT LEADS,,,19979.0,34485.0,22
CPT,33233,HC REM PERM PM PULSE GENERATOR,15081.0,8294.55,4524.3,19884.0,53
CPT,33234,HC REM TRANSVEN PM ELECTRD SGL LEAD ATRIAL VENTR,10245.0,5634.75,3073.5,14658.0,53
CPT,33235,HC REM TRANSVEN PM ELECTRD DUAL LEAD ATRIAL VENTR,7757.0,4266.35,2327.1,14658.0,53
CPT,33236,REMOVE ELECTRODE/THORACOTOMY,,,682.73,8363.0,22
CPT,33237,REMOVE ELECTRODE/THORACOTOMY,,,730.59,8363.0,22
CPT,33238,REMOVE ELECTRODE/THORACOTOMY,,,822.07,8363.0,22
CPT,33240,INSRT PULSE GEN W/SINGL LEAD,,,19979.0,34485.0,22
CPT,33241,HC REM IMPL DEFIB PULSE GENERATOR ONLY,11267.0,6196.85,3380.1,14658.0,53
CPT,33243,REMOVE ELTRD/THORACOTOMY,,,1180.73,16799.0,22
CPT,33244,HC REM SGL DUAL CHAMBER IMPL DEFIB ELECTRD BY TRANSVEN EXTRACT,7389.0,4063.95,2216.7,14658.0,53
CPT,33249,HC INSERT REPLC PERM IMPL DEFIB W TRANSVEN LEAD(S) DUAL CHAMBR,53315.0,29323.25,15994.5,46117.48,53
CPT,33249,HC INSERT REPLC PERM IMPL DEFIB W TRANSVEN LEAD(S) SGL CHAMBR,52385.0,28811.75,15715.5,45313.03,53
CPT,33250,ABLATE HEART DYSRHYTHM FOCUS,,,1247.35,17386.0,22
CPT,33251,ABLATE HEART DYSRHYTHM FOCUS,,,1389.22,17386.0,22
CPT,33254,ABLATE ATRIA LMTD,,,1165.77,17386.0,22
CPT,33255,ABLATE ATRIA W/O BYPASS EXT,,,1391.4,17386.0,22
CPT,33256,ABLATE ATRIA W/BYPASS EXTEN,,,1644.83,17386.0,22
CPT,33257,ABLATE ATRIA LMTD ADD-ON,,,504.62,17386.0,22
CPT,33258,ABLATE ATRIA X10SV ADD-ON,,,561.19,17386.0,22
CPT,33259,ABLATE ATRIA W/BYPASS ADD-ON,,,732.72,17386.0,22
CPT,33261,ABLATE HEART DYSRHYTHM FOCUS,,,1378.22,17386.0,22
CPT,33262,HC REM IMPL DEFIB PLSE GEN W REPL IMPL DEFIB PLSE GEN SGL LEAD,62747.0,34510.85,18824.1,54276.16,53
CPT,33263,HC REM IMPL DEFIB PLSE GEN W REPL IMPL DEFIB PLSE GEN DUAL LEAD,65825.0,36203.75,19747.5,56938.63,53
CPT,33264,HC REM IMPL DEFIB PLSE GEN W REPL IMPL DEFIB PLSE GEN MULT LEAD,61148.0,33631.4,18344.4,52893.02,53
CPT,33265,ABLATE ATRIA LMTD ENDO,,,1168.45,17386.0,22
CPT,33266,ABLATE ATRIA X10SV ENDO,,,1572.02,17386.0,22
CPT,33267,EXCL LAA OPEN ANY METHOD,,,895.53,24394.0,22
CPT,33268,EXCL LAA OPN OTH PX ANY METH,,,109.27,24394.0,22
CPT,33269,EXCL LAA THRSCP ANY METHOD,,,714.23,24394.0,22
CPT,33270,HC INSERT REPLC PERM SUBQ IMPLANT DEFIBRILLATOR SYS,86072.0,47339.6,19979.0,74452.28,53
CPT,33271,INSJ SUBQ IMPLTBL DFB ELCTRD,,,8410.05,21512.0,22
CPT,33272,HC REMOVAL OF SICD,11885.0,6536.75,3565.5,14658.0,53
CPT,33273,REPOS PREV IMPLTBL SUBQ DFB,,,3698.26,14658.0,22
CPT,33274,"HC TRANSCATH INSERT/REPLC PERM LEADLESS PMK, RT VENTRIC, IMG GUID-DEV EVAL",27913.0,15352.15,8373.9,28824.0,53
CPT,33275,"HC TRANSCATH REMOVAL PERM LEADLESS PMK, RT VENTRIC, INCL IMG GUID",9935.0,5464.25,2980.5,14658.0,53
CPT,33276,INSJ PHRNC NRV STIM SYS,,,19979.0,47101.39,22
CPT,33277,INSJ PHRNC NRV STIM TRANSVNS,,,253.17,3533.0,21
CPT,33278,RMVL PHRNC NRV STIM SYS,,,3494.72,14658.0,22
CPT,33279,RMVL PHRNC NRV STIM TRANSVNS,,,3494.72,14658.0,22
CPT,33280,RMVL PHRNC NRV STIM PG ONLY,,,3494.72,14658.0,22
CPT,33281,REPOSG PHRNC NRV STIM TRNSVN,,,3494.72,14658.0,22
CPT,33285,"HC INSERT, SUBCUT CARDIAC RHYTHM MONITOR, INCL PROGRAMMING",15180.0,8349.0,4554.0,21512.0,53
CPT,33286,"HC REMOVAL, SUBCUT CARDIAC RHYTHM MONITOR",4054.0,2229.7,714.99,4955.0,159
CPT,33287,RMV&RPLCMT PHRNC NRV STIM PG,,,16700.0,31896.28,22
CPT,33288,RMV&RPLCMT PHRNC NRV STIM LD,,,12463.0,21512.0,22
CPT,33289,HC TRANSCATH IMPL WIRELESS PULM ART PRESS SENSOR FOR L-T HEMODYNAM MONITOR,92989.0,51143.95,19979.0,80435.49,53
CPT,33300,REPAIR OF HEART WOUND,,,2079.55,19884.0,22
CPT,33305,"HC REPAIR OF CARDIAC WOUND, WITH CARDIOPULMONARY BYPASS",20306.0,11168.3,2453.0,19884.0,53
CPT,33310,EXPLORATORY HEART SURGERY,,,1006.75,19884.0,22
CPT,33315,EXPLORATORY HEART SURGERY,,,1627.71,19884.0,22
CPT,33320,REPAIR MAJOR BLOOD VESSEL(S),,,917.1,17386.0,22
CPT,33321,REPAIR MAJOR VESSEL,,,1021.16,17386.0,22
CPT,33322,REPAIR MAJOR BLOOD VESSEL(S),,,1187.99,17386.0,22
CPT,33330,INSERT MAJOR VESSEL GRAFT,,,1220.75,17386.0,22
CPT,33335,INSERT MAJOR VESSEL GRAFT,,,1593.83,17386.0,22
CPT,33340,HC PERC TRANSCATH CLOSURE LAA W/ ENDOCARDIAL IMPLANT,63897.0,35143.35,663.85,55270.91,53
CPT,33361,"HC TAVR/TAVI WITH PROSTHETIC VALVE, PERCUTANEOUS FEMORAL ARTERY APPROACH",23801.0,13090.55,1025.4,20587.87,53
CPT,33362,"HC TAVR/TAVI WITH PROSTHETIC VALVE, OPEN FEMORAL ARTERY APPROACH",49847.0,27415.85,1117.84,43117.66,53
CPT,33363,"HC TAVR/TAVI WITH PROSTHETIC VALVE, OPEN AXILLARY ARTERY APPROACH",49847.0,27415.85,1157.8,43117.66,53
CPT,33364,"HC TAVR/TAVI WITH PROSTHETIC VALVE, OPEN ILIAC ARTERY APPROACH",49847.0,27415.85,1155.0,43117.66,53
CPT,33365,REPLACE AORTIC VALVE OPEN,,,1206.4,19884.0,22
CPT,33366,"HC TAVR/TAVI W/ PROSTHETIC VALVE, TRANSAPICAL EXPOSURE(LEFT THORACOTOMY)",45317.0,24924.35,1331.1,39199.21,53
CPT,33367,REPLACE AORTIC VALVE W/BYP,,,514.42,19884.0,22
CPT,33368,REPLACE AORTIC VALVE W/BYP,,,622.97,19884.0,22
CPT,33369,REPLACE AORTIC VALVE W/BYP,,,822.13,19884.0,22
CPT,33370,"HC TRANSCATH PLC & SUBSEQ REM CEREBRAL EMBOLIC PROTECTION DEV(S), PERC (AD)",1943.0,1068.65,113.39,8446.0,53
CPT,33390,VALVULOPLASTY AORTIC VALVE,,,1642.66,19884.0,22
CPT,33391,VALVULOPLASTY AORTIC VALVE,,,1945.36,24394.0,22
CPT,33404,PREPARE HEART-AORTA CONDUIT,,,1495.14,17386.0,22
CPT,33405,REPLACEMENT AORTIC VALVE OPN,,,1932.84,19884.0,22
CPT,33406,REPLACEMENT AORTIC VALVE OPN,,,2444.22,19884.0,22
CPT,33410,REPLACEMENT AORTIC VALVE OPN,,,2164.15,19884.0,22
CPT,33411,REPLACEMENT OF AORTIC VALVE,,,2453.0,19884.0,22
CPT,33412,REPLACEMENT OF AORTIC VALVE,,,2453.0,19884.0,22
CPT,33413,REPLACEMENT OF AORTIC VALVE,,,2453.0,19884.0,22
CPT,33414,REPAIR OF AORTIC VALVE,,,1820.8,19884.0,22
CPT,33415,REVISION SUBVALVULAR TISSUE,,,1728.06,19884.0,22
CPT,33416,REVISE VENTRICLE MUSCLE,,,1725.4,19884.0,22
CPT,33417,REPAIR OF AORTIC VALVE,,,1427.29,19884.0,22
CPT,33418,"HC TRANSCATHETER MITRAL VALVE REPAIR, PERCUTANEOUS APPR, INIT PROSTHESIS",40614.0,22337.7,1535.11,35131.11,53
CPT,33419,"HC TRANSCATHETER MITRAL VALVE REPAIR, PERCUTANEOUS APPR, ADDL PROSTHESIS",24924.0,13708.2,358.74,21559.26,53
CPT,33420,REVISION OF MITRAL VALVE,,,1242.85,19884.0,22
CPT,33422,REVISION OF MITRAL VALVE,,,1424.51,24394.0,22
CPT,33425,REPAIR OF MITRAL VALVE,,,2317.85,19884.0,22
CPT,33426,REPAIR OF MITRAL VALVE,,,2029.25,19884.0,22
CPT,33427,REPAIR OF MITRAL VALVE,,,2078.99,19884.0,22
CPT,33430,REPLACEMENT OF MITRAL VALVE,,,2385.83,19884.0,22
CPT,33440,RPLCMT A-VALVE TLCJ AUTOL PV,,,2453.0,19884.0,22
CPT,33460,REVISION OF TRICUSPID VALVE,,,2035.94,19884.0,22
CPT,33463,VALVULOPLASTY TRICUSPID,,,2453.0,19884.0,22
CPT,33464,VALVULOPLASTY TRICUSPID,,,2079.18,19884.0,22
CPT,33465,REPLACE TRICUSPID VALVE,,,2341.51,19884.0,22
CPT,33468,REVISION OF TRICUSPID VALVE,,,2074.73,19884.0,22
CPT,33471,OP Surgery - Grouper Table,,,19884.0,19884.0,1
CPT,33474,REVISION OF PULMONARY VALVE,,,1853.45,19884.0,22
CPT,33475,REPLACEMENT PULMONARY VALVE,,,1979.67,19884.0,22
CPT,33476,REVISION OF HEART CHAMBER,,,1306.39,19884.0,22
CPT,33477,"HC TRANSCATHETER PULMONARY VALVE IMPLANTATION,PERCUTANEOUS APPROACH",50175.0,27596.25,1134.84,43401.38,53
CPT,33478,REVISION OF HEART CHAMBER,,,1348.69,19884.0,22
CPT,33496,REPAIR PROSTH VALVE CLOT,,,1424.26,17386.0,22
CPT,33500,REPAIR HEART VESSEL FISTULA,,,1335.39,19884.0,22
CPT,33501,REPAIR HEART VESSEL FISTULA,,,959.4,19884.0,22
CPT,33502,CORONARY ARTERY CORRECTION,,,1100.54,19884.0,22
CPT,33503,CORONARY ARTERY GRAFT,,,1145.38,19884.0,22
CPT,33504,CORONARY ARTERY GRAFT,,,1259.03,19884.0,22
CPT,33505,REPAIR ARTERY W/TUNNEL,,,1739.18,19884.0,22
CPT,33506,REPAIR ARTERY TRANSLOCATION,,,1737.34,19884.0,22
CPT,33507,REPAIR ART INTRAMURAL,,,1460.81,19884.0,22
CPT,33508,ENDOSCOPIC VEIN HARVEST,,,13.56,3533.0,21
CPT,33509,NDSC HRV UXTR ART 1 SGM CAB,,,146.01,8363.0,22
CPT,33510,CABG VEIN SINGLE,,,1648.45,19884.0,22
CPT,33511,CABG VEIN TWO,,,1810.24,19884.0,22
CPT,33512,CABG VEIN THREE,,,2058.86,19884.0,22
CPT,33513,CABG VEIN FOUR,,,2104.32,19884.0,22
CPT,33514,CABG VEIN FIVE,,,2218.43,19884.0,22
CPT,33516,CABG VEIN SIX OR MORE,,,2295.94,19884.0,22
CPT,33517,CABG ARTERY-VEIN SINGLE,,,157.45,19884.0,22
CPT,33518,CABG ARTERY-VEIN TWO,,,345.88,19884.0,22
CPT,33519,CABG ARTERY-VEIN THREE,,,456.88,19884.0,22
CPT,33521,CABG ARTERY-VEIN FOUR,,,548.22,19884.0,22
CPT,33522,CABG ARTERY-VEIN FIVE,,,615.63,19884.0,22
CPT,33523,CABG ART-VEIN SIX OR MORE,,,695.63,19884.0,22
CPT,33530,CORONARY ARTERY BYPASS/REOP,,,441.17,19884.0,22
CPT,33533,CABG ARTERIAL SINGLE,,,1596.7,19884.0,22
CPT,33534,CABG ARTERIAL TWO,,,1874.9,19884.0,22
CPT,33535,CABG ARTERIAL THREE,,,2083.29,19884.0,22
CPT,33536,CABG ARTERIAL FOUR OR MORE,,,2242.81,19884.0,22
CPT,33542,REMOVAL OF HEART LESION,,,2235.72,19884.0,22
CPT,33545,REPAIR OF HEART DAMAGE,,,2453.0,19884.0,22
CPT,33548,RESTORE/REMODEL VENTRICLE,,,2453.0,19884.0,22
CPT,33572,OPEN CORONARY ENDARTERECTOMY,,,193.45,19884.0,22
CPT,33600,CLOSURE OF VALVE,,,1470.02,19884.0,22
CPT,33602,CLOSURE OF VALVE,,,1427.93,19884.0,22
CPT,33606,ANASTOMOSIS/ARTERY-AORTA,,,1518.99,19884.0,22
CPT,33608,REPAIR ANOMALY W/CONDUIT,,,1538.81,19884.0,22
CPT,33610,REPAIR BY ENLARGEMENT,,,1517.77,19884.0,22
CPT,33611,REPAIR DOUBLE VENTRICLE,,,1654.7,19884.0,22
CPT,33612,REPAIR DOUBLE VENTRICLE,,,1698.39,19884.0,22
CPT,33615,REPAIR MODIFIED FONTAN,,,1700.99,19884.0,22
CPT,33617,REPAIR SINGLE VENTRICLE,,,1840.5,19884.0,22
CPT,33619,REPAIR SINGLE VENTRICLE,,,2340.05,19884.0,22
CPT,33620,APPLY R&L PULM ART BANDS,,,1399.71,17386.0,22
CPT,33621,TRANSTHOR CATH FOR STENT,,,796.59,8363.0,22
CPT,33622,REDO COMPL CARDIAC ANOMALY,,,2453.0,19884.0,22
CPT,33641,REPAIR HEART SEPTUM DEFECT,,,1393.83,19884.0,22
CPT,33645,REVISION OF HEART VEINS,,,1471.81,17386.0,22
CPT,33647,REPAIR HEART SEPTUM DEFECTS,,,1542.84,19884.0,22
CPT,33660,REPAIR OF HEART DEFECTS,,,1491.89,19884.0,22
CPT,33665,REPAIR OF HEART DEFECTS,,,1623.5,19884.0,22
CPT,33670,REPAIR OF HEART CHAMBERS,,,1665.35,19884.0,22
CPT,33675,CLOSE MULT VSD,,,1671.67,19884.0,22
CPT,33676,CLOSE MULT VSD W/RESECTION,,,1715.46,19884.0,22
CPT,33677,CL MULT VSD W/REM PUL BAND,,,1781.26,19884.0,22
CPT,33681,CLOSURE 1 VSD W/WO PATCH,,,1577.98,19884.0,22
CPT,33684,CLSR 1 VSD W/WO PATCH W/VLVT,,,1602.56,19884.0,22
CPT,33688,CLSR 1VSD W/WO PTCH RMVL BND,,,1592.29,19884.0,22
CPT,33690,BANDING PULMONARY ARTERY,,,1036.2,17386.0,22
CPT,33692,COMP RPR TOF WO PULM ATRESIA,,,1653.7,19884.0,22
CPT,33694,CMP RPR TOF WO PLM ATRS PTCH,,,1654.7,19884.0,22
CPT,33697,COMPL RPR TOF W/PULM ATRESIA,,,1742.19,19884.0,22
CPT,33702,REPAIR OF HEART DEFECTS,,,1323.8,19884.0,22
CPT,33710,REPAIR OF HEART DEFECTS,,,1739.29,19884.0,22
CPT,33720,REPAIR OF HEART DEFECT,,,1324.75,19884.0,22
CPT,33724,REPAIR VENOUS ANOMALY,,,1309.1,17386.0,22
CPT,33726,REPAIR PUL VENOUS STENOSIS,,,1722.83,17386.0,22
CPT,33730,REPAIR HEART-VEIN DEFECT(S),,,1707.55,17386.0,22
CPT,33732,REPAIR HEART-VEIN DEFECT,,,1411.05,17386.0,22
CPT,33735,REVISION OF HEART CHAMBER,,,1116.22,19884.0,22
CPT,33736,REVISION OF HEART CHAMBER,,,1209.04,24394.0,22
CPT,33737,OP Surgery - Grouper Table,,,24394.0,24394.0,1
CPT,33741,TAS CONGENITAL CAR ANOMAL,,,636.32,19884.0,22
CPT,33745,"HC TIS CREATION BY STENT PLC FOR CONGENIT CARD ANOMALIES, INIT SHUNT",48225.0,26523.75,909.35,41714.63,53
CPT,33746,TIS CGEN CAR ANOMAL EA ADDL,,,363.59,19884.0,22
CPT,33750,SHUNT SUBCLAVIAN TO PULM ART,,,1079.21,17386.0,22
CPT,33755,SHUNT AS-AORT TO PULM ART,,,1133.85,17386.0,22
CPT,33762,SHUNT DESC AORTA TO PULM ART,,,1096.08,17386.0,22
CPT,33764,SHUNT CENTRAL W/PROSTC GRAFT,,,1133.85,17386.0,22
CPT,33766,SHUNT SUPR V/C P-ART 1 LUNG,,,1137.86,17386.0,22
CPT,33767,SHUNT SUPR V/C P-ART BTH LNG,,,1213.18,17386.0,22
CPT,33768,ANAST CAVOPULM SEC SUP V/C,,,348.79,17386.0,22
CPT,33770,RPR TGA W/O SURG ENLGMNT VSD,,,1790.32,17386.0,22
CPT,33771,RPR TGA W/SURG ENLGMNT VSD,,,1836.81,17386.0,22
CPT,33774,RPR TGA ATRIAL BAFFLE PX,,,1539.72,17386.0,22
CPT,33775,RPR TGA ATR BFL RMVL PLM BND,,,1582.76,17386.0,22
CPT,33776,RPR TGA ATR BFL CLSR VSD,,,1674.63,17386.0,22
CPT,33777,RPR TGA BFL RPR SBPULM OBSTR,,,1608.05,17386.0,22
CPT,33778,RPR TGA AORTIC PULM ART RCNS,,,1995.56,17386.0,22
CPT,33779,RPR TGA RCNSTJ RMVL PLM BND,,,1962.22,17386.0,22
CPT,33780,RPR TGA RCNSTJ CLSR VSD,,,2001.19,17386.0,22
CPT,33781,RPR TGA RCNSTJ RPR SBPL OBST,,,1949.19,17386.0,22
CPT,33782,NIKAIDOH PROC,,,2453.0,17386.0,22
CPT,33783,NIKAIDOH PROC W/OSTIA IMPLT,,,2453.0,17386.0,22
CPT,33786,REPAIR ARTERIAL TRUNK,,,1927.39,17386.0,22
CPT,33788,REVISION OF PULMONARY ARTERY,,,1306.1,17386.0,22
CPT,33800,AORTIC SUSPENSION,,,844.56,17386.0,22
CPT,33802,DIVISION ABERRANT VESSEL,,,936.77,17386.0,22
CPT,33803,DIV ABERRANT VSL W/REANAST,,,983.71,17386.0,22
CPT,33813,OP Surgery - Grouper Table,,,19884.0,19884.0,1
CPT,33814,OBLTRJ A-PULM SEP DEF W/BYP,,,1307.32,19884.0,22
CPT,33820,REPAIR PDA BY LIGATION,,,831.61,23692.0,22
CPT,33822,REPAIR PDA DIV<18 YEARS,,,875.95,21512.0,22
CPT,33824,REPAIR PDA DIV 18 YRS&OLDER,,,1016.82,23692.0,22
CPT,33840,EXC COA W/DIRECT ANASTOMOSIS,,,1066.24,19884.0,22
CPT,33845,EXCISION COA W/GRAFT,,,1148.58,19884.0,22
CPT,33851,EXC COA RPR L SUBCL ART/PRST,,,1094.34,19884.0,22
CPT,33852,RPR HYPOPL A-ARCH WO BYP,,,1200.2,19884.0,22
CPT,33853,RPR HYPOPL A-ARCH W/BYP,,,1565.95,19884.0,22
CPT,33858,AS-AORT GRF F/AORTIC DSJ,,,2453.0,19884.0,22
CPT,33859,AS-AORT GRF F/DS OTH/THN DSJ,,,2067.17,19884.0,22
CPT,33863,ASCENDING AORTIC GRAFT,,,2453.0,19884.0,22
CPT,33864,ASCENDING AORTIC GRAFT,,,2453.0,19884.0,22
CPT,33866,AORTIC HEMIARCH GRAFT,,,774.02,3533.0,21
CPT,33871,TRANSVRS A-ARCH GRF HYPTHRM,,,2453.0,19884.0,22
CPT,33875,THORACIC AORTIC GRAFT,,,2322.6,19884.0,22
CPT,33877,THORACOABDOMINAL GRAFT,,,2453.0,19884.0,22
CPT,33880,HC ENDOVASC REPR DESCEND THORACIC AORTA W LT SUBCLAVIAN COVERAGE,4417.0,2429.35,1325.1,19884.0,53
CPT,33881,HC ENDOVASC REPR DESCEND THORACIC AORTA WO LT SUBCLAVIAN COVERAGE,3837.0,2110.35,1151.1,19884.0,106
CPT,33883,HC ENDOVASC REPR DESCEND THORACIC AORTA W PROX EXTENS PROSTH INIT EXT,3043.0,1673.65,912.9,19884.0,53
CPT,33884,HC ENDOVASC REPR DESCEND THORACIC AORTA W PROX EXTENS PROSTH EA ADDL,1510.0,830.5,327.73,19884.0,53
CPT,33886,HC ENDOVASC REPR DESCEND THORACIC AORTA W DISTAL EXTENSION PROSTH,3061.0,1683.55,807.15,19884.0,53
CPT,33889,APC,,,665.47,685.44,15
CPT,33889,OP Surgery - Grouper Table,,,2453.0,19884.0,7
CPT,33891,APC,,,799.28,823.26,15
CPT,33891,OP Surgery - Grouper Table,,,2453.0,19884.0,7
CPT,33894,"HC ENDOVASC STNT REPR THOR OR ABD AORTA, ACROSS MAJOR SIDE BRANCHES",3524.0,1938.2,830.64,19884.0,53
CPT,33895,HC ENDOVASC STNT REPR THOR OR ABD AORTA W/O CROSSING MAJOR SIDE BRANCHES,3498.0,1923.9,660.84,19884.0,53
CPT,33897,PERQ TRLUML ANGP NT/RECR COA,,,491.47,19884.0,22
CPT,33900,PERQ P-ART REVSC 1 NM NT UNI,,,11524.29,21512.0,22
CPT,33901,PERQ P-ART REVSC 1 NM NT BI,,,11524.29,21512.0,22
CPT,33902,PERQ P-ART REVSC 1 ABNOR UNI,,,12463.0,24394.0,22
CPT,33903,PERQ P-ART REVSC 1 ABNOR BI,,,11524.29,21512.0,22
CPT,33904,PERQ P-ART REVSC EACH ADDL,,,251.29,3533.0,21
CPT,33910,REMOVE LUNG ARTERY EMBOLI,,,2222.34,19884.0,22
CPT,33915,REMOVE LUNG ARTERY EMBOLI,,,1174.13,19884.0,22
CPT,33916,SURGERY OF GREAT VESSEL,,,2453.0,17386.0,22
CPT,33917,REPAIR PULMONARY ARTERY,,,1251.56,17386.0,22
CPT,33920,REPAIR PULMONARY ATRESIA,,,1538.34,17386.0,22
CPT,33922,TRANSECT PULMONARY ARTERY,,,1191.66,17386.0,22
CPT,33924,REMOVE PULMONARY SHUNT,,,239.51,17386.0,22
CPT,33925,RPR PUL ART UNIFOCAL W/O CPB,,,1456.33,17386.0,22
CPT,33926,REPR PUL ART UNIFOCAL W/CPB,,,2042.47,17386.0,22
CPT,33927,IMPLTJ TOT RPLCMT HRT SYS,,,2137.23,24394.0,22
CPT,33928,RMVL & RPLCMT TOT HRT SYS,,,2453.0,24394.0,7
CPT,33929,RMVL RPLCMT HRT SYS F/TRNSPL,,,2453.0,24394.0,7
CPT,33930,REMOVAL OF DONOR HEART/LUNG,,,2453.0,16786.0,7
CPT,33933,PREPARE DONOR HEART/LUNG,,,2453.0,16786.0,7
CPT,33935,TRANSPLANTATION HEART/LUNG,,,2453.0,24394.0,22
CPT,33940,REMOVAL OF DONOR HEART,,,2453.0,16786.0,7
CPT,33944,PREPARE DONOR HEART,,,2453.0,16786.0,7
CPT,33945,TRANSPLANTATION OF HEART,,,2453.0,24394.0,22
CPT,33946,ECMO/ECLS INITIATION VENOUS,,,264.33,5761.0,22
CPT,33947,ECMO/ECLS INITIATION ARTERY,,,292.2,5761.0,22
CPT,33948,ECMO/ECLS DAILY MGMT-VENOUS,,,207.7,5761.0,22
CPT,33949,ECMO/ECLS DAILY MGMT ARTERY,,,202.66,5761.0,22
CPT,33951,ECMO/ECLS INSJ PRPH CANNULA,,,356.61,5761.0,22
CPT,33952,"HC ECMO/ECLS, INSERTION OF PERIPHERAL CANNULA, PERC",17918.0,9854.9,362.14,15499.07,106
CPT,33953,ECMO/ECLS INSJ PRPH CANNULA,,,397.95,5761.0,22
CPT,33954,ECMO/ECLS INSJ PRPH CANNULA,,,402.3,5761.0,22
CPT,33955,ECMO/ECLS INSJ CTR CANNULA,,,695.92,5761.0,22
CPT,33956,ECMO/ECLS INSJ CTR CANNULA,,,703.29,5761.0,22
CPT,33957,ECMO/ECLS REPOS PERPH CNULA,,,155.64,5761.0,22
CPT,33958,ECMO/ECLS REPOS PERPH CNULA,,,155.64,5761.0,22
CPT,33959,ECMO/ECLS REPOS PERPH CNULA,,,197.41,5761.0,22
CPT,33962,ECMO/ECLS REPOS PERPH CNULA,,,197.41,5761.0,22
CPT,33963,ECMO/ECLS REPOS PERPH CNULA,,,393.04,5761.0,22
CPT,33964,ECMO/ECLS REPOS PERPH CNULA,,,414.62,5761.0,22
CPT,33965,ECMO/ECLS RMVL PERPH CANNULA,,,155.64,5761.0,22
CPT,33966,ECMO/ECLS RMVL PRPH CANNULA,,,200.95,5761.0,22
CPT,33967,HC INSERT IA PERCUT DEVICE,4808.0,2644.4,219.41,28824.0,53
CPT,33968,HC REMOVAL INTRA-AORTIC BALLOON ASSIST DEVICE PERCUTANEOUS,3787.0,2082.85,28.81,28824.0,53
CPT,33969,ECMO/ECLS RMVL PERPH CANNULA,,,229.15,5761.0,22
CPT,33970,AORTIC CIRCULATION ASSIST,,,298.18,8363.0,22
CPT,33971,AORTIC CIRCULATION ASSIST,,,609.12,8363.0,22
CPT,33973,INSERT BALLOON DEVICE,,,422.01,8363.0,22
CPT,33974,REMOVE INTRA-AORTIC BALLOON,,,770.95,8363.0,22
CPT,33975,IMPLANT VENTRICULAR DEVICE,,,1100.01,19884.0,22
CPT,33976,IMPLANT VENTRICULAR DEVICE,,,1330.46,19884.0,22
CPT,33977,REMOVE VENTRICULAR DEVICE,,,954.02,19884.0,22
CPT,33978,REMOVE VENTRICULAR DEVICE,,,1126.01,19884.0,22
CPT,33979,INSERT INTRACORPOREAL DEVICE,,,1634.85,19884.0,22
CPT,33980,REMOVE INTRACORPOREAL DEVICE,,,1506.1,19884.0,22
CPT,33981,REPLACE VAD PUMP EXT,,,697.02,19884.0,22
CPT,33982,REPLACE VAD INTRA W/O BP,,,1638.48,19884.0,22
CPT,33983,REPLACE VAD INTRA W/BP,,,1927.47,19884.0,22
CPT,33984,ECMO/ECLS RMVL PRPH CANNULA,,,239.13,5761.0,22
CPT,33985,ECMO/ECLS RMVL CTR CANNULA,,,431.6,5761.0,22
CPT,33986,ECMO/ECLS RMVL CTR CANNULA,,,443.15,5761.0,22
CPT,33987,ARTERY EXPOS/GRAFT ARTERY,,,174.78,13936.0,22
CPT,33988,INSERTION OF LEFT HEART VENT,,,652.97,19884.0,22
CPT,33989,REMOVAL OF LEFT HEART VENT,,,414.62,19884.0,22
CPT,33990,"HC IMPELLA, INSERT/CUT DOWN VAD, PERC, LEFT HEART ARTERIAL ACCESS ONLY",45558.0,25056.9,305.3,39407.67,53
CPT,33990,"HC INSERT VAD, PERC, LEFT HEART ARTERIAL ACCESS ONLY",23088.0,12698.4,305.3,19971.12,53
CPT,33991,INSJ PERQ VAD L HRT ARTL&VEN,,,382.48,19884.0,22
CPT,33992,"HC IMPELLA, REM PERC LT HRT VAD, ART/ART & VEN CANNULA(S), SEP FROM INSERT",5112.0,2811.6,159.1,19884.0,53
CPT,33993,HC REPOSITION PERC RT/LT HEART VAD W/ IMG GUID SEP FROM INSERT,3613.0,1987.15,142.0,19884.0,53
CPT,33995,"HC INSERT VAD, PERC, RIGHT HEART, VENOUS ACCESS ONLY",24803.0,13641.65,300.13,21454.6,53
CPT,33997,"HC REM PERC RIGHT HEART VAD, VENOUS CANNULA, SEPARATE FROM INSERT",5112.0,2811.6,136.62,8363.0,53
CPT,33999,"HC TAVR - SUBLAIVIAN APPROACH, UNLISTED PROC, CARDIAC SURGERY",49847.0,27415.85,628.28,43117.66,53
CPT,34001,REMOVAL OF ARTERY CLOT,,,768.79,13936.0,22
CPT,34051,REMOVAL OF ARTERY CLOT,,,857.22,13936.0,22
CPT,34101,REMOVAL OF ARTERY CLOT,,,5493.27,17804.0,22
CPT,34111,REMOVAL OF ARM ARTERY CLOT,,,5493.27,17804.0,22
CPT,34151,REMOVAL OF ARTERY CLOT,,,1169.2,13936.0,22
CPT,34201,REMOVAL OF ARTERY CLOT,,,5493.27,17804.0,22
CPT,34203,REMOVAL OF LEG ARTERY CLOT,,,5493.27,17804.0,22
CPT,34401,REMOVAL OF VEIN CLOT,,,1123.07,13936.0,22
CPT,34421,REMOVAL OF VEIN CLOT,,,3198.49,14658.0,22
CPT,34451,REMOVAL OF VEIN CLOT,,,1202.92,13936.0,22
CPT,34471,REMOVAL OF VEIN CLOT,,,628.28,4955.0,22
CPT,34490,REMOVAL OF VEIN CLOT,,,3198.49,14658.0,22
CPT,34501,REPAIR VALVE FEMORAL VEIN,,,5493.27,17804.0,22
CPT,34502,RECONSTRUCT VENA CAVA,,,1325.62,19884.0,22
CPT,34510,TRANSPOSITION OF VEIN VALVE,,,5493.27,17804.0,22
CPT,34520,CROSS-OVER VEIN GRAFT,,,5493.27,17804.0,22
CPT,34530,LEG VEIN FUSION,,,3198.49,14658.0,22
CPT,34701,"HC ENDVASC RPR INFRAREN AORTA AORT TUBE ENDGRFT, FOR OTH THAN RUPTURE",2747.0,1510.85,824.1,19884.0,53
CPT,34702,"HC ENDVASC RPR INFRAREN AORTA AORT TUBE ENDGRFT, FOR RUPTURE",2747.0,1510.85,824.1,19884.0,53
CPT,34703,"HC ENDVASC RPR INFRAREN AORTA AORT-UNI-IL ENDGRFT, FOR OTH THAN RUPTURE",2818.0,1549.9,845.4,19884.0,53
CPT,34704,"HC ENDVASC RPR INFRAREN AORTA AORT-UNI-IL ENDGRFT, FOR RUPTURE",2818.0,1549.9,845.4,19884.0,53
CPT,34705,"HC ENDVASC RPR INFRAREN AORTA AORT-BI-IL ENDGRFT, FOR OTH THAN RUPTURE",2867.0,1576.85,860.1,19884.0,106
CPT,34706,"HC ENDVASC RPR INFRAREN AORTA AORT-BI-IL ENDGRFT, FOR RUPTURE",2867.0,1576.85,860.1,19884.0,53
CPT,34707,"HC ENDVASC REPR ILIAC ART BY ILIO-ILIAC TUBE ENDGRFT, UNILAT, WO RUPTURE",2331.0,1282.05,699.3,17386.0,106
CPT,34708,"HC ENDVASC REPR ILIAC ART BY ILIO-ILIAC TUBE ENDGRFT, UNILAT, W RUPTURE",2331.0,1282.05,699.3,17386.0,106
CPT,34709,"HC PLC EXTENS PROSTH DIST CIA/PROX RA ENDVASC RPR ANEURYSM, PER VESSL (ADD)",2172.0,1194.6,268.44,17386.0,53
CPT,34710,"HC DELAY PLC DISTAL/PROX EXTENS PROSTH ENDVASC RPR ANEURYSM, INIT VESSEL",1964.0,1080.2,589.2,17386.0,53
CPT,34711,"HC DELAY PLC DISTAL/PROX EXTENS PROSTH ENDVASC RPR ANEURYSM, EA AD VES (AD)",1697.0,933.35,245.31,17386.0,53
CPT,34712,HC TRANSCATH DELIVERY OF ENHANCED FIXATION DEVICE(S) TO ENDGRAFT,13002.0,7151.1,553.85,11246.73,53
CPT,34713,HC PERC ACCESS-CLOSR FEM ART ENDGRFT THRU LG SHEATH (12 FR OR LARGER) (AD),4491.0,2470.05,102.77,3884.72,53
CPT,34714,OPN FEM ART EXPOS CNDT CRTJ,,,226.03,3533.0,21
CPT,34715,OPN AX/SUBCLA ART EXPOS,,,248.2,3533.0,21
CPT,34716,OPN AX/SUBCLA ART EXPOS CNDT,,,313.21,3533.0,21
CPT,34717,HC EVASCULAR REPAIR ILIAC ART TM OF A-ILIAC ART ENDOGRAFT UNI (ADD ON),27101.0,14905.55,368.11,23442.37,53
CPT,34718,HC EVASCULAR REPAIR ILIAC ART N/A A-ILIAC ART ENDOGRAFT UNILATERAL,27101.0,14905.55,1035.1,23442.37,53
CPT,34808,HC ENDVASC PLC ILIAC ART OCCLUSION DEVICE (ADD ON),1050.0,577.5,168.23,8363.0,53
CPT,34812,"HC OPEN FEM ART EXPOSURE DELIV OF ENDVASC PROSTH, BY GROIN INC, UNILAT (AD)",1522.0,837.1,171.13,5761.0,53
CPT,34813,HC PLC FEM GRAFT DURING ENDOVASC AAA REPR (ADD ON),1522.0,837.1,195.22,8363.0,53
CPT,34820,OPN ILIAC ART EXPOS,,,279.82,8363.0,22
CPT,34830,OPEN AORTIC TUBE PROSTH REPR,,,1473.85,19884.0,22
CPT,34831,OPEN AORTOILIAC PROSTH REPR,,,1619.21,19884.0,22
CPT,34832,OPEN AORTOFEMOR PROSTH REPR,,,1583.92,19884.0,22
CPT,34833,OPN ILAC ART EXPOS CNDT CRTJ,,,326.22,8363.0,22
CPT,34834,OPN BRACH ART EXPOS,,,107.43,5761.0,22
CPT,34839,PLNNING PT SPEC FENEST GRAFT,,,4258.0,4258.0,1
CPT,34841,HC ENDOVASC REPR VISCERAL AORTA W 1 VISC ART ENDOPROSTH,1522.0,837.1,456.6,17386.0,38
CPT,34842,HC ENDOVASC REPR VISCERAL AORTA W 2 VISC ART ENDOPROSTH,3044.0,1674.2,913.2,17386.0,38
CPT,34843,HC ENDOVASC REPR VISCERAL AORTA W 3 VISC ART ENDOPROSTH,4566.0,2511.3,1369.8,17386.0,38
CPT,34844,HC ENDOVASC REPR VISCERAL AORTA W/ 4 OR MORE VISC ART ENDOPROSTH,6087.0,3347.85,1826.1,17386.0,38
CPT,34845,HC ENDOVASC REPR VISCERAL INFRARENAL ABD AORTA 1 VISC ART ENDOPROSTH,2636.0,1449.8,790.8,17386.0,38
CPT,34846,HC ENDOVASC REPR VISCERAL INFRARENAL ABD AORTA 2 VISC ART ENDOPROSTH,5273.0,2900.15,1581.9,17386.0,38
CPT,34847,HC ENDOVASC REPR VISCERAL INFRARENAL ABD AORTA 3 VISC ART ENDOPROSTH,7911.0,4351.05,2373.3,17386.0,38
CPT,34848,HC ENDOVASC REPR VISCERAL INFRAREN ABD AORTA W/4 OR MORE VISC ART ENDOPROST,10547.0,5800.85,2453.0,17386.0,38
CPT,35001,REPAIR DEFECT OF ARTERY,,,935.13,17386.0,22
CPT,35002,REPAIR ARTERY RUPTURE NECK,,,956.04,17386.0,22
CPT,35005,REPAIR DEFECT OF ARTERY,,,838.58,17386.0,22
CPT,35011,REPAIR DEFECT OF ARTERY,,,5493.27,17804.0,22
CPT,35013,REPAIR ARTERY RUPTURE ARM,,,994.47,13936.0,22
CPT,35021,REPAIR DEFECT OF ARTERY,,,1081.58,13936.0,22
CPT,35022,REPAIR ARTERY RUPTURE CHEST,,,1234.46,13936.0,22
CPT,35045,REPAIR DEFECT OF ARM ARTERY,,,5493.27,17804.0,22
CPT,35081,REPAIR DEFECT OF ARTERY,,,1449.32,13936.0,22
CPT,35082,REPAIR ARTERY RUPTURE AORTA,,,1815.15,13936.0,22
CPT,35091,REPAIR DEFECT OF ARTERY,,,1488.56,13936.0,22
CPT,35092,REPAIR ARTERY RUPTURE AORTA,,,2172.96,13936.0,22
CPT,35102,REPAIR DEFECT OF ARTERY,,,1573.08,13936.0,22
CPT,35103,REPAIR ARTERY RUPTURE AORTA,,,1809.19,13936.0,22
CPT,35111,REPAIR DEFECT OF ARTERY,,,1113.64,13936.0,22
CPT,35112,REPAIR ARTERY RUPTURE SPLEEN,,,1367.54,13936.0,22
CPT,35121,REPAIR DEFECT OF ARTERY,,,1322.85,13936.0,22
CPT,35122,REPAIR ARTERY RUPTURE BELLY,,,1580.16,13936.0,22
CPT,35131,REPAIR DEFECT OF ARTERY,,,1165.28,13936.0,22
CPT,35132,REPAIR ARTERY RUPTURE GROIN,,,1367.54,13936.0,22
CPT,35141,REPAIR DEFECT OF ARTERY,,,917.02,13936.0,22
CPT,35142,REPAIR ARTERY RUPTURE THIGH,,,1108.04,13936.0,22
CPT,35151,REPAIR DEFECT OF ARTERY,,,1038.94,13936.0,22
CPT,35152,REPAIR RUPTD POPLITEAL ART,,,1171.41,13936.0,22
CPT,35180,RPR CGEN AV FISTULA HEAD&NCK,,,1578.61,4955.0,22
CPT,35182,RPR CGEN AV FISTULA THRX&ABD,,,1530.41,8363.0,22
CPT,35184,RPR CGEN AV FISTULA XTR,,,3198.49,14658.0,22
CPT,35188,RPR ACQ AV FISTULA HEAD&NECK,,,5493.27,17804.0,22
CPT,35189,RPR ACQ AV FISTULA THRX&ABD,,,1264.0,8363.0,22
CPT,35190,REPAIR ACQ AV FISTULA XTR,,,5493.27,17804.0,22
CPT,35201,REPAIR BLOOD VESSEL DIR NECK,,,5493.27,17804.0,22
CPT,35206,"HC REPAIR BLOOD VESSEL, DIRECT; UPPER EXTREMITY",28882.0,15885.1,3198.49,24982.93,106
CPT,35207,RPR BLD VSL DIR HAND FINGER,,,3198.49,14658.0,22
CPT,35211,RPR BLVSL DIR NTRATHRC W/BYP,,,1192.41,13936.0,22
CPT,35216,HC REPR BLOOD VESSEL DIRECT INTRATHORACIC WO BYPASS,26590.0,14624.5,1784.07,23000.35,53
CPT,35221,RPR BLD VSL DIR INTRA-ABDL,,,1252.88,13936.0,22
CPT,35226,HC REPAIR BLOOD VESSEL DIRECT LOWER EXTREMITY,2330.0,1281.5,699.0,4955.0,53
CPT,35231,REPAIR BLVSL VN GRF NECK,,,3198.49,14658.0,22
CPT,35236,REPAIR BLVSL VN GRF UXTR,,,5493.27,17804.0,22
CPT,35241,RPR BLVSL VN GRF NTRTHRC W/B,,,1229.22,13936.0,22
CPT,35246,RPR BLVSL VN GRF NTRTHRC W/O,,,1335.51,13936.0,22
CPT,35251,RPR BLVSL VN GRF INTRA-ABDL,,,1468.55,13936.0,22
CPT,35256,REPAIR BLVSL VN GRF LXTR,,,5493.27,17804.0,22
CPT,35261,RPR BLVSL GRF OTH/THN VN NCK,,,3198.49,14658.0,22
CPT,35266,RPR BLVSL GRF OTH/TH VN UXTR,,,5493.27,17804.0,22
CPT,35271,RPR BLVS GR OT/TH VN NTRTH W,,,1179.76,13936.0,22
CPT,35276,RPR BLVS GR OT/T VN NTRTH WO,,,1249.82,13936.0,22
CPT,35281,RPR BLVSL GR OT/TH VN NTR-AB,,,1381.28,13936.0,22
CPT,35286,RPR BLVSL GRF OTH/TH VN LXTR,,,5493.27,17804.0,22
CPT,35301,RECHANNELING OF ARTERY,,,947.36,13936.0,22
CPT,35302,RECHANNELING OF ARTERY,,,936.35,13936.0,22
CPT,35303,RECHANNELING OF ARTERY,,,1028.33,13936.0,22
CPT,35304,RECHANNELING OF ARTERY,,,1067.7,13936.0,22
CPT,35305,RECHANNELING OF ARTERY,,,1024.63,13936.0,22
CPT,35306,RECHANNELING OF ARTERY,,,369.43,13936.0,22
CPT,35311,RECHANNELING OF ARTERY,,,1322.64,13936.0,22
CPT,35321,RECHANNELING OF ARTERY,,,5493.27,17804.0,22
CPT,35331,RECHANNELING OF ARTERY,,,1215.74,13936.0,22
CPT,35341,RECHANNELING OF ARTERY,,,1154.41,13936.0,22
CPT,35351,RECHANNELING OF ARTERY,,,1080.1,13936.0,22
CPT,35355,RECHANNELING OF ARTERY,,,861.92,13936.0,22
CPT,35361,RECHANNELING OF ARTERY,,,1274.51,13936.0,22
CPT,35363,RECHANNELING OF ARTERY,,,1358.86,13936.0,22
CPT,35371,"HC THROMBOENDARTERECTOMY, INCL PATCH GRAFT, COMMON FEMORAL",33818.0,18599.9,684.69,29252.57,106
CPT,35372,RECHANNELING OF ARTERY,,,819.14,17804.0,22
CPT,35390,REOPERATION CAROTID ADD-ON,,,132.69,13936.0,22
CPT,35400,ANGIOSCOPY,,,119.71,5761.0,22
CPT,35500,HARVEST VEIN FOR BYPASS,,,264.74,3533.0,21
CPT,35501,ART BYP GRFT IPSILAT CAROTID,,,1220.07,13936.0,22
CPT,35506,ART BYP GRFT SUBCLAV-CAROTID,,,1066.83,13936.0,22
CPT,35508,ART BYP GRFT CAROTID-VERTBRL,,,1115.63,13936.0,22
CPT,35509,ART BYP GRFT CONTRAL CAROTID,,,1181.13,13936.0,22
CPT,35510,ART BYP GRFT CAROTID-BRCHIAL,,,1029.62,13936.0,22
CPT,35511,ART BYP GRFT SUBCLAV-SUBCLAV,,,938.56,13936.0,22
CPT,35512,ART BYP GRFT SUBCLAV-BRCHIAL,,,1009.79,13936.0,22
CPT,35515,ART BYP GRFT SUBCLAV-VERTBRL,,,1115.63,13936.0,22
CPT,35516,ART BYP GRFT SUBCLAV-AXILARY,,,1021.93,13936.0,22
CPT,35518,ART BYP GRFT AXILLARY-AXILRY,,,957.09,13936.0,22
CPT,35521,ART BYP GRFT AXILL-FEMORAL,,,1030.47,13936.0,22
CPT,35522,ART BYP GRFT AXILL-BRACHIAL,,,980.11,13936.0,22
CPT,35523,ART BYP GRFT BRCHL-ULNR-RDL,,,1032.02,13936.0,22
CPT,35525,ART BYP GRFT BRACHIAL-BRCHL,,,922.12,13936.0,22
CPT,35526,ART BYP GRFT AOR/CAROT/INNOM,,,1474.35,13936.0,22
CPT,35531,ART BYP GRFT AORCEL/AORMESEN,,,1628.93,13936.0,22
CPT,35533,ART BYP GRFT AXILL/FEM/FEM,,,1261.64,13936.0,22
CPT,35535,ART BYP GRFT HEPATORENAL,,,1590.22,13936.0,22
CPT,35536,ART BYP GRFT SPLENORENAL,,,1413.94,13936.0,22
CPT,35537,ART BYP GRFT AORTOILIAC,,,1740.56,13936.0,22
CPT,35538,ART BYP GRFT AORTOBI-ILIAC,,,1949.64,13936.0,22
CPT,35539,ART BYP GRFT AORTOFEMORAL,,,1829.73,13936.0,22
CPT,35540,ART BYP GRFT AORTBIFEMORAL,,,2038.08,13936.0,22
CPT,35556,ART BYP GRFT FEM-POPLITEAL,,,1168.09,13936.0,22
CPT,35558,ART BYP GRFT FEM-FEMORAL,,,1027.63,13936.0,22
CPT,35560,ART BYP GRFT AORTORENAL,,,1426.05,13936.0,22
CPT,35563,ART BYP GRFT ILIOILIAC,,,1110.1,13936.0,22
CPT,35565,ART BYP GRFT ILIOFEMORAL,,,1098.71,13936.0,22
CPT,35566,ART BYP FEM-ANT-POST TIB/PRL,,,1388.97,13936.0,22
CPT,35570,ART BYP TIBIAL-TIB/PERONEAL,,,1234.5,13936.0,22
CPT,35571,ART BYP POP-TIBL-PRL-OTHER,,,1108.79,13936.0,22
CPT,35572,HARVEST FEMOROPOPLITEAL VEIN,,,286.55,3533.0,21
CPT,35583,VEIN BYP GRFT FEM-POPLITEAL,,,1207.75,13936.0,22
CPT,35585,VEIN BYP FEM-TIBIAL PERONEAL,,,1396.83,13936.0,22
CPT,35587,VEIN BYP POP-TIBL PERONEAL,,,1117.25,13936.0,22
CPT,35600,OPEN HRV UXTR ART 1 SGM CAB,,,156.49,8363.0,22
CPT,35601,BPG COM CRTD-IPSI INT CRTD,,,1180.36,13936.0,22
CPT,35606,BPG CAROTID-SUBCLAVIAN,,,985.98,13936.0,22
CPT,35612,BPG SUBCLAVIAN-SUBCLAVIAN,,,878.85,13936.0,22
CPT,35616,BPG SUBCLAVIAN-AXILLARY,,,923.55,13936.0,22
CPT,35621,BPG AXILLARY-FEMORAL,,,918.04,13936.0,22
CPT,35623,BPG AXILLARY-POP/-TIBIAL,,,1102.27,13936.0,22
CPT,35626,BPG AOR-SUBCLA/INNOM/CAROTID,,,1352.67,13936.0,22
CPT,35631,BPG AOR-CELIAC-MSN-RENAL,,,1546.42,13936.0,22
CPT,35632,BPG ILIO-CELIAC,,,1510.27,13936.0,22
CPT,35633,BPG ILIO-MESENTERIC,,,1653.46,13936.0,22
CPT,35634,BPG ILIORENAL,,,1478.23,13936.0,22
CPT,35636,BPG SPLENORENAL,,,1334.85,13936.0,22
CPT,35637,BPG AORTOILIAC,,,1387.75,13936.0,22
CPT,35638,BPG AORTOBI-ILIAC,,,1463.89,13936.0,22
CPT,35642,BPG CAROTID-VERTEBRAL,,,834.03,13936.0,22
CPT,35645,BPG SUBCLAVIAN-VERTEBRAL,,,796.64,13936.0,22
CPT,35646,BPG AORTOBIFEMORAL,,,1426.21,13936.0,22
CPT,35647,BPG AORTOFEMORAL,,,1287.04,13936.0,22
CPT,35650,BPG AXILLARY-AXILLARY,,,856.89,13936.0,22
CPT,35654,BPG AXILLARY-FEMORAL-FEMORAL,,,1145.72,13936.0,22
CPT,35656,BPG FEMORAL-POPLITEAL,,,898.63,13936.0,22
CPT,35661,BPG FEMORAL-FEMORAL,,,910.21,13936.0,22
CPT,35663,BPG ILIOILIAC,,,1022.65,13936.0,22
CPT,35665,BPG ILIOFEMORAL,,,984.27,13936.0,22
CPT,35666,BPG FEM-ANT TIB PST TIB/PRNL,,,1080.85,13936.0,22
CPT,35671,BPG POP-TIBL/-PRNL ARTERY,,,948.6,13936.0,22
CPT,35681,COMPOSITE BYP GRFT PROS&VEIN,,,66.15,8363.0,22
CPT,35682,COMPOSITE BYP GRFT 2 VEINS,,,291.67,8363.0,22
CPT,35683,COMPOSITE BYP GRFT 3/> SEGMT,,,339.62,8363.0,22
CPT,35685,BYPASS GRAFT PATENCY/PATCH,,,164.6,3533.0,21
CPT,35686,BYPASS GRAFT/AV FIST PATENCY,,,133.53,3533.0,21
CPT,35691,ART TRNSPOSJ VERTBRL CAROTID,,,795.58,13936.0,22
CPT,35693,ART TRNSPOSJ SUBCLAVIAN,,,708.32,13936.0,22
CPT,35694,ART TRNSPOSJ SUBCLAV CAROTID,,,830.82,13936.0,22
CPT,35695,ART TRNSPOSJ CAROTID SUBCLAV,,,861.8,13936.0,22
CPT,35697,REIMPLANT ARTERY EACH,,,121.88,13936.0,22
CPT,35700,REOPERATION BYPASS GRAFT,,,126.03,13936.0,22
CPT,35701,EXPL N/FLWD SURG NECK ART,,,389.13,8363.0,22
CPT,35702,HC EXPLORATION NOT FLWD SURGICAL UPPER EXTREMITY ARTERY,7685.0,4226.75,353.13,6647.53,106
CPT,35703,HC EXPLORATION NOT FLWD SURGICAL LOWER EXTREMITY ARTERY,7685.0,4226.75,357.0,6647.53,106
CPT,35800,EXPLORE NECK VESSELS,,,650.86,17804.0,22
CPT,35820,EXPLORE CHEST VESSELS,,,1717.1,8363.0,22
CPT,35840,EXPLORE ABDOMINAL VESSELS,,,1057.29,8363.0,22
CPT,35860,EXPLORE LIMB VESSELS,,,3198.49,14658.0,22
CPT,35870,REPAIR VESSEL GRAFT DEFECT,,,1046.92,13936.0,22
CPT,35875,REMOVAL OF CLOT IN GRAFT,,,5493.27,17804.0,22
CPT,35876,REMOVAL OF CLOT IN GRAFT,,,5493.27,17804.0,22
CPT,35879,REVISE GRAFT W/VEIN,,,5493.27,17804.0,22
CPT,35881,REVISE GRAFT W/VEIN,,,5493.27,17804.0,22
CPT,35883,REVJ FEM ANAST NONAUTOG GRF,,,5493.27,17804.0,22
CPT,35884,REVJ FEM ANAST AUTOG VN GRF,,,5493.27,17804.0,22
CPT,35901,EXCISION GRAFT NECK,,,407.14,8363.0,22
CPT,35903,EXCISION GRAFT EXTREMITY,,,3198.49,14658.0,22
CPT,35905,EXCISION GRAFT THORAX,,,1405.37,13936.0,22
CPT,35907,EXCISION GRAFT ABDOMEN,,,1600.72,13936.0,22
CPT,36000,HC INSERT PERIPHERAL IV,182.0,100.1,28.63,3533.0,318
CPT,36000,HC INSERT POWER GLIDE IV,149.0,81.95,28.63,3533.0,53
CPT,36000,HC INTRO NEEDLE OR INTRACATHETER VEIN,160.0,88.0,28.63,3533.0,159
CPT,36002,HC INJ PROC PERC TX OF EXTREM PSEUDOANEURYSM,1626.0,894.3,487.8,4955.0,53
CPT,36005,"HC IN, INJ PROC EXTREM VENOGRAPHY",1033.0,568.15,221.58,3533.0,53
CPT,36005,HC INJ PROC EXTREM VENOGRAPHY,1033.0,568.15,221.58,3533.0,106
CPT,36010,"HC INTRO CATH, SUPERIOR/INFERIOR VENA CAVA",1752.0,963.6,465.66,3533.0,106
CPT,36011,"HC IN, SEL CATH PLC, VEN SYS, 1ST ORDER BRANCH",1384.0,761.2,415.2,3533.0,53
CPT,36011,"HC SEL CATH PLC, VEN SYS, 1ST ORDER BRANCH",1384.0,761.2,415.2,3533.0,53
CPT,36012,"HC IN, SEL CATH PLC, VEN SYS, 2ND ORDER/MORE SELECTIVE, BRANCH",1690.0,929.5,507.0,3533.0,53
CPT,36012,"HC SEL CATH PLC, VEN SYS, 2ND ORDER/MORE SELECTIVE, BRANCH",1690.0,929.5,507.0,3533.0,53
CPT,36013,HC INTRO CATH RT HEART OR MAIN PULMONARY ART,1071.0,589.05,321.3,3533.0,53
CPT,36014,"HC SEL CATH PLC, LT/RT PULM ART",2285.0,1256.75,685.5,3533.0,53
CPT,36015,"HC SEL CATH PLC, SEGMENTAL/SUBSEGMENTAL PULM ART",2285.0,1256.75,685.5,3533.0,106
CPT,36100,"HC INTRO NEEDLE/INTRCATH, CAROTID/VERT ART",536.0,294.8,160.8,3533.0,53
CPT,36140,HC IN SG EXT ARTERY CATH NEEDLE,3044.0,1674.2,443.71,3533.0,53
CPT,36140,"HC INTRO NEEDLE OR INTRACATHETER, UP/LOW EXTREMITY ARTERY",3044.0,1674.2,443.71,3533.0,106
CPT,36160,"HC INTRO NEEDLE OR INTRACATHETER, AORTIC, TRANSLUMBAR",680.0,374.0,204.0,3533.0,53
CPT,36200,"HC INTRO CATH, AORTA",2463.0,1354.65,512.7,3533.0,106
CPT,36215,HC IN SG 1ST ORDER CHEST,2032.0,1117.6,609.6,3533.0,53
CPT,36215,HC SELECTIVE CATH PLC THORACIC BRACHIOCEPHALIC BRANCH EA 1ST ORDER,2032.0,1117.6,609.6,3533.0,106
CPT,36216,HC IN SG 2ND ORDER CHEST,1829.0,1005.95,548.7,3533.0,53
CPT,36216,HC SELECTIVE CATH PLC THORACIC BRACHIOCEPHALIC BRANCH INIT 2ND ORDER,1829.0,1005.95,548.7,3533.0,53
CPT,36217,HC IN SG 3RD ORDER CHEST,3189.0,1753.95,835.0,3533.0,53
CPT,36217,HC SELECTIVE CATH PLC THORAC BRACHIOCEPHALIC BRANCH INIT 3RD ORDER OR MORE,3189.0,1753.95,835.0,3533.0,53
CPT,36218,HC IN SG ADDL 2ND OR 3RD ORDER CHEST,396.0,217.8,118.8,3533.0,53
CPT,36218,HC SELECTIVE CATH PLC THORAC BRACHIOCEPHALIC BRANCH ADDL 2ND ORDER OR MORE,396.0,217.8,118.8,3533.0,53
CPT,36221,HC IN AROTIC ARCH-IMAGE- AORTA-CATH PLACE,9385.0,5161.75,2815.5,14658.0,53
CPT,36221,"HC NONSELECT CATH PLACE, THORACIC AORTA, W/ ANGIO EXT/INTCRANIAL VESSELS",9385.0,5161.75,2815.5,14658.0,53
CPT,36221,PLACE CATH THORACIC AORTA,,,5597.36,5597.36,1
CPT,36222,"HC IN, SEL CATH PLC, CCA/INNOM ART, ANGIOGR IPSILAT EXTCRAN CAROTID CIRC",12025.0,6613.75,3198.49,14658.0,53
CPT,36222,"HC SEL CATH PLC, CCA/INNOM ART, ANGIOGR IPSILAT EXTCRAN CAROTID CIRC",12025.0,6613.75,3198.49,14658.0,53
CPT,36222,PLACE CATH CAROTID/INOM ART,,,5597.36,5597.36,1
CPT,36223,"HC IN, SEL CATH PLC, CCA/INNOM ART, ANGIOGR IPSILAT INTCRAN CAROTID CIRC",12025.0,6613.75,3607.5,17804.0,53
CPT,36223,"HC SEL CATH PLC, CCA/INNOM ART, ANGIOGR IPSILAT INTCRAN CAROTID CIRC",12025.0,6613.75,3607.5,17804.0,53
CPT,36223,PLACE CATH CAROTID/INOM ART,,,9613.23,9613.23,1
CPT,36224,"HC IN, SEL CATH PLC, ICA, ANGIOGR IPSILAT INTRCRAN CAROTID CIRC",19437.0,10690.35,5493.27,17804.0,53
CPT,36224,"HC SEL CATH PLC, ICA, ANGIOGR IPSILAT INTRCRAN CAROTID CIRC",18934.0,10413.7,5493.27,17804.0,53
CPT,36224,PLACE CATH CAROTD ART,,,9613.23,9613.23,1
CPT,36225,"HC IN, SEL CATH PLC, SUBCLAV/INNOM ART, ANGIOGR IPSILAT VERT CIRC",12025.0,6613.75,3198.49,14658.0,53
CPT,36225,"HC SEL CATH PLC, SUBCLAV/INNOM ART, ANGIOGR IPSILAT VERT CIRC",12025.0,6613.75,3198.49,14658.0,53
CPT,36225,PLACE CATH SUBCLAVIAN ART,,,5597.36,5597.36,1
CPT,36226,"HC IN, SEL CATH PLC, VERT ART, ANGIOGR IPSILAT VERT CIRC",18343.0,10088.65,5493.27,17804.0,53
CPT,36226,"HC SEL CATH PLC, VERT ART, ANGIOGR IPSILAT VERT CIRC",17869.0,9827.95,5360.7,17804.0,53
CPT,36226,PLACE CATH VERTEBRAL ART,,,9613.23,9613.23,1
CPT,36227,"HC IN, SEL CATH PLC, ECA, ANGIOGR IPSILAT EXTRNL CAROTID CIRC (AD)",7430.0,4086.5,215.51,6426.95,53
CPT,36227,"HC SEL CATH PLC, ECA, ANGIOGR IPSILAT EXTRNL CAROTID CIRC (AD)",7430.0,4086.5,215.51,6426.95,53
CPT,36227,PLACE CATH XTRNL CAROTID,,,377.14,377.14,1
CPT,36228,"HC IN, SEL CATH PLC, EA INTRCRAN BR ICA/VERT ART, W ANGIO SEL VES CIRC (AD)",3049.0,1676.95,835.0,3533.0,53
CPT,36228,PLACE CATH INTRACRANIAL ART,,,2054.85,2054.85,1
CPT,36245,"HC IN, SEL CATH PLC, ART SYS, EA 1ST ORDER ABD/PELV/LOW EXTREM ART BRANCH",3990.0,2194.5,835.0,3533.0,53
CPT,36245,"HC SEL CATH PLC, ART SYS, EA 1ST ORDER ABD/PELV/LOW EXTREM ART BRANCH",3990.0,2194.5,835.0,3533.0,53
CPT,36246,"HC IN, SEL CATH PLC, ART SYS, INIT 2ND ORDER ABD/PELV/LOW EXTREM ART BRANCH",3442.0,1893.1,722.76,3533.0,53
CPT,36246,"HC SEL CATH PLC, ART SYS, INIT 2ND ORDER ABD/PELV/LOW EXTREM ART BRANCH",3442.0,1893.1,722.76,3533.0,53
CPT,36247,"HC SEL CATH PLC, ART SYS, INIT 3RD ORD/MORE ABD/PELV/LOW EXTREM ART BRANCH",3100.0,1705.0,835.0,3533.0,53
CPT,36248,"HC SELECT CATH PLC, ART, ADL 2ND-3RD ORD&BEYOND, ABD, PELV/LOW EXTR ART(AD)",3600.0,1980.0,103.71,3533.0,53
CPT,36251,HC SELECTIVE CATH PLC RENAL ART FOR RENAL ANGIO 1ST ORDER,10239.0,5631.45,3071.7,14658.0,53
CPT,36251,INS CATH REN ART 1ST UNILAT,,,5597.36,5597.36,1
CPT,36252,"HC BILAT, SELECTIVE CATH PLC, RENAL ART FOR RENAL ANGIO, 1ST ORDER",13001.0,7150.55,3198.49,14658.0,106
CPT,36252,INS CATH REN ART 1ST BILAT,,,5597.36,5597.36,1
CPT,36253,HC SUPERSELECTIVE CATH PLC RENAL ART FOR RENAL ANGIO 2ND+ ORDER,10495.0,5772.25,3148.5,17804.0,53
CPT,36253,INS CATH REN ART 2ND+ UNILAT,,,9613.23,9613.23,1
CPT,36254,HC SUPERSELECTIVE CATH PLC RENAL ART FOR RENAL ANGIO 2ND+ ORDER BILAT,12077.0,6642.35,3198.49,14658.0,53
CPT,36254,INS CATH REN ART 2ND+ BILAT,,,5597.36,5597.36,1
CPT,36260,INSERTION OF INFUSION PUMP,,,5493.27,17804.0,22
CPT,36261,REVISION OF INFUSION PUMP,,,3698.26,14658.0,22
CPT,36262,REMOVAL OF INFUSION PUMP,,,3698.26,14658.0,22
CPT,36299,"HC UNLIST PROC, VASC INJ EXT JUGULAR, INT JUGULAR, OR COLLATERAL VEIN",914.0,502.7,274.2,3533.0,38
CPT,36400,VNPNXR<3YRS PHY/QHP FEM/JUG,,,25.3,26.06,15
CPT,36405,VNPNXR<3YRS PHY/QHP SCALP VN,,,22.0,22.66,15
CPT,36406,VNPNXR<3YRS PHY/QHP OTHER VN,,,16.45,16.95,15
CPT,36410,"HC VENIPUNCTURE, REQ PHYSICIAN/OTH QHC PROF SKILL, DX/THER (NON ROUTINE VP)",280.0,154.0,16.56,242.2,159
CPT,36415,HC COLLECTION VENOUS BLOOD BY VENIPUNCTURE,42.0,23.1,8.33,36.33,2279
CPT,36415,HC DX COLLECTION VENOUS BLOOD BY VENIPUNCTURE,42.0,23.1,8.33,36.33,53
CPT,36415,HC MR COLLECTION VENOUS BLOOD BY VENIPUNCTURE,42.0,23.1,8.33,36.33,53
CPT,36415,HC US COLLECTION VENOUS BLOOD BY VENIPUNCTURE,42.0,23.1,8.33,36.33,53
CPT,36416,HC CAPILLARY BLOOD DRAW,26.0,14.3,7.8,22.49,38
CPT,36420,VENIPUNCTURE CUTDOWN < 1 YR,,,130.99,4258.0,22
CPT,36425,VENIPUNCTURE CUTDOWN 1 YR/>,,,405.5,4258.0,22
CPT,36430,"HC TRANSFUSION, BLOOD OR BLOOD COMPONENTS",1445.0,794.75,337.0,4258.0,3180
CPT,36440,BLD PUSH TFUJ 2 YR/<,,,444.26,4258.0,22
CPT,36450,BLD EXCHANGE TRUJ NEWBORN,,,444.26,4258.0,22
CPT,36455,BLD EXCHANGE TRUJ OTH THN NB,,,444.26,4258.0,22
CPT,36456,PRTL EXCHANGE TRANSFUSE NB,,,444.26,4258.0,22
CPT,36460,"HC TRANSFUSION, INTRAUTERINE, FETAL",1173.0,645.15,351.9,4258.0,53
CPT,36465,"HC INJ NON-COMPOUNDED FOAM SCLEROSANT W/ US COMP MNVRS, SNGL INCMPTNT VEIN",5345.0,2939.75,1603.5,6766.0,53
CPT,36465,NJX NONCMPND SCLRSNT 1 VEIN,,,3253.01,3253.01,1
CPT,36466,"HC INJ NON-COMP FOAM SCLEROSANT W/ US, MULT INCOMPET TRUNC VEINS, SAME LEG",5443.0,2993.65,1632.9,6766.0,53
CPT,36466,NJX NONCMPND SCLRSNT MLT VN,,,3253.01,3253.01,1
CPT,36468,"HC INJ(S) SCLEROSANT FOR SPIDER VEINS, LIMB/TRUNK",701.0,385.55,210.3,4258.0,53
CPT,36470,"HC INJ SCLEROSANT, SINGLE INCOMPET VEIN",685.0,376.75,205.5,4258.0,53
CPT,36471,"HC INJ SCLEROSANT, MULT INCOMPET VEINS, SAME LEG",695.0,382.25,208.5,4258.0,53
CPT,36473,"HC ENDOVEN ABLT INCOMPET VEIN, EXTR, IMAG GUID, MECHANOCHEMICAL, FIRST VEIN",7068.0,3887.4,2120.4,14658.0,53
CPT,36474,"HC ENDVEN ABLAT THER INCOMPET VEIN, EXTREM, MECHANOCHEM, SUBSEQ, EA (AD)",3494.0,1921.7,222.05,3533.0,53
CPT,36475,"HC ENDOVENOUS ABLATION THERAPY, EXTREMITY, IMAG GUIDE, RF, 1ST VEIN",6942.0,3818.1,2082.6,14658.0,53
CPT,36476,"HC ENDOVEN ABLATION THERAPY, EXTREMITY, IMAG GUIDE, RF, SUB VEIN (ADD ON)",4475.0,2461.25,246.09,3870.88,53
CPT,36478,"HC ENDVEN ABLAT THER INCOMPET VEIN, EXTREM, LASER, 1ST VEIN",8373.0,4605.15,2511.9,14658.0,53
CPT,36479,"HC ENDVEN ABLAT THER INCOMPET VEIN, EXTREM, LASER, SUBSEQ, EA (AD)",6979.0,3838.45,268.26,6036.84,53
CPT,36481,HC CATH PORTAL VEIN PERCUTAN,1067.0,586.85,320.1,3533.0,53
CPT,36482,ENDOVEN THER CHEM ADHES 1ST,,,9613.23,9613.23,1
CPT,36482,"HC ENDOVEN ABLAT THER, EXTRM, TRANCATH CHEM ADHESIVE, FIRST VEIN",12308.0,6769.4,3692.4,17804.0,53
CPT,36483,ENDOVEN THER CHEM ADHES SBSQ,,,213.63,213.63,1
CPT,36483,"HC ENDOVEN ABLAT THER, EXTRM, TRANCATH CHEM ADHESIVE, SUBSEQ VEIN(S) (ADD)",6044.0,3324.2,122.07,5228.06,53
CPT,36500,HC IN SG VENOUS ORGAN SAMPLING UNILAT,1938.0,1065.9,158.06,3533.0,53
CPT,36500,HC VENOUS CATH FOR SELECTIVE ORGAN BLOOD SAMPLING,1938.0,1065.9,158.06,3533.0,53
CPT,36510,INSERTION OF CATHETER VEIN,,,79.34,3533.0,21
CPT,36511,HC DEPLETION APHERESIS_BILL WBC,4044.0,2224.2,1213.2,6766.0,53
CPT,36512,HC EXCHANGE APHERESIS_BILL RBC,4044.0,2224.2,1213.2,6766.0,53
CPT,36513,HC DEPLETION APHERESIS_BILL PLT,2462.0,1354.1,444.26,4258.0,53
CPT,36514,HC PLASMAPHERESIS AT BCW,4965.0,2730.75,1489.5,6766.0,53
CPT,36514,HC PLASMAPHERESIS AT FMLH,4965.0,2730.75,1489.5,6766.0,53
CPT,36514,"HC THERAPEUTIC APHERESIS, PLASMA PHERESIS",4164.5,2290.48,1249.35,6766.0,53
CPT,36516,HC THER APHERESIS W EXTRCORP SEL ADSORP FILT & PLASMA REINFUSN,12502.0,6876.1,3750.6,16799.0,53
CPT,36522,HC PHOTOPHERESIS,16950.0,9322.5,4761.07,16799.0,212
CPT,36522,HC PHOTOPHERESIS_BILL,5364.0,2950.2,1609.2,16799.0,53
CPT,36555,"HC INSERT NON-TUNNEL CENTRALLY INSERT CVC, YOUNGER THAN 5 YRS",8130.0,4471.5,2439.0,7032.45,53
CPT,36556,HC ANES INSERT CENTRAL VENOUS CATH,4744.0,2609.2,1423.2,5761.0,53
CPT,36556,"HC INSERT NON-TUNNEL CENTRALLY INSERT CVC, AGE 5 YRS OR OLDER",4744.0,2609.2,1423.2,5761.0,159
CPT,36557,"HC INSERT TUNNEL CENTRALLY INSERT CVC, W/O SUBCUT PORT/PUMP, YNGR THAN 5YRS",7345.0,4039.75,2203.5,17804.0,106
CPT,36558,HC INSERT TUNNELED CVC WO SUBQ PORT PUMP,5510.0,3030.5,1653.0,14658.0,106
CPT,36560,"HC INSERT TUNNEL CENTRALLY INSERT CVAD, W/ SUBCUT PORT, YOUNGER THAN 5 YRS",5120.0,2816.0,1536.0,14658.0,53
CPT,36561,HC INSERT TUNNELED CENTRAL VEN ACC DEV W SUBQ PORT,8458.0,4651.9,2537.4,14658.0,53
CPT,36563,INSERT TUNNELED CV CATH,,,5493.27,17804.0,22
CPT,36565,INSERT TUNNELED CV CATH,,,3198.49,14658.0,22
CPT,36566,INSERT TUNNELED CV CATH,,,5493.27,17804.0,22
CPT,36568,"HC INSERT PICC, W/O SUBCUT PORT/PUMP, W/O IMG GUID, AGE YNGR TH 5 YRS",2246.0,1235.3,673.8,4955.0,53
CPT,36569,"HC INSERT PICC, W/O SUBCUT PORT/PUMP, W/O IMG GUID, AGE 5 YRS/OLDER",3140.0,1727.0,942.0,5761.0,265
CPT,36569,"HC MIDLINE/DEFER, INSERT PICC,WO SUBCUT PORT/PUMP,WO IMG GUID,AGE 5 YR/OLDR",2713.0,1492.15,813.9,5761.0,53
CPT,36570,INSERT PICVAD CATH,,,3198.49,14658.0,22
CPT,36571,"HC INSERT PERIPH INSERT CVAD, W SUBCUT PORT, AGE 5 YRS OR OLDER",4859.0,2672.45,1457.7,14658.0,53
CPT,36572,"HC INSERT PICC, W/O SUBCUT PORT/PUMP, INCL ALL IMG GUID, AGE YNGR TH 5 YRS",1966.0,1081.3,589.8,4955.0,53
CPT,36572,INSJ PICC RS&I <5 YR,,,1099.48,1099.48,1
CPT,36573,"HC INSERT PICC, W/O SUBCUT PORT/PUMP, INCL ALL IMG GUID, AGE 5 YRS/OLDER",4901.0,2695.55,1470.3,6766.0,53
CPT,36573,INSJ PICC RS&I 5 YR+,,,2762.56,2762.56,1
CPT,36575,HC REPR TUN NON-TUN CENT VEN ACC CATH WO SUBQ PORT,1697.0,933.35,509.1,4955.0,106
CPT,36576,HC REPR CENTRAL VEN ACCESS DEVICE W SUBQ PORT PUMP,3823.0,2102.65,1146.9,5761.0,53
CPT,36578,REPLACE TUNNELED CV CATH,,,3198.49,14658.0,22
CPT,36580,HC REPLC COMPL NON-TUNNELED CVC WO SUBQ PORT PUMP,2675.0,1471.25,802.5,5761.0,53
CPT,36581,HC REPLC COMPL TUNNELED CVC WO SUBQ PORT PUMP,5510.0,3030.5,1653.0,14658.0,53
CPT,36582,"HC REPLC, COMPL, TUNN CENTRL VEN ACC DEV, W SUBQ PORT, THRU SAME VEN ACCESS",7160.0,3938.0,2148.0,14658.0,53
CPT,36583,REPLACE TUNNELED CV CATH,,,5493.27,17804.0,22
CPT,36584,"HC REPLC, COMPL, PICC, W/O SUBCUT PORT/PUMP, THRU SAME VEN ACCESS, W/ IMG",4196.0,2307.8,1258.8,5761.0,318
CPT,36585,"HC REPLC, COMPL, PERIPH INSERTED CVAD, W/ SUBCUT PORT, THRU SAME VEN ACCESS",7794.0,4286.7,2338.2,14658.0,53
CPT,36589,HC REMOVE TUNNELED CVC WO SUBQ PORT OR PUMP,2812.5,1546.875,628.28,4955.0,530
CPT,36590,HC REM TUNNEL CENTRAL VEN ACC DEV W SUBQ PORT PUMP,4685.5,2577.0249999999996,1043.1,6766.0,742
CPT,36591,"HC 2 HRS, COLLECTION BLOOD SPECIMEN FROM A COMPLETELY IMPLANTABLE VAD",443.0,243.65,130.99,383.2,53
CPT,36591,"HC 3 HRS, COLLECTION BLOOD SPECIMEN FROM A COMPLETELY IMPLANTABLE VAD",668.0,367.4,130.99,577.82,53
CPT,36591,"HC 4 HRS, COLLECTION BLOOD SPECIMEN FROM A COMPLETELY IMPLANTABLE VAD",890.0,489.5,130.99,769.85,53
CPT,36591,"HC 5 HRS, COLLECTION BLOOD SPECIMEN FROM A COMPLETELY IMPLANTABLE VAD",1113.0,612.15,130.99,962.75,53
CPT,36591,"HC 6 HRS, COLLECTION BLOOD SPECIMEN FROM A COMPLETELY IMPLANTABLE VAD",1337.0,735.35,130.99,1156.51,53
CPT,36591,HC COLLECTION BLOOD SPECIMEN FROM A COMPLETELY IMPLANTABLE VAD,220.5,121.275,65.1,193.76,1590
CPT,36591,HC MR COLLECTION BLOOD SPECIMEN FROM A COMP IMPLANTABLE VEN ACCESS DEVICE,224.0,123.2,67.2,193.76,53
CPT,36591,HC US COLLECTION BLOOD SPECIMEN FROM A COMP IMPLANTABLE VEN ACCESS DEVICE,224.0,123.2,67.2,193.76,53
CPT,36592,"HC 2 HRS, COLLECT BLOOD SPECIMEN USING EST CENTRAL/PERIPH CATH, VENOUS, NOS",404.0,222.2,121.2,349.46,53
CPT,36592,"HC 3 HRS, COLLECT BLOOD SPECIMEN USING EST CENTRAL/PERIPH CATH, VENOUS, NOS",471.0,259.05,130.99,407.42,53
CPT,36592,"HC 4 HRS, COLLECT BLOOD SPECIMEN USING EST CENTRAL/PERIPH CATH, VENOUS, NOS",627.0,344.85,130.99,542.36,53
CPT,36592,"HC 5 HRS, COLLECT BLOOD SPECIMEN USING EST CENTRAL/PERIPH CATH, VENOUS, NOS",785.0,431.75,130.99,679.03,53
CPT,36592,"HC 6HRS, COLLECT BLOOD SPECIMEN USING EST CENTRAL/PERIPHERAL CATH, VEN, NOS",942.0,518.1,130.99,814.83,106
CPT,36592,"HC COLLECT BLOOD SPECIMEN USE ESTABLISHED CENTRAL/PERIPH CATH, VENOUS, NOS",206.0,113.30000000000001,60.9,180.79,1484
CPT,36593,HC DECLOT BY THROMBOLYTIC AGENT OF IMPLANTED VASC ACCESS DEVICE/CATH,899.5,494.725,264.9,4258.0,1484
CPT,36595,HC MECH REM PERICATH OBSTRUCT MATRL FROM CV DEVICE,4474.0,2460.7,1342.2,14658.0,53
CPT,36596,MECH REMOV TUNNELED CV CATH,,,1578.61,5761.0,22
CPT,36597,HC REPOSITION PREV PLACED CVC UNDER FLUORO GUIDE,2454.0,1349.7,736.2,5761.0,53
CPT,36597,HC REPOSITION PREV PLACED CVC WITHOUT FLUORO GUIDE,2454.0,1349.7,736.2,5761.0,53
CPT,36598,HC INJ CONTRAST FOR RAD EVAL OF CVAD INCL FLUORO,670.0,368.5,201.0,4258.0,53
CPT,36598,INJ W/FLUOR EVAL CV DEVICE,,,374.68,374.68,1
CPT,36600,"HC ARTERIAL PUNCTURE, BLOOD WITHDRAWAL FOR DIAGNOSIS",228.0,125.4,68.4,4258.0,265
CPT,36600,"HC EXTENDED SETUP 100% OXYGEN, ARTERIAL PUNCTURE, BLOOD WITHDRAWAL FOR DIAG",228.0,125.4,68.4,4258.0,53
CPT,36620,HC ANES INSERT ARTERY CATH,2319.0,1275.45,39.7,3533.0,53
CPT,36620,"HC ARTERIAL CATH OR CANNULATION FOR SAMPLING, MONITORING/TRANSFUSION, PERC",2319.0,1275.45,39.7,3533.0,53
CPT,36625,INSERTION CATHETER ARTERY,,,92.82,3533.0,21
CPT,36640,INSERTION CATHETER ARTERY,,,3198.49,14658.0,22
CPT,36660,INSERTION CATHETER ARTERY,,,62.14,5761.0,22
CPT,36680,HC INSERT NDL INTRAOSSEOUS INFUSN,611.0,336.05,183.3,4258.0,53
CPT,36680,HC NEEDLE PLACEMENT FOR INTRAOSSEOUS INFUSION,611.0,336.05,183.3,4258.0,2226
CPT,36800,INSERTION OF CANNULA,,,5493.27,17804.0,22
CPT,36810,INSERTION OF CANNULA,,,3198.49,14658.0,22
CPT,36815,INSERTION OF CANNULA,,,5493.27,17804.0,22
CPT,36818,AV FUSE UPPR ARM CEPHALIC,,,5493.27,17804.0,22
CPT,36819,AV FUSE UPPR ARM BASILIC,,,5493.27,17804.0,22
CPT,36820,AV FUSION/FOREARM VEIN,,,5493.27,17804.0,22
CPT,36821,AV FUSION DIRECT ANY SITE,,,3198.49,14658.0,22
CPT,36823,INSERTION OF CANNULA(S),,,1223.04,9469.0,22
CPT,36825,ARTERY-VEIN AUTOGRAFT,,,5493.27,17804.0,22
CPT,36830,ARTERY-VEIN NONAUTOGRAFT,,,5493.27,17804.0,22
CPT,36831,OPEN THROMBECT AV FISTULA,,,5493.27,17804.0,22
CPT,36832,AV FISTULA REVISION OPEN,,,5493.27,17804.0,22
CPT,36833,AV FISTULA REVISION,,,5493.27,17804.0,22
CPT,36835,INSERTION THOMAS SHUNT,,,3198.49,14658.0,22
CPT,36836,"HC PERC ARTVEN FIST CREAT, UPR EXTREM, SGL ACC PERIPH ART&VEIN, IMG GUID",48323.0,26577.65,12463.0,41799.4,53
CPT,36837,PRQ AV FSTL CRT UXTR SEP ACS,,,12463.0,24394.0,22
CPT,36838,DIST REVAS LIGATION HEMO,,,5493.27,17804.0,22
CPT,36860,EXTERNAL CANNULA DECLOTTING,,,1578.61,4955.0,22
CPT,36861,CANNULA DECLOTTING,,,5493.27,17804.0,22
CPT,36901,"HC INTRO NEEDLE/CATH, DIALYSIS CIRCUIT",3329.0,1830.95,998.7,6766.0,53
CPT,36901,INTRO CATH DIALYSIS CIRCUIT,,,2762.56,2762.56,1
CPT,36902,"HC INTRO NEEDLE/CATH, DIALYSIS CIRCUIT, W/ PERIPHERAL PTA",13560.0,7458.0,4068.0,17804.0,53
CPT,36902,INTRO CATH DIALYSIS CIRCUIT,,,10139.3,10139.3,1
CPT,36903,"HC INTRO NEEDLE/CATH, DIALYSIS CIRCUIT, W/ PERIPHERAL STENT/PTA",25773.0,14175.15,7731.9,22293.65,53
CPT,36903,INTRO CATH DIALYSIS CIRCUIT,,,20167.5,20167.5,1
CPT,36904,"HC PERC TRANSLUM MECH THROMBECT/INFUS, DIALYS CIRCUIT",12307.0,6768.85,3692.1,17804.0,53
CPT,36904,THRMBC/NFS DIALYSIS CIRCUIT,,,10139.3,10139.3,1
CPT,36905,"HC PERC TRANSLUM MECH THROMBECT/INFUS, DIALYS CIRCUIT, PERIPH PTA",23730.0,13051.5,7119.0,21512.0,53
CPT,36905,THRMBC/NFS DIALYSIS CIRCUIT,,,20167.5,20167.5,1
CPT,36906,"HC PERC TRANSLUM MECH THROMBECT/INFUS, DIALYS CIRCUIT, PERIPH STENT/PTA",29912.0,16451.6,8973.6,28824.0,53
CPT,36906,THRMBC/NFS DIALYSIS CIRCUIT,,,31933.33,31933.33,1
CPT,36907,BALO ANGIOP CTR DIALYSIS SEG,,,903.1,903.1,1
CPT,36907,"HC TRANSLUM BALLOON ANGIOPLASTY, CENTRAL, DIALYS CIRCUIT (ADD ON)",10989.0,6043.95,516.06,9505.49,53
CPT,36908,"HC TRANSCATH PLACE INTRAVASC STENT(S), CENTRAL, DIALYSIS CIRCUIT (ADD ON)",10072.0,5539.6,835.0,8712.28,53
CPT,36908,STENT PLMT CTR DIALYSIS SEG,,,2159.12,2159.12,1
CPT,36909,DIALYSIS CIRCUIT EMBOLJ,,,2865.36,2865.36,1
CPT,36909,HC DIALYSIS CIRCUIT PERM VASC EMOBLIZATION/OCCLUSION (ADD ON CODE),11004.0,6052.2,835.0,9518.46,53
CPT,37140,REVISION OF CIRCULATION,,,2004.12,13936.0,22
CPT,37145,REVISION OF CIRCULATION,,,1860.56,13936.0,22
CPT,37160,REVISION OF CIRCULATION,,,1910.64,13936.0,22
CPT,37180,REVISION OF CIRCULATION,,,1836.8,13936.0,22
CPT,37181,SPLICE SPLEEN/KIDNEY VEINS,,,2004.12,13936.0,22
CPT,37182,HC INSERT TIPS,16046.0,8825.3,725.53,21512.0,53
CPT,37183,HC REVISION TRANSVENOUS INTRAHEPATIC PORTOSYSTEMIC SHUNT(S) (TIPS),13297.0,7313.35,3989.1,21512.0,53
CPT,37184,"HC IN, PRIM PERC TRNSLM MECH THROMBECT, NON-COR/INTRCRAN, ART, INIT VES",20843.0,11463.65,6252.9,18795.05,53
CPT,37184,"HC PRIM PERC TRNSLM MECH THROMBECT, NON-COR/INTRCRAN, ART, INIT VES",20843.0,11463.65,6252.9,18795.05,106
CPT,37185,"HC PERC TRANSLM MECH THRMBT, NONCRNRY, NONINTRCRN, ART, 2ND/SUBSEQ VES",4583.0,2520.65,414.65,3964.3,53
CPT,37186,"HC SEC PERC TRANSLUM THROMBECT, NON-COR/INTCRAN, ART, W ANOTH INTERV (ADD)",5821.0,3201.55,835.0,5035.17,53
CPT,37187,"HC IN, PERC TRNSLM MECH THROMBECT, VEIN(S)",13076.0,7191.8,3922.8,17804.0,53
CPT,37187,"HC PERC TRNSLM MECH THROMBECT, VEIN(S)",13076.0,7191.8,3922.8,17804.0,53
CPT,37188,HC IN THROMB VEINS REPEAT TX,5928.0,3260.4,1778.4,14658.0,53
CPT,37188,"HC PERC TRNSLM MECH THROMBECT, VEIN(S), REPEAT TX SUBSEQ DAY",5928.0,3260.4,1778.4,14658.0,53
CPT,37191,HC INSERT INTRAVASC VENA CAVA FILTER,13103.0,7206.65,3930.9,17804.0,53
CPT,37191,INS ENDOVAS VENA CAVA FILTR,,,9613.23,9613.23,1
CPT,37192,REDO ENDOVAS VENA CAVA FILTR,,,3198.49,14658.0,23
CPT,37193,HC RETRIEVAL REM INTRAVASC VENA CAVA FILTER,8874.0,4880.7,2662.2,14658.0,53
CPT,37193,REM ENDOVAS VENA CAVA FILTER,,,5597.36,5597.36,1
CPT,37195,HC THROMBOLYSIS CEREBRAL BY INTRAVENOUS INFUSION,1026.0,564.3,307.8,4258.0,53
CPT,37197,HC TRANSCATH RETRIEVAL PERCUTAN INTRVASC FOREIGN BODY,7110.0,3910.5,2133.0,14658.0,106
CPT,37197,REMOVE INTRVAS FOREIGN BODY,,,5597.36,5597.36,1
CPT,37200,HC TRANSCATHETER BIOPSY,5780.5,3179.28,1734.15,17804.0,53
CPT,37211,"HC TRNSCATH THER, ART INFUS THROMBLYS NON-COR/INTRCRAN, INIT TX DAY",9130.0,5021.5,2739.0,17804.0,106
CPT,37211,THROMBOLYTIC ART THERAPY,,,9613.23,9613.23,1
CPT,37212,"HC IN, TRNSCATH THER, VEN INFUS THROMBLYS NON-COR/INTRCRAN, INIT TX DAY",4638.0,2550.9,1391.4,14658.0,53
CPT,37212,"HC TRNSCATH THER, VEN INFUS THROMBLYS NON-COR/INTRCRAN, INIT TX DAY",4638.0,2550.9,1391.4,14658.0,53
CPT,37212,THROMBOLYTIC VENOUS THERAPY,,,5597.36,5597.36,1
CPT,37213,"HC IN, TRNSCATH THER, ART/VEN INFUS THROMBLYS NON-COR, CONT SUBSEQ DAY",7421.0,4081.55,2226.3,6419.17,53
CPT,37213,"HC TRNSCATH THER, ART/VEN INFUS THROMBLYS NON-COR, CONT SUBSEQ DAY",7421.0,4081.55,2226.3,6419.17,53
CPT,37213,THROMBLYTIC ART/VEN THERAPY,,,5597.36,5597.36,1
CPT,37214,CESSJ THERAPY CATH REMOVAL,,,5597.36,5597.36,1
CPT,37214,"HC IN, TRNSCATH THER, ART/VEN INFUS THROMBLYS NON-COR, CONT SUBSEQ DAY, REM",6744.0,3709.2,2023.2,5833.56,53
CPT,37214,"HC TRNSCATH THER, ART/VEN INFUS THROMBLYS NON-COR, CONT SUBSEQ DAY, REM",6744.0,3709.2,2023.2,5833.56,53
CPT,37215,"HC IN, TRNSCATH PLC INTRVASC STENT, CERV CAROTID ART, W DIST EMB PROTECT",10680.0,5874.0,830.78,9238.2,53
CPT,37215,"HC TRNSCATH PLC INTRVASC STENT, CERV CAROTID ART, W DIST EMB PROTECT",10680.0,5874.0,830.78,9238.2,53
CPT,37215,TRANSCATH STENT CCA W/EPS,,,1453.87,1453.87,1
CPT,37216,"HC IN, TRNSCATH PLC INTRVASC STENT, CERV CAROTID ART, WO DIST EMB PROTECT",8852.0,4868.6,894.74,18485.0,53
CPT,37216,"HC TRANSCATH PLACE INTRVASC STENT, CERV CAROTID ART, WO DIST EMB PROTECT",8852.0,4868.6,894.74,18485.0,53
CPT,37216,TRANSCATH STENT CCA W/O EPS,,,1565.79,1565.79,1
CPT,37217,"HC TRANSCATH PLACE INTRVASC STENT, INTRATHORACIC CCA BY RETROGRADE TX",2961.0,1628.55,888.3,17386.0,53
CPT,37218,"HC TRANSCATH PLACE INTRVASC STENT, INTRATHORACIC CCA BY ANTEGRADE TX",2643.0,1453.65,705.08,8363.0,106
CPT,37220,"HC REVASC, ENDVASC, ILIAC ART, INIT VES, W TLA",19917.0,10954.35,5793.88,17804.0,106
CPT,37221,"HC REVASC, ENDVASC, ILIAC ART, INIT VES, W STENT",24504.0,13477.2,7351.2,21512.0,106
CPT,37222,"HC REVASC, ENDVASC, ILIAC ART, EA ADL IPSILAT VES, W TLA (AD)",12354.0,6794.7,536.81,17804.0,53
CPT,37223,"HC REVASC, ENDVASC, ILIAC ART, EA ADL IPSILAT VES, W STENT (AD)",16679.0,9173.45,1092.11,17804.0,53
CPT,37224,"HC REVASC, ENDVASC, FEM, POPLIT ART, W TLA",20228.0,11125.4,5793.88,17804.0,106
CPT,37225,"HC REVASC, ENDVASC, FEM, POPLIT ART, W ATHRECT",23122.0,12717.1,6936.6,21512.0,53
CPT,37226,"HC REVASC, ENDVASC, FEM, POPLIT ART, W STENT",26422.0,14532.1,7926.6,22855.03,106
CPT,37227,"HC REVASC, ENDVASC, FEM, POPLIT ART, W STENT & ATHRECT",31781.0,17479.55,9534.3,28824.0,53
CPT,37228,"HC REVASC, ENDVASC, TIB, PERON ART, INIT VES, W TLA",20841.0,11462.55,6252.3,19884.0,106
CPT,37229,"HC REVASC, ENDVASC, TIB, PERON ART, INIT VES, W ATHRECT",22076.0,12141.8,6622.8,24394.0,53
CPT,37230,"HC REVASC, ENDVASC, TIB, PERON ART, INIT VES, W STENT",22076.0,12141.8,6622.8,24394.0,53
CPT,37231,"HC REVASC, ENDVASC, TIB, PERON ART, INIT VES, W STENT & ATHRECT",46598.0,25628.9,13979.4,40307.27,53
CPT,37232,"HC REVASC, ENDVASC, TIB/PERON ART, EA ADL VES, W TLA (AD)",13644.0,7504.2,708.06,17804.0,106
CPT,37233,"HC REVASC, ENDVASC, TIB/PERON ART, EA ADL VES, W ATHRECT (AD)",24962.0,13729.1,920.65,21592.13,53
CPT,37234,"HC REVASC, ENDVASC, TIB/PERON ART, EA ADL VES, W STENT (AD)",11759.0,6467.45,3126.46,17804.0,53
CPT,37235,APC,,,3469.76,3573.85,15
CPT,37235,OP Surgery - Grouper Table,,,10315.0,17804.0,6
CPT,37236,"HC TRANSCATH PLC INTRAVASC STENT, INIT ARTERY",24536.0,13494.8,7360.8,21512.0,106
CPT,37237,"HC TRANSCATH PLACEMENT INTRAVASC STENT, OPEN OR PERC, EA ADDL ARTERY",16608.0,9134.4,1119.34,17804.0,53
CPT,37238,HC IN INTRA VASC STENT PTA VEIN INITIAL VESSEL,24933.0,13713.15,7479.9,21567.05,53
CPT,37238,HC TRANSCATH PLC INTRAVASC STENT INIT VEIN,24933.0,13713.15,7479.9,21567.05,53
CPT,37239,HC TRANSCATH PLC INTRAVASC STENT EA ADDL VEIN,16882.0,9285.1,1494.88,17804.0,53
CPT,37241,HC VASC EMBOLZ OCCLUSION VENOUS NON HEMORRHAGE,34396.0,18917.8,10318.8,29752.54,53
CPT,37242,HC VASC EMBOLZ OCCLUSION ART NON HEMORRHAGE-TUMOR,33900.0,18645.0,10170.0,29323.5,106
CPT,37243,"HC VASC EMBOLIZATION/OCCLUSION, FOR TUMORS, ORGAN ISCHEMIA/INFARCTION",31640.0,17402.0,9492.0,27368.6,53
CPT,37244,HC VASC EMBOLIZATION OCCLUSION ART VEN HEMORRHAGE LYMPH EXTRAVASATION,34396.0,18917.8,10318.8,29752.54,106
CPT,37246,"HC IN, TRNSLM BALLOON ANGIOPLASTY, OPEN/PERC, INIT ART",12823.0,7052.65,3846.9,17804.0,53
CPT,37246,"HC TRNSLM BALLOON ANGIOPLASTY, OPEN/PERC, INIT ART",12823.0,7052.65,3846.9,17804.0,106
CPT,37247,"HC IN, TRNSLM BALLOON ANGIOPLASTY, OPEN/PERC, EA ADL ART (AD)",7354.0,4044.7,531.05,6361.21,53
CPT,37247,"HC TRNSLM BALLOON ANGIOPLASTY, OPEN/PERC, EA ADL ART (AD)",7354.0,4044.7,531.05,6361.21,106
CPT,37248,"HC IN, TRNSLM BALLOON ANGIOPLASTY, OPEN/PERC, INIT VEIN",17999.0,9899.45,5399.7,17804.0,53
CPT,37248,"HC TRNSLM BALLOON ANGIOPLASTY, OPEN/PERC, INIT VEIN",17999.0,9899.45,5399.7,17804.0,106
CPT,37249,"HC IN, TRNSLM BALLOON ANGIOPLASTY, OPEN/PERC, EA ADL VEIN (AD)",8839.0,4861.45,387.57,7645.74,53
CPT,37249,"HC TRNSLM BALLOON ANGIOPLASTY, OPEN/PERC, EA ADL VEIN (AD)",8839.0,4861.45,387.57,7645.74,106
CPT,37252,"HC INTRAVASCULAR US NONCORONARY VESSEL, INCL RS-I, INITIAL VESSEL (ADD ON)",3400.0,1870.0,818.63,3533.0,106
CPT,37253,"HC INTRAVASCULAR US NONCORONARY VESSEL, EACH ADDL VESSEL (ADD ON CODE)",1302.0,716.1,153.59,3533.0,106
CPT,37500,APC,,,5493.27,5658.07,15
CPT,37500,OP Surgery - Grouper Table,,,10315.0,17804.0,7
CPT,37501,UNLISTED VASC ENDOSCOPY PX,,,628.28,4955.0,22
CPT,37565,LIGATION INT JUGULAR VEIN,,,2932.0,5761.0,22
CPT,37600,LIGATION XTRNL CAROTID ART,,,3198.49,14658.0,22
CPT,37605,LIGATION INT/COM CAROTID ART,,,3198.49,14658.0,22
CPT,37606,LIG INT/COM CAROTID ART OCCL,,,3198.49,14658.0,22
CPT,37607,HC LIGATION OF A-V FISTULA,11388.0,6263.4,3198.49,14658.0,53
CPT,37609,HC TEMPORAL ARTERY PROCEDURE,6269.0,3447.95,1646.49,6766.0,53
CPT,37615,LIGATION MAJOR ARTERY NECK,,,2932.0,5761.0,22
CPT,37616,LIGATION MAJOR ARTERY CHEST,,,989.77,8363.0,22
CPT,37617,LIGATION MAJOR ARTERY ABD,,,1141.67,14658.0,22
CPT,37618,HC LIGATION OF EXTREMITY ARTERY,883.0,485.65,264.9,8363.0,53
CPT,37619,LIGATION OF INF VENA CAVA,,,5493.27,17804.0,22
CPT,37650,LIGATION OF FEMORAL VEIN,,,3198.49,14658.0,22
CPT,37660,LIGATION COMMON ILIAC VEIN,,,1139.75,8363.0,22
CPT,37700,LIGATION&DIV LONG SAPH VEIN,,,3198.49,14658.0,22
CPT,37718,LIG DIV&STRPG SHORT SAPH VN,,,3198.49,14658.0,22
CPT,37722,LIG DIV&STRPG LONG SAPH VEIN,,,3198.49,14658.0,22
CPT,37735,LIG&DIV&COMPL STRPG SAPH VN,,,3198.49,14658.0,22
CPT,37760,LIG PRFRATR VN RADICAL 1 LEG,,,3198.49,14658.0,22
CPT,37761,LIGATE LEG VEINS OPEN,,,2932.0,5761.0,22
CPT,37765,"HC STAB PHLEBECTOMY VARICOSE VEINS, 1 EXTREMITY, 10-20 STAB INCISIONS",5510.0,3030.5,1653.0,14658.0,53
CPT,37766,"HC STAB PHLEBECTOMY VARICOSE VEINS, 1 EXTREMITY, MORE THAN 20 INCISIONS",6698.0,3683.9,2009.4,14658.0,53
CPT,37780,REVISION OF LEG VEIN,,,2932.0,5761.0,22
CPT,37785,HC LIGATION DIVISION EXC VARICOSE VEIN CLUSTERS 1 LEG,8487.0,4667.85,2546.1,14658.0,53
CPT,37788,REVASCULARIZATION PENIS,,,1143.4,8363.0,22
CPT,37790,PENILE VENOUS OCCLUSION,,,3504.84,14658.0,22
CPT,37799,HC ARTERIAL LINE DRAW,105.0,57.75,31.5,29323.0,53
CPT,37799,"HC CRYO-ABLATION VASCULAR LESION, UNLIST PROC, VASCULAR SURGERY",2301.0,1265.55,628.28,29323.0,53
CPT,37799,"HC FIBRIN SHEATH INTERRUPTION ANGIOPLASTY BALLOON SAME ACCESS, UNLIST PROC",12307.0,6768.85,628.28,29323.0,53
CPT,37799,"HC IMPELLA INSERTION - OPEN AXILLARY CUTDOWN APPROACH, UNLIST PX VASC SURG",55252.0,30388.6,628.28,47792.98,53
CPT,37799,"HC MAN REPOS OF FLIPPED SUBQ MEDIPORT, NON-INVASIVE, UNLISTED PX, VASC SURG",3823.0,2102.65,628.28,29323.0,53
CPT,37799,HC PHLEBECTOMY STAB < 10 UNILAT,1457.0,801.35,437.1,29323.0,106
CPT,37799,"HC SCLEROTHERAPY VARICES, NON EXTREMITY, BILAT",614.0,337.7,184.2,29323.0,53
CPT,38100,REMOVAL OF SPLEEN TOTAL,,,1005.13,8363.0,22
CPT,38101,REMOVAL OF SPLEEN PARTIAL,,,1012.8,8363.0,22
CPT,38102,REMOVAL OF SPLEEN TOTAL,,,226.87,8363.0,22
CPT,38115,REPAIR OF RUPTURED SPLEEN,,,1121.41,8363.0,22
CPT,38120,LAPAROSCOPY SPLENECTOMY,,,10315.0,19884.0,22
CPT,38129,UNLISTED LAPS PX SPLEEN,,,5928.88,16799.0,22
CPT,38200,HC INJ PROC FOR SPLENOPORTOGRAPHY,498.0,273.9,117.88,3533.0,53
CPT,38204,BL DONOR SEARCH MANAGEMENT,,,91.4,94.14,15
CPT,38205,HC HARVEST ALLOGENIC STEM CELLS,4202.0,2311.1,76.83,13936.0,159
CPT,38205,HC HARVEST ALLOGENIC STEM CELLS-BCSEW,4202.0,2311.1,76.83,13936.0,53
CPT,38206,HC HARVEST AUTO STEM CELLS,6858.0,3771.9,1665.84,6766.0,159
CPT,38207,HC FACTOR VIII TRANSDUCED AUTOLOGOUS CD34+ PREPARATION,23624.0,12993.2,444.26,20434.76,53
CPT,38207,HC STEM CELL HARVEST PKG OC,5795.0,3187.25,444.26,5012.68,53
CPT,38207,HC STEM CELL LEUKO CRYOPRESERVATION,5795.0,3187.25,444.26,5012.68,53
CPT,38207,HC STEM CELL LEUKO PREP NON-CRYOPRESERVATION,5795.0,3187.25,444.26,5012.68,53
CPT,38207,HC VIRAL-SPECIFIC CTL PREP USING CYTOKINE CAPTURE SYSTEM,21424.0,11783.2,444.26,18531.76,53
CPT,38208,HC THAW PRESERVED STEM CELLS,3636.0,1999.8,444.26,4258.0,53
CPT,38209,HC CORD BLOOD THAWED WASHED,5448.0,2996.4,444.26,4712.52,53
CPT,38209,HC CORD BLOOD THAWED WSH BB IND 7555,658.0,361.9,197.4,4258.0,53
CPT,38209,HC STEM CELL LEUKO THAW ADDL UNIT,5448.0,2996.4,444.26,4712.52,53
CPT,38209,HC STEM CELL OR LEUKO THAW WASH,5448.0,2996.4,444.26,4712.52,53
CPT,38210,HC CD34 SELECTION (FACTOR VIII),22470.0,12358.5,444.26,19436.55,53
CPT,38210,"HC CD34 SELECTION, CTN 1301",3390.0,1864.5,444.26,4258.0,53
CPT,38210,"HC CD34 SELECTION, HDE (1 BOTTLE, 1 COLUMN)",22470.0,12358.5,444.26,19436.55,53
CPT,38210,"HC CD34 SELECTION, SCD, 14359",1510.0,830.5,444.26,4258.0,53
CPT,38210,"HC CLINIMACS 2ND BTL CD 19, IDE G13641",12657.5,6961.63,444.26,10948.74,53
CPT,38210,"HC CLINIMACS 2ND DEPL TUBING SET, IDE G13641",8013.0,4407.15,444.26,6931.25,53
CPT,38210,"HC CLINIMACS 2ND TCR AB/CD19 DEPL KIT, IDE G13641",26592.5,14625.88,444.26,23002.51,53
CPT,38210,HC CLINIMACS TCR AB/CD19 DEPLETION IDE G13641,33000.0,18150.0,444.26,28545.0,53
CPT,38210,HC TC-NK-CD3-CD56+ DLI (STIR) IND BB 13794,23615.0,12988.25,444.26,20426.98,53
CPT,38211,TUMOR CELL DEPLETE OF HARVST,,,444.26,4258.0,22
CPT,38212,RBC DEPLETION OF HARVEST,,,444.26,4258.0,22
CPT,38213,PLATELET DEPLETE OF HARVEST,,,444.26,4258.0,22
CPT,38214,HC VOLUME DEPLETE OF HARVEST,3284.0,1806.2,444.26,4258.0,53
CPT,38215,HC BUFFY COAT PREPARATION,8276.0,4551.8,444.26,7158.74,53
CPT,38215,HC GRADIENT DENSITY MONONUCLEAR C,8276.0,4551.8,444.26,7158.74,53
CPT,38220,"HC DX BONE MARROW, ASPIRATION(S)",3086.0,1697.3,925.8,5761.0,530
CPT,38221,"HC DX BONE MARROW, BIOPSY(IES)",2677.0,1472.35,803.1,5761.0,530
CPT,38222,HC DX BONE MARROW BX & ASPIR,3567.0,1961.85,953.7,6766.0,583
CPT,38225,"HC CAR-T THERAPY HRVG OF BLD-DERIVED T LYMPHOCYTES, PER DAY",5516.0,3033.8,88.42,4771.34,53
CPT,38226,HC CAR-T THERAPY; PREP OF BLD-DERIVED T LYMPHOCYTES FOR TRNS,5484.0,3016.2,35.9,4743.66,53
CPT,38227,HC CAR-T THERAPY RECEIPT AND PREP OF CAR-T CELLS FOR ADMN,4347.0,2390.85,36.22,4602.0,53
CPT,38228,HC CAR-T THERAPY AUTOLOGOUS CELL ADMINISTRATION,1028.0,565.4,308.4,4258.0,106
CPT,38230,BONE MARROW HARVEST ALLOGEN,,,1665.84,6766.0,22
CPT,38232,BONE MARROW HARVEST AUTOLOG,,,4761.07,16799.0,22
CPT,38240,HC HEMATOPOIETIC PROGENITOR CELL (HPC) ALLOGENEIC TRANSPLANTATION PER DONOR,66110.5,36360.78,9733.0,61903.45,265
CPT,38241,"HC HEMATOPOIETIC PROGENITOR CELL (HPC), AUTOLOGOUS TRANSPLANTATION",7000.0,3850.0,1665.84,6766.0,265
CPT,38242,HC ALLOGENEIC LYMPHOCYTE INFUSIONS,4145.0,2279.75,1243.5,6766.0,265
CPT,38243,"HC HEMATOPOIETIC PROGENITOR CELL (HPC), HPC BOOST",4597.0,2528.35,1379.1,6766.0,212
CPT,38300,DRAINAGE LYMPH NODE LESION,,,2908.42,6766.0,22
CPT,38305,DRAINAGE LYMPH NODE LESION,,,2908.42,9469.0,22
CPT,38308,INCISION OF LYMPH CHANNELS,,,3891.31,9469.0,22
CPT,38380,THORACIC DUCT PROCEDURE,,,527.63,8363.0,22
CPT,38381,THORACIC DUCT PROCEDURE,,,704.49,8363.0,22
CPT,38382,THORACIC DUCT PROCEDURE,,,597.17,8363.0,22
CPT,38500,HC BX EXC LYMPH NODES OPEN SUPERFICIAL,10511.0,5781.05,3153.3,9469.0,265
CPT,38505,"HC BX/EXCISION LYMPH NODE(S), BY NEEDLE, SUPERFICIAL",2892.5,1590.875,818.7,6766.0,318
CPT,38510,BIOPSY/REMOVAL LYMPH NODES,,,3891.31,9469.0,22
CPT,38520,BIOPSY/REMOVAL LYMPH NODES,,,3891.31,9469.0,22
CPT,38525,BIOPSY/REMOVAL LYMPH NODES,,,3891.31,9469.0,22
CPT,38530,BIOPSY/REMOVAL LYMPH NODES,,,3891.31,9469.0,22
CPT,38531,OPEN BX/EXC INGUINOFEM NODES,,,3891.31,14658.0,22
CPT,38542,EXPLORE DEEP NODE(S) NECK,,,5928.88,17804.0,22
CPT,38550,REMOVAL NECK/ARMPIT LESION,,,3891.31,9469.0,22
CPT,38555,REMOVAL NECK/ARMPIT LESION,,,5480.0,17386.0,22
CPT,38562,REMOVAL PELVIC LYMPH NODES,,,639.09,17804.0,22
CPT,38564,REMOVAL ABDOMEN LYMPH NODES,,,624.33,16786.0,22
CPT,38570,LAPAROSCOPY LYMPH NODE BIOP,,,5928.88,17804.0,22
CPT,38571,LAPAROSCOPY LYMPHADENECTOMY,,,10315.0,19884.0,22
CPT,38572,LAPAROSCOPY LYMPHADENECTOMY,,,10315.0,19884.0,22
CPT,38573,LAPS PELVIC LYMPHADEC,,,10315.0,19884.0,22
CPT,38589,UNLISTED LAPS PX LYMPHTC SYS,,,5928.88,16799.0,22
CPT,38700,REMOVAL OF LYMPH NODES NECK,,,5480.0,17386.0,22
CPT,38720,REMOVAL OF LYMPH NODES NECK,,,5480.0,19884.0,22
CPT,38724,REMOVAL OF LYMPH NODES NECK,,,1312.9,16786.0,22
CPT,38740,REMOVE ARMPIT LYMPH NODES,,,5928.88,17804.0,22
CPT,38745,REMOVE ARMPIT LYMPH NODES,,,5928.88,17804.0,22
CPT,38746,REMOVE THORACIC LYMPH NODES,,,180.5,16786.0,22
CPT,38747,REMOVE ABDOMINAL LYMPH NODES,,,228.78,16786.0,22
CPT,38760,REMOVE GROIN LYMPH NODES,,,5480.0,17386.0,22
CPT,38765,REMOVE GROIN LYMPH NODES,,,1161.02,16786.0,22
CPT,38770,REMOVE PELVIS LYMPH NODES,,,728.52,16786.0,22
CPT,38780,REMOVE ABDOMEN LYMPH NODES,,,941.21,16786.0,22
CPT,38790,"HC INJ PROC, LYMPHANGIOGRAPHY",331.0,182.05,74.2,3533.0,106
CPT,38792,HC IDENTIFY SENTINEL NODE,936.0,514.8,280.8,4258.0,53
CPT,38794,"HC CANNULATION, THORACIC DUCT",699.0,384.45,209.7,3533.0,53
CPT,38900,IO MAP OF SENT LYMPH NODE,,,118.76,3533.0,21
CPT,38999,"HC CRYOABLATION LYMPH NODE, UNLISTD PX HEMIC/LYMPHTC SYS",8599.0,4729.45,444.26,29323.0,53
CPT,38999,"HC TIL CELLULAR THERAPY INFUSION, UNLISTED PROC",998.5,549.18,299.55,29323.0,53
CPT,39000,EXPLORATION OF CHEST,,,447.35,16786.0,22
CPT,39010,EXPLORATION OF CHEST,,,685.32,16786.0,22
CPT,39200,RESECT MEDIASTINAL CYST,,,748.22,16786.0,22
CPT,39220,RESECT MEDIASTINAL TUMOR,,,989.04,16786.0,22
CPT,39401,MEDIASTINOSCPY W/MEDSTNL BX,,,5928.88,16799.0,22
CPT,39402,MEDIASTINOSCPY W/LMPH NOD BX,,,5928.88,16799.0,22
CPT,39499,UNLISTED PX MEDIASTINUM,,,2453.0,29323.0,7
CPT,39501,REPAIR DIAPHRAGM LACERATION,,,745.91,16786.0,22
CPT,39503,REPAIR OF DIAPHRAGM HERNIA,,,2453.0,16786.0,22
CPT,39540,REPAIR OF DIAPHRAGM HERNIA,,,751.36,16786.0,22
CPT,39541,REPAIR OF DIAPHRAGM HERNIA,,,815.15,16786.0,22
CPT,39545,REVISION OF DIAPHRAGM,,,779.88,16786.0,22
CPT,39560,RESECT DIAPHRAGM SIMPLE,,,708.88,16786.0,22
CPT,39561,RESECT DIAPHRAGM COMPLEX,,,1101.66,16786.0,22
CPT,39599,UNLISTED PX DIAPHRAGM,,,2453.0,29323.0,7
CPT,40490,HC LIP BX,806.5,443.57500000000005,178.2,4258.0,212
CPT,40500,PARTIAL EXCISION OF LIP,,,3295.61,6766.0,22
CPT,40510,HC EXC LIP TRANSVERSE WEDGE EXC W PRIMARY CLOSURE,8698.0,4783.9,2609.4,9469.0,53
CPT,40520,PARTIAL EXCISION OF LIP,,,3295.61,6766.0,22
CPT,40525,RECONSTRUCT LIP WITH FLAP,,,3295.61,9469.0,22
CPT,40527,RECONSTRUCT LIP WITH FLAP,,,5480.0,13936.0,22
CPT,40530,PARTIAL REMOVAL OF LIP,,,3295.61,9469.0,22
CPT,40650,HC REPR LIP FULL THICKNESS VERMILION ONLY,1674.0,920.7,502.2,4258.0,53
CPT,40652,"HC REPAIR LIP, FULL THICKNESS; UP TO HALF VERTICAL HEIGHT",1486.0,817.3,445.8,4258.0,53
CPT,40654,"HC REPAIR LIP, FULL THICKNESS, OVER ONE-HALF VERTICAL HEIGHT, OR COMPLEX",3780.0,2079.0,1134.0,6766.0,53
CPT,40700,REPAIR CLEFT LIP/NASAL,,,6011.49,16799.0,22
CPT,40701,REPAIR CLEFT LIP/NASAL,,,6011.49,16799.0,22
CPT,40702,REPAIR CLEFT LIP/NASAL,,,6011.49,16799.0,22
CPT,40720,REPAIR CLEFT LIP/NASAL,,,3295.61,16799.0,22
CPT,40761,REPAIR CLEFT LIP/NASAL,,,6011.49,16799.0,22
CPT,40799,UNLISTED PROCEDURE LIPS,,,235.98,29323.0,22
CPT,40800,"HC DRAIN ABSCESS, CYST, HEMATOMA, VESTIBULE OF MOUTH, SIMPLE",1562.0,859.1,468.6,4955.0,53
CPT,40801,DRAINAGE OF MOUTH LESION,,,517.5,4258.0,22
CPT,40804,"HC REMOVE EMBEDDED FOREIGN BODY, VESTIBULE OF MOUTH, SIMPLE",2204.0,1212.2,661.2,6766.0,53
CPT,40805,REMOVAL FOREIGN BODY MOUTH,,,517.5,4258.0,22
CPT,40806,INCISION OF LIP FOLD,,,517.5,4258.0,22
CPT,40808,HC BX MOUTH LESION,1247.0,685.85,332.1,4258.0,212
CPT,40810,EXCISION OF MOUTH LESION,,,3295.61,6766.0,22
CPT,40812,HC EXC LESION MUCOSA OF MOUTH W SIMPLE REPR,4771.0,2624.05,1112.4,6766.0,159
CPT,40814,EXCISE/REPAIR MOUTH LESION,,,3295.61,9469.0,22
CPT,40816,EXCISION OF MOUTH LESION,,,3295.61,9469.0,22
CPT,40818,EXCISE ORAL MUCOSA FOR GRAFT,,,517.5,4258.0,22
CPT,40819,EXCISE LIP OR CHEEK FOLD,,,1505.28,6766.0,22
CPT,40820,HC DESTRUCT MOUTH LESION SCAR,6644.0,3654.2,1993.2,6766.0,212
CPT,40830,"HC LACERATION CLOSURE, VESTIBULE OF MOUTH, 2.5 CM OR LESS",975.0,536.25,235.98,4258.0,53
CPT,40831,"HC LACERATION CLOSURE , VESTIBULE OF MOUTH, OVER 2.5 CM OR COMPLEX",1486.0,817.3,445.8,4258.0,53
CPT,40840,RECONSTRUCTION OF MOUTH,,,5480.0,13936.0,22
CPT,40842,RECONSTRUCTION OF MOUTH,,,5480.0,13936.0,22
CPT,40843,RECONSTRUCTION OF MOUTH,,,5480.0,13936.0,22
CPT,40844,RECONSTRUCTION OF MOUTH,,,6011.49,16799.0,22
CPT,40845,RECONSTRUCTION OF MOUTH,,,6011.49,16799.0,22
CPT,40899,UNLISTED PX VESTIBULE MOUTH,,,235.98,29323.0,22
CPT,41000,HC INTRORAL INC & DRN ABSCESS CYST TONGUE-FLR MOUTH-LINGUAL,1987.0,1092.85,517.5,4258.0,53
CPT,41005,"HC INTRAORAL I&D ABSCESS, CYST, HEMATOMA, SUBLINGUAL, SUPERFICIAL",660.0,363.0,198.0,4258.0,53
CPT,41006,DRAINAGE OF MOUTH LESION,,,1505.28,6766.0,22
CPT,41007,DRAINAGE OF MOUTH LESION,,,1505.28,6766.0,22
CPT,41008,"HC INTRAORAL INC-DRAIN ABSC/CYST/HEMATOMA TONGUE/FLOOR MOUTH, SUBMANDBLR SP",8698.0,4783.9,2609.4,7523.77,53
CPT,41009,"HC INTRAORAL INC-DRAIN ABSC/CYST/HEMATOMA TONGUE/FLOOR MOUTH, MASTICATOR SP",1895.0,1042.25,517.5,4258.0,53
CPT,41010,HC INCISION LINGUAL FRENUM (FRENOTOMY),3708.0,2039.4,1112.4,6766.0,53
CPT,41015,DRAINAGE OF MOUTH LESION,,,517.5,4258.0,22
CPT,41016,"HC EXTRAORAL I&D ABSCESS, CYST, HEMATOMA OF FLOOR OF MOUTH, SUBMENTAL",10109.0,5559.95,3032.7,13936.0,53
CPT,41017,"HC EXTAORAL I&D OF ABSCESS, CYST, HEMATOMA FLOOR OF MOUTH; SUBMANDIBULAR",15028.5,8265.68,3295.61,12999.65,53
CPT,41018,"HC EXTAORAL I&D OF ABSCESS, CYST, HEMATOMA FLOOR OF MOUTH, MASTICATOR SPACE",4509.0,2479.95,1352.7,6766.0,53
CPT,41019,PLACE NEEDLES H&N FOR RT,,,5480.0,13936.0,23
CPT,41100,HC TONGUE BX,1717.0,944.35,413.7,4258.0,212
CPT,41105,HC BX TONGUE POSTERIOR 1/3RD,4082.0,2245.1,1224.6,6766.0,159
CPT,41108,HC BX FLOOR OF MOUTH,1930.0,1061.5,579.0,5761.0,265
CPT,41110,HC EXCISION OF LESION OF TONGUE WITHOUT CLOSURE,8252.0,4538.6,2196.0,7944.16,212
CPT,41112,"HC EXCISION TONGUE LESION W CLOSURE, ANTERIOR TWO-THIRDS",4942.0,2718.1,1465.2,6766.0,159
CPT,41113,EXCISION OF TONGUE LESION,,,3295.61,6766.0,22
CPT,41114,EXCISION OF TONGUE LESION,,,3295.61,9469.0,22
CPT,41115,EXCISION OF TONGUE FOLD,,,1505.28,6766.0,22
CPT,41116,EXCISION OF MOUTH LESION,,,3295.61,9469.0,22
CPT,41120,PARTIAL REMOVAL OF TONGUE,,,6011.49,16799.0,22
CPT,41130,PARTIAL REMOVAL OF TONGUE,,,1188.27,13936.0,22
CPT,41135,TONGUE AND NECK SURGERY,,,1953.56,13936.0,22
CPT,41140,REMOVAL OF TONGUE,,,1966.68,13936.0,22
CPT,41145,TONGUE REMOVAL NECK SURGERY,,,2453.0,13936.0,22
CPT,41150,TONGUE MOUTH JAW SURGERY,,,1980.84,13936.0,22
CPT,41153,TONGUE MOUTH NECK SURGERY,,,2156.39,13936.0,22
CPT,41155,TONGUE JAW & NECK SURGERY,,,2453.0,13936.0,22
CPT,41250,"HC LACERATION REPAIR 2.5 CM/LESS, FLOOR MOUTH/ANTERIOR TWO-THIRDS OF TONGUE",1095.0,602.25,328.5,4258.0,53
CPT,41251,"HC REPAIR OF LACERATION 2.5 CM OR LESS, POSTERIOR ONE-THIRD OF TONGUE",623.0,342.65,186.9,4258.0,53
CPT,41252,"HC LACERATION REPAIR TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX",1318.0,724.9,235.98,4258.0,53
CPT,41510,TONGUE TO LIP SURGERY,,,3295.61,6766.0,22
CPT,41512,TONGUE SUSPENSION,,,6011.49,16799.0,22
CPT,41520,RECONSTRUCTION TONGUE FOLD,,,3295.61,16799.0,22
CPT,41530,TONGUE BASE VOL REDUCTION,,,3295.61,9469.0,22
CPT,41599,HC CAUTERIZATION TONGUE,271.0,149.05,81.3,29323.0,53
CPT,41599,"HC REMOVAL OF FOREIGN BODY, TONGUE",393.0,216.15,117.9,29323.0,53
CPT,41800,"HC DRAIN ABSCESS, CYST, HEMATOMA FROM DENTOALVEOLAR STRUCTURES",623.0,342.65,130.99,4258.0,53
CPT,41805,HC REM EMBEDDED FB DENTOALVEOLAR STRUCT SOFT TISS,6387.0,3512.85,1505.28,6766.0,53
CPT,41806,REMOVAL FOREIGN BODY JAWBONE,,,1505.28,6766.0,22
CPT,41820,EXCISION GUM EACH QUADRANT,,,3295.61,9469.0,22
CPT,41821,EXCISION OF GUM FLAP,,,1505.28,6766.0,22
CPT,41822,EXCISION OF GUM LESION,,,1505.28,6766.0,22
CPT,41823,EXCISION OF GUM LESION,,,5480.0,13936.0,22
CPT,41825,EXCISION OF GUM LESION,,,3295.61,6766.0,22
CPT,41826,EXCISION OF GUM LESION,,,3295.61,9469.0,22
CPT,41827,EXCISION OF GUM LESION,,,6011.49,16799.0,22
CPT,41828,EXCISION OF GUM LESION,,,1505.28,6766.0,22
CPT,41830,REMOVAL OF GUM TISSUE,,,3295.61,9469.0,22
CPT,41850,"HC DESTRUCTION LESION, DENTOALVEOLAR STRUCTURES",3708.0,2039.4,1112.4,6766.0,53
CPT,41870,PERIODONTAL MUCOSAL GRAFTING,,,1505.28,6766.0,22
CPT,41872,GINGIVOPLASTY EACH QUADRANT,,,3295.61,16799.0,22
CPT,41874,ALVEOLOPLASTY EACH QUADRANT,,,3295.61,6766.0,22
CPT,41899,HC CAUTERIZATION AFTER TOOTH EXTRACTION,271.0,149.05,81.3,29323.0,53
CPT,41899,"HC CLOSED TREATMENT TOOTH DISCLOCATION, EACH TOOTH",501.0,275.55,150.3,29323.0,53
CPT,41899,"HC NEEDLE ASPIRATION, PERIODONTAL ABSCESS",669.0,367.95,200.7,29323.0,53
CPT,41899,"HC WOUND REPAIR, GUM LACERATION",4466.0,2456.3,235.98,29323.0,53
CPT,42000,"HC DRAINAGE OF ABSCESS OF PALATE, UVULA",817.0,449.35,235.98,4258.0,53
CPT,42100,HC PALATE UVULA BX,1961.0,1078.55,588.3,6766.0,318
CPT,42104,HC EXC LESION PALATE UVULA WO CLOSURE,7828.0,4305.4,2348.4,6771.22,53
CPT,42106,EXCISION LESION MOUTH ROOF,,,3295.61,6766.0,22
CPT,42107,EXCISION LESION MOUTH ROOF,,,5480.0,13936.0,22
CPT,42120,HC RESECTION OF PALATE OR EXTENSIVE RESECTION OF LESION,14239.0,7831.45,4271.7,13936.0,53
CPT,42140,"HC UVULECTOMY, EXCISION OF UVULA",8698.0,4783.9,2609.4,7523.77,53
CPT,42145,REPAIR PALATE PHARYNX/UVULA,,,5480.0,13936.0,22
CPT,42160,TREATMENT MOUTH ROOF LESION,,,3295.61,6766.0,22
CPT,42180,"HC REPAIR, LACERATION OF PALATE, UP TO 2 CM",1403.0,771.65,420.9,4258.0,53
CPT,42182,"HC REPAIR, LACERATION OF PALATE, OVER 2 CM OR COMPLEX",14936.0,8214.8,4480.8,13936.0,53
CPT,42200,RECONSTRUCT CLEFT PALATE,,,6011.49,16799.0,22
CPT,42205,RECONSTRUCT CLEFT PALATE,,,3295.61,16799.0,22
CPT,42210,RECONSTRUCT CLEFT PALATE,,,6011.49,16799.0,22
CPT,42215,RECONSTRUCT CLEFT PALATE,,,6011.49,16799.0,22
CPT,42220,RECONSTRUCT CLEFT PALATE,,,6011.49,16799.0,22
CPT,42225,RECONSTRUCT CLEFT PALATE,,,6011.49,16799.0,22
CPT,42226,LENGTHENING OF PALATE,,,6011.49,16799.0,22
CPT,42227,LENGTHENING OF PALATE,,,6011.49,16799.0,22
CPT,42235,REPAIR PALATE,,,6011.49,16799.0,22
CPT,42260,REPAIR NOSE TO LIP FISTULA,,,5480.0,13936.0,22
CPT,42280,PREPARATION PALATE MOLD,,,517.5,4258.0,22
CPT,42281,INSERTION PALATE PROSTHESIS,,,3917.0,13936.0,22
CPT,42299,"HC SP ONLY, PALATE RADIOFREQUENCY",500.0,275.0,150.0,29323.0,53
CPT,42300,"HC DRAINAGE OF ABSCESS, PAROTID, SIMPLE",3879.0,2133.45,1163.7,6766.0,53
CPT,42305,DRAINAGE OF SALIVARY GLAND,,,3295.61,9469.0,22
CPT,42310,"HC DRAINAGE OF ABSCESS, SUBMAXILLARY OR SUBLINGUAL, INTRAORAL",1567.0,861.85,470.1,4258.0,53
CPT,42320,DRAINAGE OF SALIVARY GLAND,,,517.5,4258.0,22
CPT,42330,HC SIALOLITHOTOMY SUBMANDBLR UNCOMPLICATD INTRORAL,7813.0,4297.15,1830.9,8237.4,212
CPT,42335,REMOVAL OF SALIVARY STONE,,,3295.61,9469.0,22
CPT,42340,REMOVAL OF SALIVARY STONE,,,3295.61,6766.0,22
CPT,42400,HC NEEDLE BX SALIVARY GLAND,2258.0,1241.9,677.4,4955.0,212
CPT,42405,HC BX SALIVARY GLAND INCISIONAL,3708.0,2039.4,1112.4,6766.0,53
CPT,42408,EXCISION OF SALIVARY CYST,,,3295.61,9469.0,22
CPT,42409,DRAINAGE OF SALIVARY CYST,,,3295.61,9469.0,22
CPT,42410,EXCISE PAROTID GLAND/LESION,,,6011.49,16799.0,22
CPT,42415,EXCISE PAROTID GLAND/LESION,,,6011.49,16799.0,22
CPT,42420,HC EXCISION OF PAROTID TUMOR OR GLAND TOTAL DISSECTION & PRSRV FACIAL NERVE,17577.0,9667.35,5273.1,16799.0,106
CPT,42425,EXCISE PAROTID GLAND/LESION,,,6011.49,16799.0,22
CPT,42426,EXCISE PAROTID GLAND/LESION,,,1220.13,13936.0,22
CPT,42440,EXCISE SUBMAXILLARY GLAND,,,6011.49,16799.0,22
CPT,42450,EXCISE SUBLINGUAL GLAND,,,5480.0,13936.0,22
CPT,42500,"HC PLASTIC REPR SALIVARY DUCT, SIALODOCHOPLASTY, PRIMARY OR SIMPLE",14239.0,7831.45,4271.7,13936.0,53
CPT,42505,REPAIR SALIVARY DUCT,,,6011.49,16799.0,22
CPT,42507,PAROTID DUCT DIVERSION,,,6011.49,16799.0,22
CPT,42509,PAROTID DUCT DIVERSION,,,6011.49,16799.0,22
CPT,42510,PAROTID DUCT DIVERSION,,,3295.61,16799.0,22
CPT,42550,INJECTION FOR SALIVARY X-RAY,,,138.92,3533.0,22
CPT,42600,CLOSURE OF SALIVARY FISTULA,,,3295.61,6766.0,22
CPT,42650,DILATION OF SALIVARY DUCT,,,1505.28,6766.0,22
CPT,42660,DILATION OF SALIVARY DUCT,,,905.62,905.62,1
CPT,42660,"HC DILATION AND CATHETERIZATION OF SALIVARY DUCT, WITH OR WITHOUT INJECTION",1338.0,735.9,401.4,4258.0,53
CPT,42665,LIGATION OF SALIVARY DUCT,,,3295.61,9469.0,22
CPT,42699,UNLISTED PX SALIVRY GLND/DUX,,,235.98,29323.0,22
CPT,42700,HC INC & DRN TONSIL ABSCESS,953.0,524.15,235.98,4258.0,106
CPT,42720,I&D ABSC PHRNGL NTRAORL APPR,,,3295.61,6766.0,22
CPT,42725,I&D ABSC PHRNGL XTRNL APPR,,,6011.49,16799.0,22
CPT,42800,HC OROPHARYNX BX,4997.0,2748.3500000000004,1112.4,5761.0,159
CPT,42804,BIOPSY OF UPPER NOSE/THROAT,,,3295.61,6766.0,22
CPT,42806,BIOPSY OF UPPER NOSE/THROAT,,,3295.61,9469.0,22
CPT,42808,EXCISE PHARYNX LESION,,,3295.61,9469.0,22
CPT,42809,HC REM FOREIGN BODY PHARYNX,728.0,400.4,218.4,4258.0,53
CPT,42810,EXCISION OF NECK CYST,,,3295.61,9469.0,22
CPT,42815,EXCISION OF NECK CYST,,,6011.49,16799.0,22
CPT,42820,REMOVE TONSILS AND ADENOIDS,,,5480.0,13936.0,22
CPT,42821,REMOVE TONSILS AND ADENOIDS,,,3295.61,9469.0,22
CPT,42825,REMOVAL OF TONSILS,,,5480.0,13936.0,22
CPT,42826,REMOVAL OF TONSILS,,,3295.61,9469.0,22
CPT,42830,REMOVAL OF ADENOIDS,,,3295.61,9469.0,22
CPT,42831,REMOVAL OF ADENOIDS,,,3295.61,9469.0,22
CPT,42835,REMOVAL OF ADENOIDS,,,3295.61,9469.0,22
CPT,42836,REMOVAL OF ADENOIDS,,,3295.61,9469.0,22
CPT,42842,EXTENSIVE SURGERY OF THROAT,,,5480.0,13936.0,22
CPT,42844,EXTENSIVE SURGERY OF THROAT,,,6011.49,16799.0,22
CPT,42845,EXTENSIVE SURGERY OF THROAT,,,1987.0,13936.0,22
CPT,42860,EXCISION OF TONSIL TAGS,,,3295.61,9469.0,22
CPT,42870,EXCISION OF LINGUAL TONSIL,,,5480.0,13936.0,22
CPT,42890,LIMITED PHARYNGECTOMY,,,6011.49,16799.0,22
CPT,42892,REVISION OF PHARYNGEAL WALLS,,,6011.49,16799.0,22
CPT,42894,REVISION OF PHARYNGEAL WALLS,,,2134.16,13936.0,22
CPT,42900,REPAIR THROAT WOUND,,,1505.28,6766.0,22
CPT,42950,HC PHARYNGOPLASTY,10272.0,5649.6,3081.6,13936.0,106
CPT,42953,REPAIR THROAT ESOPHAGUS,,,874.59,8363.0,22
CPT,42955,SURGICAL OPENING OF THROAT,,,1505.28,6766.0,22
CPT,42960,HC CONTROL THROAT BLEEDING,1017.0,559.35,305.1,4258.0,53
CPT,42961,CONTROL THROAT BLEEDING,,,385.28,9469.0,22
CPT,42962,CONTROL THROAT BLEEDING,,,3295.61,9469.0,22
CPT,42970,CONTROL NOSE/THROAT BLEEDING,,,235.98,4258.0,22
CPT,42971,CONTROL NOSE/THROAT BLEEDING,,,415.27,8363.0,22
CPT,42972,CONTROL NOSE/THROAT BLEEDING,,,3295.61,6766.0,22
CPT,42975,DISE EVAL SLP DO BRTH FLX DX,,,835.0,5761.0,22
CPT,42999,HC EXCISION/DESTRUCTION LESION TONSIL,393.0,216.15,117.9,29323.0,53
CPT,42999,HC NEEDLE ASPIRATION OF PERITONSILLAR ABSCESS,897.0,493.35,235.98,29323.0,106
CPT,43020,INCISION OF ESOPHAGUS,,,1505.28,6766.0,22
CPT,43030,CRICOPHARYNGEAL MYOTOMY,,,6011.49,16799.0,22
CPT,43045,ESOPHAGOTOMY THRC RMVL FB,,,1127.93,13936.0,22
CPT,43100,EXCISION OF ESOPHAGUS LESION,,,582.11,8363.0,22
CPT,43101,EXCISION OF ESOPHAGUS LESION,,,869.21,13936.0,22
CPT,43107,REMOVAL OF ESOPHAGUS,,,2453.0,13936.0,22
CPT,43108,REMOVAL OF ESOPHAGUS,,,2453.0,13936.0,22
CPT,43112,ESPHG TOT W/THRCM,,,2453.0,13936.0,22
CPT,43113,REMOVAL OF ESOPHAGUS,,,2453.0,13936.0,22
CPT,43116,PARTIAL REMOVAL OF ESOPHAGUS,,,2453.0,13936.0,22
CPT,43117,PARTIAL REMOVAL OF ESOPHAGUS,,,2453.0,13936.0,22
CPT,43118,PARTIAL REMOVAL OF ESOPHAGUS,,,2453.0,13936.0,22
CPT,43121,PARTIAL REMOVAL OF ESOPHAGUS,,,2435.85,13936.0,22
CPT,43122,PARTIAL REMOVAL OF ESOPHAGUS,,,2220.94,13936.0,22
CPT,43123,PARTIAL REMOVAL OF ESOPHAGUS,,,2453.0,13936.0,22
CPT,43124,REMOVAL OF ESOPHAGUS,,,2453.0,13936.0,22
CPT,43130,REMOVAL OF ESOPHAGUS POUCH,,,6011.49,16799.0,22
CPT,43135,REMOVAL OF ESOPHAGUS POUCH,,,1257.51,8363.0,22
CPT,43180,ESOPHAGOSCOPY RIGID TRNSO,,,5480.0,13936.0,22
CPT,43191,ESOPHAGOSCOPY RIGID TRNSO DX,,,1927.72,6766.0,22
CPT,43192,ESOPHAGOSCP RIG TRNSO INJECT,,,1927.72,6766.0,22
CPT,43193,ESOPHAGOSCP RIG TRNSO BIOPSY,,,1927.72,6766.0,22
CPT,43194,ESOPHAGOSCP RIG TRNSO REM FB,,,1927.72,6766.0,22
CPT,43195,ESOPHAGOSCOPY RIGID BALLOON,,,3866.16,8363.0,22
CPT,43196,ESOPHAGOSCP GUIDE WIRE DILAT,,,1927.72,8363.0,22
CPT,43197,ESOPHAGOSCOPY FLEX DX BRUSH,,,952.75,6766.0,22
CPT,43198,ESOPHAGOSC FLEX TRNSN BIOPSY,,,952.75,6766.0,22
CPT,43200,ESOPHAGOSCOPY FLEXIBLE BRUSH,,,952.75,6766.0,22
CPT,43201,ESOPH SCOPE W/SUBMUCOUS INJ,,,1927.72,6766.0,22
CPT,43202,ESOPHAGOSCOPY FLEX BIOPSY,,,1927.72,6766.0,22
CPT,43204,ESOPH SCOPE W/SCLEROSIS INJ,,,1927.72,6766.0,22
CPT,43205,ESOPHAGUS ENDOSCOPY/LIGATION,,,1927.72,6766.0,22
CPT,43206,ESOPH OPTICAL ENDOMICROSCOPY,,,1927.72,6766.0,22
CPT,43210,EGD ESOPHAGOGASTRC FNDOPLSTY,,,8488.0,19884.0,22
CPT,43211,ESOPHAGOSCOP MUCOSAL RESECT,,,1927.72,6766.0,22
CPT,43212,ESOPHAGOSCOP STENT PLACEMENT,,,6049.25,14658.0,22
CPT,43213,ESOPHAGOSCOPY RETRO BALLOON,,,1927.72,6766.0,22
CPT,43214,ESOPHAGOSC DILATE BALLOON 30,,,1927.72,6766.0,22
CPT,43215,ESOPHAGOSCOPY FLEX REMOVE FB,,,1927.72,6766.0,22
CPT,43216,ESOPHAGOSCOPY LESION REMOVAL,,,1927.72,9469.0,22
CPT,43217,ESOPHAGOSCOPY SNARE LES REMV,,,1927.72,6766.0,22
CPT,43220,ESOPHAGOSCOPY BALLOON <30MM,,,1927.72,6766.0,22
CPT,43226,ESOPH ENDOSCOPY DILATION,,,1927.72,6766.0,22
CPT,43227,ESOPHAGOSCOPY CONTROL BLEED,,,1927.72,6766.0,22
CPT,43229,ESOPHAGOSCOPY LESION ABLATE,,,3866.16,9469.0,22
CPT,43231,ESOPHAGOSCOP ULTRASOUND EXAM,,,1927.72,6766.0,22
CPT,43232,ESOPHAGOSCOPY W/US NEEDLE BX,,,1927.72,6766.0,22
CPT,43233,EGD BALLOON DIL ESOPH30 MM/>,,,1927.72,6766.0,22
CPT,43235,HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC,2826.0,1554.3,847.8,6766.0,53
CPT,43236,UPPR GI SCOPE W/SUBMUC INJ,,,952.75,6766.0,22
CPT,43237,ENDOSCOPIC US EXAM ESOPH,,,1927.72,6766.0,22
CPT,43238,"HC EGD, FLEX, TRANS-ORAL W/ US GUIDE INTRMURAL FNA/BX INCL US EXAM OF EGD",4853.0,2669.15,1455.9,6766.0,53
CPT,43239,EGD BIOPSY SINGLE/MULTIPLE,,,952.75,6766.0,22
CPT,43240,EGD W/TRANSMURAL DRAIN CYST,,,5480.0,9469.0,22
CPT,43241,EGD TUBE/CATH INSERTION,,,1927.72,6766.0,22
CPT,43242,EGD US FINE NEEDLE BX/ASPIR,,,1927.72,6766.0,22
CPT,43243,EGD INJECTION VARICES,,,1927.72,6766.0,22
CPT,43244,EGD VARICES LIGATION,,,1927.72,6766.0,22
CPT,43245,"HC ESOPHGDSCOPY, FLEX, TRANSORAL, W/ DILATION GASTRIC/DUODENAL STRICTURE(S)",4810.0,2645.5,1443.0,6766.0,53
CPT,43246,HC ESOPHAGOGASTRODUODENOSC FLEX TRANSORAL W DIR PLC PERC G-TUBE,5140.0,2827.0,1542.0,6766.0,53
CPT,43247,HC EGD FLEXIBLE FOREIGN BODY REMOVAL,2826.0,1554.3,847.8,6766.0,53
CPT,43248,EGD GUIDE WIRE INSERTION,,,952.75,6766.0,22
CPT,43249,ESOPH EGD DILATION <30 MM,,,1927.72,6766.0,22
CPT,43250,EGD CAUTERY TUMOR POLYP,,,1927.72,6766.0,22
CPT,43251,EGD REMOVE LESION SNARE,,,1927.72,6766.0,22
CPT,43252,EGD OPTICAL ENDOMICROSCOPY,,,1927.72,8363.0,22
CPT,43253,EGD US TRANSMURAL INJXN/MARK,,,1927.72,6766.0,22
CPT,43254,EGD ENDO MUCOSAL RESECTION,,,1927.72,6766.0,22
CPT,43255,EGD CONTROL BLEEDING ANY,,,1927.72,6766.0,22
CPT,43257,EGD W/THRML TXMNT GERD,,,3866.16,9469.0,22
CPT,43259,EGD US EXAM DUODENUM/JEJUNUM,,,1927.72,6766.0,22
CPT,43260,"HC ERCP, DX, INCL COLLECT SPECIMEN(S) BY BRUSHING/WASHING",8403.0,4621.65,2520.9,9469.0,53
CPT,43261,ENDO CHOLANGIOPANCREATOGRAPH,,,3866.16,9469.0,22
CPT,43262,"HC ERCP, W/ SPHINCTERTOMY/PAPILLOTOMY",6348.0,3491.4,1904.4,9469.0,53
CPT,43263,HC ERCP W PRESSURE MEASURE SPHINCTER OF ODDI,4640.0,2552.0,1392.0,9469.0,53
CPT,43264,"HC ERCP, W/ REM CALCULI/DEBRIS FROM BILILARY/PANCREATIC DUCT(S)",5963.0,3279.65,1788.9,9469.0,53
CPT,43265,ERCP LITHOTRIPSY CALCULI,,,5480.0,13936.0,22
CPT,43266,"HC EGD, FLEXIBLE, TRANSORAL, W/ PLACEMENT OF ENDOSCOPIC STENT",13506.0,7428.3,4051.8,14658.0,53
CPT,43270,EGD LESION ABLATION,,,1927.72,6766.0,22
CPT,43273,ENDOSCOPIC PANCREATOSCOPY,,,106.3,3533.0,21
CPT,43274,"HC ERCP, W/ PLC ENDOSCOPIC STENT INTO BILIARY/PANCREATIC DUCT, EA STENT",7411.0,4076.05,2223.3,13936.0,53
CPT,43275,ERCP REMOVE FORGN BODY DUCT,,,1927.72,8363.0,22
CPT,43276,ERCP STENT EXCHANGE W/DILATE,,,5480.0,13936.0,22
CPT,43277,ERCP EA DUCT/AMPULLA DILATE,,,3866.16,9469.0,22
CPT,43278,ERCP LESION ABLATE W/DILATE,,,3866.16,9469.0,22
CPT,43279,LAP MYOTOMY HELLER,,,1113.01,19884.0,22
CPT,43280,LAPAROSCOPY FUNDOPLASTY,,,10315.0,19884.0,22
CPT,43281,LAP PARAESOPHAG HERN REPAIR,,,10315.0,19884.0,22
CPT,43282,LAP PARAESOPH HER RPR W/MESH,,,10315.0,19884.0,22
CPT,43283,LAP ESOPH LENGTHENING,,,134.09,19884.0,22
CPT,43284,LAPS ESOPHGL SPHNCTR AGMNTJ,,,10315.0,19884.0,22
CPT,43285,RMVL ESOPHGL SPHNCTR DEV,,,5928.88,17804.0,22
CPT,43286,ESPHG TOT W/LAPS MOBLJ,,,2453.0,16786.0,22
CPT,43287,ESPHG DSTL 2/3 W/LAPS MOBLJ,,,2453.0,16786.0,22
CPT,43288,ESPHG THRSC MOBLJ,,,2453.0,16786.0,22
CPT,43289,UNLISTED LAPS PX ESOPH,,,5928.88,16799.0,22
CPT,43290,EGD FLX TRNSORL DPLMNT BALO,,,1927.72,6766.0,22
CPT,43291,EGD FLX TRNSORL RMVL BALO,,,952.75,6766.0,22
CPT,43300,REPAIR OF ESOPHAGUS,,,574.21,13936.0,22
CPT,43305,REPAIR ESOPHAGUS AND FISTULA,,,994.9,13936.0,22
CPT,43310,REPAIR OF ESOPHAGUS,,,1269.3,13936.0,22
CPT,43312,REPAIR ESOPHAGUS AND FISTULA,,,1349.27,13936.0,22
CPT,43313,ESOPHAGOPLASTY CONGENITAL,,,2453.0,13936.0,22
CPT,43314,TRACHEO-ESOPHAGOPLASTY CONG,,,2453.0,13936.0,22
CPT,43320,FUSE ESOPHAGUS & STOMACH,,,1217.23,13936.0,22
CPT,43325,REVISE ESOPHAGUS & STOMACH,,,1184.18,13936.0,22
CPT,43327,ESOPH FUNDOPLASTY LAP,,,730.22,16786.0,22
CPT,43328,ESOPH FUNDOPLASTY THOR,,,960.83,16786.0,22
CPT,43330,ESOPHAGOMYOTOMY ABDOMINAL,,,1164.9,13936.0,22
CPT,43331,ESOPHAGOMYOTOMY THORACIC,,,1154.03,13936.0,22
CPT,43332,TRANSAB ESOPH HIAT HERN RPR,,,996.42,16786.0,22
CPT,43333,TRANSAB ESOPH HIAT HERN RPR,,,1095.33,16786.0,22
CPT,43334,TRANSTHOR DIAPHRAG HERN RPR,,,1061.92,16786.0,22
CPT,43335,TRANSTHOR DIAPHRAG HERN RPR,,,1138.05,16786.0,22
CPT,43336,THORABD DIAPHR HERN REPAIR,,,1237.67,16786.0,22
CPT,43337,THORABD DIAPHR HERN REPAIR,,,1317.9,16786.0,22
CPT,43338,ESOPH LENGTHENING,,,96.46,16786.0,22
CPT,43340,FUSE ESOPHAGUS & INTESTINE,,,1202.31,13936.0,22
CPT,43341,FUSE ESOPHAGUS & INTESTINE,,,1205.09,13936.0,22
CPT,43351,SURGICAL OPENING ESOPHAGUS,,,1142.21,13936.0,22
CPT,43352,SURGICAL OPENING ESOPHAGUS,,,925.21,13936.0,22
CPT,43360,GASTROINTESTINAL REPAIR,,,1923.22,13936.0,22
CPT,43361,GASTROINTESTINAL REPAIR,,,2341.43,13936.0,22
CPT,43400,LIGATE ESOPHAGUS VEINS,,,1324.14,17804.0,22
CPT,43405,LIGATE/STAPLE ESOPHAGUS,,,1259.08,13936.0,22
CPT,43410,REPAIR ESOPHAGUS WOUND,,,943.75,13936.0,22
CPT,43415,REPAIR ESOPHAGUS WOUND,,,2212.73,13936.0,22
CPT,43420,REPAIR ESOPHAGUS OPENING,,,3295.61,9469.0,22
CPT,43425,REPAIR ESOPHAGUS OPENING,,,1240.45,13936.0,22
CPT,43450,DILATE ESOPHAGUS 1/MULT PASS,,,952.75,6766.0,22
CPT,43453,DILATE ESOPHAGUS,,,1927.72,6766.0,22
CPT,43460,PRESSURE TREATMENT ESOPHAGUS,,,190.77,5761.0,22
CPT,43496,FREE JEJUNUM FLAP MICROVASC,,,2453.0,8363.0,7
CPT,43497,TRANSORL LWR ESOPHGL MYOTOMY,,,5480.0,9469.0,22
CPT,43499,UNLISTED PROCEDURE ESOPHAGUS,,,952.75,29323.0,22
CPT,43500,SURGICAL OPENING OF STOMACH,,,692.61,8363.0,22
CPT,43501,SURGICAL REPAIR OF STOMACH,,,1175.95,8363.0,22
CPT,43502,SURGICAL REPAIR OF STOMACH,,,1327.26,8363.0,22
CPT,43510,SURGICAL OPENING OF STOMACH,,,952.75,6766.0,22
CPT,43520,INCISION OF PYLORIC MUSCLE,,,626.75,8363.0,22
CPT,43605,BIOPSY OF STOMACH,,,740.26,9469.0,22
CPT,43610,EXCISION OF STOMACH LESION,,,853.98,8363.0,22
CPT,43611,EXCISION OF STOMACH LESION,,,1075.13,8363.0,22
CPT,43620,REMOVAL OF STOMACH,,,1717.36,8363.0,22
CPT,43621,REMOVAL OF STOMACH,,,1975.61,8363.0,22
CPT,43622,REMOVAL OF STOMACH,,,1997.15,8363.0,22
CPT,43631,REMOVAL OF STOMACH PARTIAL,,,1266.71,8363.0,22
CPT,43632,REMOVAL OF STOMACH PARTIAL,,,1768.03,8363.0,22
CPT,43633,REMOVAL OF STOMACH PARTIAL,,,1673.61,8363.0,22
CPT,43634,REMOVAL OF STOMACH PARTIAL,,,1838.86,8363.0,22
CPT,43635,REMOVAL OF STOMACH PARTIAL,,,96.35,8363.0,22
CPT,43640,VAGOTOMY & PYLORUS REPAIR,,,1041.29,8363.0,22
CPT,43641,VAGOTOMY & PYLORUS REPAIR,,,1053.01,8363.0,22
CPT,43644,LAP GASTRIC BYPASS/ROUX-EN-Y,,,1510.77,17804.0,22
CPT,43645,LAP GASTR BYPASS INCL SMLL I,,,1609.9,17804.0,22
CPT,43647,LAP IMPL ELECTRODE ANTRUM,,,12463.0,21512.0,22
CPT,43648,LAP REVISE/REMV ELTRD ANTRUM,,,9733.0,16799.0,22
CPT,43651,LAPAROSCOPY VAGUS NERVE,,,5928.88,17804.0,22
CPT,43652,LAPAROSCOPY VAGUS NERVE,,,5928.88,17804.0,22
CPT,43653,LAPAROSCOPY GASTROSTOMY,,,5928.88,17804.0,22
CPT,43659,UNLISTED LAPS PX STOMACH,,,5928.88,16799.0,22
CPT,43752,HC NASO ORO GASTRIC TUBE PLC BY PHYS FLUORO GUIDE,1142.5,628.375,239.4,4258.0,265
CPT,43753,"HC GASTRIC INTUBATION/ASPIR THERAPEUT, NECESSITATING PHYS SKILL INCL LAVAGE",411.0,226.05,123.3,4258.0,53
CPT,43754,DX GASTR INTUB W/ASP SPEC,,,316.44,4258.0,22
CPT,43755,HC GASTRIC INTUBATION ASPIR DX MULT SPECIMEN,346.0,190.3,103.8,4258.0,53
CPT,43756,DX DUOD INTUB W/ASP SPEC,,,952.75,6766.0,22
CPT,43757,DX DUOD INTUB W/ASP SPECS,,,952.75,6766.0,22
CPT,43761,HC REPOSITION NASO ORO GASTRIC FEEDING TUBE,2062.0,1134.1,247.15,4258.0,212
CPT,43762,"HC REPLC GASTROSTOMY TUBE, INCL REM, W/O IMG GUID, W/O REV GASTROST TRACT",1005.5,553.0250000000001,247.15,4258.0,583
CPT,43763,"HC REPLC GASTROSTOMY TUBE, INCL REM, W/O IMG GUID, W REV GASTROST TRACT",1030.0,566.5,247.15,4258.0,371
CPT,43770,LAP PLACE GASTR ADJ DEVICE,,,10315.0,19884.0,22
CPT,43771,LAP REVISE GASTR ADJ DEVICE,,,1117.41,16786.0,22
CPT,43772,LAP RMVL GASTR ADJ DEVICE,,,3866.16,14658.0,22
CPT,43773,LAP REPLACE GASTR ADJ DEVICE,,,5928.88,16799.0,22
CPT,43774,LAP RMVL GASTR ADJ ALL PARTS,,,3866.16,21512.0,22
CPT,43775,LAP SLEEVE GASTRECTOMY,,,950.86,17804.0,22
CPT,43800,PYLOROPLASTY,,,813.45,8363.0,22
CPT,43810,GASTRODUODENOSTOMY,,,888.09,8363.0,22
CPT,43820,GASTROJEJUNOSTOMY WO VAGOTMY,,,1176.16,8363.0,22
CPT,43825,GASTROJEJUNOSTOMY W/VAGOTOMY,,,1144.14,8363.0,22
CPT,43830,GSTRST OPEN WO CONSTJ TUBE,,,1927.72,9469.0,22
CPT,43831,GASTROSTOMY OPEN NEONATAL,,,952.75,6766.0,22
CPT,43832,GSTRST OPEN W/CONSTJ TUBE,,,916.98,8363.0,22
CPT,43840,GSTRRPHY SUTR DUOL/GSTR ULCR,,,1188.58,14658.0,22
CPT,43842,GSTR RSTCV PX V-BANDED GSTP,,,1056.87,8363.0,22
CPT,43843,GSTR RSTCV OTH/THN V-BAND,,,1121.23,16799.0,22
CPT,43845,GASTROPLASTY DUODENAL SWITCH,,,1708.68,8363.0,22
CPT,43846,GSTR RSTCV PX SHRT ROUX-EN-Y,,,1439.92,8363.0,22
CPT,43847,GSTR RSTCV PX SM INT RCNSTJ,,,1573.7,8363.0,22
CPT,43848,REVJ OPEN GSTR RSTCV PX,,,1686.74,8363.0,22
CPT,43860,REVJ GSTR/JJ ANAST W/O VGTMY,,,1425.79,8363.0,22
CPT,43865,REVJ GSTR/JJ ANAST W/VGTMY,,,1484.25,8363.0,22
CPT,43870,CLOSURE GASTROSTOMY SURGICAL,,,3866.16,9469.0,22
CPT,43880,CLOSURE GASTROCOLIC FISTULA,,,1396.86,8363.0,22
CPT,43881,IMPL/RPLCMT GSTR NSTIM ELTRD,,,2453.0,8363.0,7
CPT,43882,REV/RMVL GSTR NSTIM ELTRD,,,2453.0,8363.0,7
CPT,43886,GSTR RSTCV PX OPN REVJ PORT,,,3720.28,14658.0,22
CPT,43887,GSTR RSTCV PX OPN RMVL PORT,,,1858.86,6766.0,22
CPT,43888,GSTR RSTCV PX OPN RMVL&RPLC,,,3720.28,14658.0,22
CPT,43999,HC ADJUST GASTRIC BAND DIAMETER EST PATIENT,85.0,46.75,25.5,29323.0,106
CPT,43999,HC ADJUST GASTRIC BAND DIAMETER NEW PATIENT,85.0,46.75,25.5,29323.0,106
CPT,43999,HC INSERT NASTROGASTRIC TUBE BY RN,1444.0,794.2,433.2,29323.0,53
CPT,44005,FREEING OF BOWEL ADHESION,,,954.31,8363.0,22
CPT,44010,INCISION OF SMALL BOWEL,,,759.25,8363.0,22
CPT,44015,INSERT NEEDLE CATH BOWEL,,,120.9,8363.0,22
CPT,44020,EXPLORE SMALL INTESTINE,,,853.3,8363.0,22
CPT,44021,DECOMPRESS SMALL BOWEL,,,852.5,8363.0,22
CPT,44025,INCISION OF LARGE BOWEL,,,862.64,8363.0,22
CPT,44050,REDUCE BOWEL OBSTRUCTION,,,820.47,8363.0,22
CPT,44055,CORRECT MALROTATION OF BOWEL,,,1299.53,8363.0,22
CPT,44100,BIOPSY OF BOWEL,,,952.75,6766.0,22
CPT,44110,EXCISE INTESTINE LESION(S),,,750.85,8363.0,22
CPT,44111,EXCISION OF BOWEL LESION(S),,,865.89,8363.0,22
CPT,44120,REMOVAL OF SMALL INTESTINE,,,1066.68,8363.0,22
CPT,44121,REMOVAL OF SMALL INTESTINE,,,207.07,8363.0,22
CPT,44125,REMOVAL OF SMALL INTESTINE,,,1031.76,8363.0,22
CPT,44126,ENTERECTOMY W/O TAPER CONG,,,2139.11,8363.0,22
CPT,44127,ENTERECTOMY W/TAPER CONG,,,2453.0,8363.0,22
CPT,44128,ENTERECTOMY CONG ADD-ON,,,207.32,8363.0,22
CPT,44130,BOWEL TO BOWEL FUSION,,,1153.37,8363.0,22
CPT,44132,ENTERECTOMY CADAVER DONOR,,,2453.0,13936.0,7
CPT,44133,ENTERECTOMY LIVE DONOR,,,2453.0,8363.0,7
CPT,44135,INTESTINE TRANSPLNT CADAVER,,,2453.0,13936.0,7
CPT,44136,INTESTINE TRANSPLANT LIVE,,,2453.0,8363.0,7
CPT,44137,REMOVE INTESTINAL ALLOGRAFT,,,2453.0,8363.0,7
CPT,44139,MOBILIZATION OF COLON,,,103.8,8363.0,22
CPT,44140,PARTIAL REMOVAL OF COLON,,,1174.7,8363.0,22
CPT,44141,PARTIAL REMOVAL OF COLON,,,1581.24,8363.0,22
CPT,44143,PARTIAL REMOVAL OF COLON,,,1439.74,8363.0,22
CPT,44144,PARTIAL REMOVAL OF COLON,,,1539.52,8363.0,22
CPT,44145,PARTIAL REMOVAL OF COLON,,,1447.47,8363.0,22
CPT,44146,PARTIAL REMOVAL OF COLON,,,1837.09,8363.0,22
CPT,44147,PARTIAL REMOVAL OF COLON,,,1686.88,8363.0,22
CPT,44150,REMOVAL OF COLON,,,1625.07,8363.0,22
CPT,44151,REMOVAL OF COLON/ILEOSTOMY,,,1864.88,8363.0,22
CPT,44155,REMOVAL OF COLON/ILEOSTOMY,,,1818.16,8363.0,22
CPT,44156,REMOVAL OF COLON/ILEOSTOMY,,,1992.64,8363.0,22
CPT,44157,COLECTOMY W/ILEOANAL ANAST,,,1895.77,8363.0,22
CPT,44158,COLECTOMY W/NEO-RECTUM POUCH,,,1942.45,8363.0,22
CPT,44160,REMOVAL OF COLON,,,1088.87,8363.0,22
CPT,44180,LAP ENTEROLYSIS,,,5928.88,17804.0,22
CPT,44186,LAP JEJUNOSTOMY,,,5928.88,17804.0,22
CPT,44187,LAP ILEO/JEJUNO-STOMY,,,968.4,16786.0,22
CPT,44188,LAP COLOSTOMY,,,1069.36,16786.0,22
CPT,44202,LAP ENTERECTOMY,,,1212.73,16799.0,22
CPT,44203,LAP RESECT S/INTESTINE ADDL,,,206.65,16799.0,22
CPT,44204,LAPARO PARTIAL COLECTOMY,,,1346.3,16799.0,22
CPT,44205,LAP COLECTOMY PART W/ILEUM,,,1172.62,16786.0,22
CPT,44206,LAP PART COLECTOMY W/STOMA,,,1521.22,16786.0,22
CPT,44207,L COLECTOMY/COLOPROCTOSTOMY,,,1590.17,16786.0,22
CPT,44208,L COLECTOMY/COLOPROCTOSTOMY,,,1731.05,16786.0,22
CPT,44210,LAPARO TOTAL PROCTOCOLECTOMY,,,1566.45,16786.0,22
CPT,44211,LAP COLECTOMY W/PROCTECTOMY,,,1897.13,16786.0,22
CPT,44212,LAPARO TOTAL PROCTOCOLECTOMY,,,1800.85,16786.0,22
CPT,44213,LAP MOBIL SPLENIC FL ADD-ON,,,161.99,16786.0,22
CPT,44227,LAP CLOSE ENTEROSTOMY,,,1449.44,16786.0,22
CPT,44238,UNLISTED LAPS PX INTESTINE,,,5928.88,16799.0,22
CPT,44300,OPEN BOWEL TO SKIN,,,737.98,8363.0,22
CPT,44310,ILEOSTOMY/JEJUNOSTOMY,,,916.0,8363.0,22
CPT,44312,REVISION OF ILEOSTOMY,,,3720.28,14658.0,22
CPT,44314,REVISION OF ILEOSTOMY,,,891.61,14658.0,22
CPT,44316,DEVISE BOWEL POUCH,,,1232.5,8363.0,22
CPT,44320,COLOSTOMY,,,1057.02,8363.0,22
CPT,44322,COLOSTOMY WITH BIOPSIES,,,886.81,8363.0,22
CPT,44340,REVISION OF COLOSTOMY,,,3720.28,14658.0,22
CPT,44345,REVISION OF COLOSTOMY,,,929.8,14658.0,22
CPT,44346,REVISION OF COLOSTOMY,,,1043.17,14658.0,22
CPT,44360,SMALL BOWEL ENDOSCOPY,,,1927.72,6766.0,22
CPT,44361,SMALL BOWEL ENDOSCOPY/BIOPSY,,,1927.72,6766.0,22
CPT,44363,SMALL BOWEL ENDOSCOPY,,,1927.72,6766.0,22
CPT,44364,SMALL BOWEL ENDOSCOPY,,,1927.72,6766.0,22
CPT,44365,SMALL BOWEL ENDOSCOPY,,,1927.72,6766.0,22
CPT,44366,SMALL BOWEL ENDOSCOPY,,,1927.72,6766.0,22
CPT,44369,SMALL BOWEL ENDOSCOPY,,,1927.72,6766.0,22
CPT,44370,SMALL BOWEL ENDOSCOPY/STENT,,,6049.25,14658.0,22
CPT,44372,"HC ENDOSCOPY, SM INTEST, NOT INCL ILEUM, W/ PLC OF PERC JEJUNOSTOMY TUBE",5140.0,2827.0,1542.0,6766.0,53
CPT,44373,SMALL BOWEL ENDOSCOPY,,,1927.72,6766.0,22
CPT,44376,SMALL BOWEL ENDOSCOPY,,,1927.72,6766.0,22
CPT,44377,SMALL BOWEL ENDOSCOPY/BIOPSY,,,1927.72,6766.0,22
CPT,44378,SMALL BOWEL ENDOSCOPY,,,1927.72,6766.0,22
CPT,44379,S BOWEL ENDOSCOPE W/STENT,,,6049.25,14658.0,22
CPT,44380,HC ILEOSCOPY STOMA DX,2009.0,1104.95,602.7,6766.0,53
CPT,44381,SMALL BOWEL ENDOSCOPY BR/WA,,,1927.72,6766.0,22
CPT,44382,HC ILEOSCOPY STOMA W BX SINGLE OR MULT,2369.0,1302.95,710.7,6766.0,53
CPT,44384,HC ILEOSCOPY STOMA W PLACEMENT ENDOSCOPIC STENT,6140.0,3377.0,1842.0,8363.0,53
CPT,44385,HC ENDOSCOPIC EVAL OF SMALL INTESTINAL POUCH DX,2026.0,1114.3,607.8,6766.0,53
CPT,44386,HC ENDOSCOPIC EVAL OF SMALL INTESTINAL POUCH W BX SGL OR MULT,2318.0,1274.9,695.4,6766.0,53
CPT,44388,COLONOSCOPY THRU STOMA SPX,,,926.48,6766.0,22
CPT,44389,COLONOSCOPY WITH BIOPSY,,,1198.18,6766.0,22
CPT,44390,COLONOSCOPY FOR FOREIGN BODY,,,926.48,6766.0,22
CPT,44391,COLONOSCOPY FOR BLEEDING,,,1198.18,6766.0,22
CPT,44392,COLONOSCOPY & POLYPECTOMY,,,1198.18,6766.0,22
CPT,44394,COLONOSCOPY W/SNARE,,,1198.18,6766.0,22
CPT,44401,COLONOSCOPY WITH ABLATION,,,1198.18,6766.0,22
CPT,44402,COLONOSCOPY W/STENT PLCMT,,,3917.0,13936.0,22
CPT,44403,COLONOSCOPY W/RESECTION,,,1198.18,6766.0,22
CPT,44404,COLONOSCOPY W/INJECTION,,,1198.18,6766.0,22
CPT,44405,COLONOSCOPY W/DILATION,,,1198.18,6766.0,22
CPT,44406,COLONOSCOPY W/ULTRASOUND,,,1198.18,6766.0,22
CPT,44407,COLONOSCOPY W/NDL ASPIR/BX,,,1198.18,6766.0,22
CPT,44408,COLONOSCOPY W/DECOMPRESSION,,,926.48,6766.0,22
CPT,44500,HC INTRODUCTION LONG GASTROINTESTINAL TUBE,2119.0,1165.45,635.7,6766.0,106
CPT,44602,SUTURE SMALL INTESTINE,,,1221.22,9469.0,22
CPT,44603,SUTURE SMALL INTESTINE,,,1409.72,8363.0,22
CPT,44604,SUTURE LARGE INTESTINE,,,921.39,8363.0,22
CPT,44605,REPAIR OF BOWEL LESION,,,1125.13,8363.0,22
CPT,44615,INTESTINAL STRICTUROPLASTY,,,938.63,8363.0,22
CPT,44620,REPAIR BOWEL OPENING,,,763.15,8363.0,22
CPT,44625,REPAIR BOWEL OPENING,,,892.63,8363.0,22
CPT,44626,REPAIR BOWEL OPENING,,,1387.95,8363.0,22
CPT,44640,REPAIR BOWEL-SKIN FISTULA,,,1220.0,8363.0,22
CPT,44650,REPAIR BOWEL FISTULA,,,1259.54,8363.0,22
CPT,44660,REPAIR BOWEL-BLADDER FISTULA,,,1186.52,8363.0,22
CPT,44661,REPAIR BOWEL-BLADDER FISTULA,,,1355.63,8363.0,22
CPT,44680,SURGICAL REVISION INTESTINE,,,938.61,8363.0,22
CPT,44700,SUSPEND BOWEL W/PROSTHESIS,,,890.67,8363.0,22
CPT,44701,INTRAOP COLON LAVAGE ADD-ON,,,145.06,3533.0,21
CPT,44705,HC PREP W INSTILLATION FECAL MICROBIOTA,2222.0,1222.1,103.67,4258.0,53
CPT,44715,PREPARE DONOR INTESTINE,,,2453.0,8363.0,7
CPT,44720,PREP DONOR INTESTINE/VENOUS,,,233.32,8363.0,22
CPT,44721,PREP DONOR INTESTINE/ARTERY,,,327.0,8363.0,22
CPT,44799,UNLISTED PX SMALL INTESTINE,,,952.75,29323.0,22
CPT,44800,EXCISION OF BOWEL POUCH,,,685.69,8363.0,22
CPT,44820,EXCISION OF MESENTERY LESION,,,746.77,8363.0,22
CPT,44850,REPAIR OF MESENTERY,,,661.7,8363.0,22
CPT,44899,UNLISTED PX MECKEL'S DVRTCLM,,,2453.0,29323.0,7
CPT,44900,I&D APPENDIX ABSCESS OPEN,,,687.57,5761.0,22
CPT,44950,APPENDECTOMY,,,6340.83,14658.0,22
CPT,44955,APPENDECTOMY ADD-ON,,,72.32,3533.0,21
CPT,44960,APPENDECTOMY,,,767.6,8363.0,22
CPT,44970,LAPAROSCOPY APPENDECTOMY,,,5928.88,17804.0,22
CPT,44979,UNLISTED LAPS PX APPENDIX,,,5928.88,16799.0,22
CPT,45000,DRAINAGE OF PELVIC ABSCESS,,,1198.18,6766.0,22
CPT,45005,DRAINAGE OF RECTAL ABSCESS,,,1198.18,6766.0,22
CPT,45020,DRAINAGE OF RECTAL ABSCESS,,,2786.82,6766.0,22
CPT,45100,HC BX ANORECTAL WALL ANAL APPROACH,7891.0,4340.05,2367.3,6825.72,106
CPT,45108,ANORECTAL MYOMECTOMY,,,2786.82,9469.0,22
CPT,45110,REMOVAL OF RECTUM,,,1611.13,8363.0,22
CPT,45111,PARTIAL REMOVAL OF RECTUM,,,962.41,8363.0,22
CPT,45112,REMOVAL OF RECTUM,,,1628.79,8363.0,22
CPT,45113,PARTIAL PROCTECTOMY,,,1673.53,8363.0,22
CPT,45114,PARTIAL REMOVAL OF RECTUM,,,1576.83,8363.0,22
CPT,45116,PARTIAL REMOVAL OF RECTUM,,,1390.08,8363.0,22
CPT,45119,REMOVE RECTUM W/RESERVOIR,,,1685.25,8363.0,22
CPT,45120,REMOVAL OF RECTUM,,,1394.87,8363.0,22
CPT,45121,REMOVAL OF RECTUM AND COLON,,,1519.69,8363.0,22
CPT,45123,PARTIAL PROCTECTOMY,,,995.23,17804.0,22
CPT,45126,PELVIC EXENTERATION,,,2432.67,8363.0,22
CPT,45130,EXCISION OF RECTAL PROLAPSE,,,968.52,8363.0,22
CPT,45135,EXCISION OF RECTAL PROLAPSE,,,1172.05,8363.0,22
CPT,45136,EXCISE ILEOANAL RESERVIOR,,,1603.82,8363.0,22
CPT,45150,EXCISION OF RECTAL STRICTURE,,,1198.18,6766.0,22
CPT,45160,EXCISION OF RECTAL LESION,,,2786.82,9469.0,22
CPT,45171,EXC RECT TUM TRANSANAL PART,,,2786.82,9469.0,22
CPT,45172,EXC RECT TUM TRANSANAL FULL,,,2786.82,14658.0,22
CPT,45190,DESTRUCTION RECTAL TUMOR,,,2786.82,9469.0,22
CPT,45300,HC PROCTOSIGMOIDOSCOPY DX,2314.5,1272.975,603.9,4955.0,371
CPT,45303,PROCTOSIGMOIDOSCOPY DILATE,,,1198.18,6766.0,22
CPT,45305,HC PROCTOSIGMOIDOSCOPY W BX SGL OR MULT,3366.0,1851.3000000000002,860.7,6766.0,318
CPT,45307,"HC PROCTOSIGMOIDOSCOPY, RIGID; WITH REMOVAL OF FOREIGN BODY",7161.0,3938.55,2148.3,9469.0,53
CPT,45308,PROCTOSIGMOIDOSCOPY REMOVAL,,,2786.82,6766.0,22
CPT,45309,PROCTOSIGMOIDOSCOPY REMOVAL,,,1198.18,6766.0,22
CPT,45315,PROCTOSIGMOIDOSCOPY REMOVAL,,,1198.18,6766.0,22
CPT,45317,HC PROCTOSIGMOIDOSCOPY CONTROL BLEED,3188.0,1753.4,956.4,6766.0,212
CPT,45320,PROCTOSIGMOIDOSCOPY ABLATE,,,2786.82,9469.0,22
CPT,45321,HC PROCTOSIGMOIDOSCOPY W VOLVULUS DECOMPRESSION,6887.0,3787.85,2066.1,9469.0,53
CPT,45327,PROCTOSIGMOIDOSCOPY W/STENT,,,6049.25,14658.0,22
CPT,45330,HC SIGMOIDOSCOPY FLEXIBLE DX,2205.5,1213.025,575.4,4955.0,318
CPT,45331,HC SIGMOIDOSCOPY W BX SGL OR MULT,2205.5,1213.025,575.4,4955.0,318
CPT,45332,SIGMOIDOSCOPY W/FB REMOVAL,,,1198.18,6766.0,22
CPT,45333,SIGMOIDOSCOPY & POLYPECTOMY,,,926.48,4955.0,22
CPT,45334,SIGMOIDOSCOPY FOR BLEEDING,,,1198.18,6766.0,22
CPT,45335,SIGMOIDOSCOPY W/SUBMUC INJ,,,926.48,4955.0,22
CPT,45337,"HC SIGMOIDOSCOPY, FLEXIBLE WITH DECOMPRESSION W/ PLMT DCMPRN TUBE",2882.0,1585.1,864.6,6766.0,53
CPT,45338,SIGMOIDOSCOPY W/TUMR REMOVE,,,1198.18,6766.0,22
CPT,45340,SIG W/TNDSC BALLOON DILATION,,,1198.18,6766.0,22
CPT,45341,SIGMOIDOSCOPY W/ULTRASOUND,,,926.48,6766.0,22
CPT,45342,SIGMOIDOSCOPY W/US GUIDE BX,,,1198.18,6766.0,22
CPT,45346,SIGMOIDOSCOPY W/ABLATION,,,1198.18,6766.0,22
CPT,45347,SIGMOIDOSCOPY W/PLCMT STENT,,,3917.0,13936.0,22
CPT,45349,SIGMOIDOSCOPY W/RESECTION,,,2786.82,6766.0,22
CPT,45350,SGMDSC W/BAND LIGATION,,,1198.18,6766.0,22
CPT,45378,DIAGNOSTIC COLONOSCOPY,,,926.48,6766.0,22
CPT,45379,COLONOSCOPY W/FB REMOVAL,,,1198.18,6766.0,22
CPT,45380,COLONOSCOPY AND BIOPSY,,,1198.18,6766.0,22
CPT,45381,COLONOSCOPY SUBMUCOUS NJX,,,1198.18,6766.0,22
CPT,45382,COLONOSCOPY W/CONTROL BLEED,,,1198.18,6766.0,22
CPT,45384,COLONOSCOPY W/LESION REMOVAL,,,1198.18,6766.0,22
CPT,45385,COLONOSCOPY W/LESION REMOVAL,,,1198.18,6766.0,22
CPT,45386,COLONOSCOPY W/BALLOON DILAT,,,1198.18,6766.0,22
CPT,45388,COLONOSCOPY W/ABLATION,,,1198.18,6766.0,22
CPT,45389,COLONOSCOPY W/STENT PLCMT,,,3917.0,13936.0,22
CPT,45390,COLONOSCOPY W/RESECTION,,,2786.82,6766.0,22
CPT,45391,COLONOSCOPY W/ENDOSCOPE US,,,1198.18,6766.0,22
CPT,45392,COLONOSCOPY W/ENDOSCOPIC FNB,,,1198.18,6766.0,22
CPT,45393,COLONOSCOPY W/DECOMPRESSION,,,1198.18,6766.0,22
CPT,45395,LAP REMOVAL OF RECTUM,,,1731.95,8363.0,22
CPT,45397,LAP REMOVE RECTUM W/POUCH,,,1884.45,8363.0,22
CPT,45398,COLONOSCOPY W/BAND LIGATION,,,1198.18,6766.0,22
CPT,45399,UNLISTED PROCEDURE COLON,,,926.48,29323.0,22
CPT,45400,LAPAROSCOPIC PROC,,,1010.72,14658.0,22
CPT,45402,LAP PROCTOPEXY W/SIG RESECT,,,1341.66,8363.0,22
CPT,45499,LAPAROSCOPE PROC RECTUM,,,5928.88,29323.0,22
CPT,45500,REPAIR OF RECTUM,,,2786.82,9469.0,22
CPT,45505,REPAIR OF RECTUM,,,2786.82,14658.0,22
CPT,45520,TREATMENT OF RECTAL PROLAPSE,,,926.48,4955.0,22
CPT,45540,CORRECT RECTAL PROLAPSE,,,939.45,8363.0,22
CPT,45541,CORRECT RECTAL PROLAPSE,,,2786.82,14658.0,22
CPT,45550,REPAIR RECTUM/REMOVE SIGMOID,,,1294.73,8363.0,22
CPT,45560,REPAIR OF RECTOCELE,,,2786.82,14658.0,22
CPT,45562,EXPLORATION/REPAIR OF RECTUM,,,1027.48,8363.0,22
CPT,45563,EXPLORATION/REPAIR OF RECTUM,,,1447.16,8363.0,22
CPT,45800,REPAIR RECT/BLADDER FISTULA,,,1112.88,8363.0,22
CPT,45805,REPAIR FISTULA W/COLOSTOMY,,,1281.63,8363.0,22
CPT,45820,REPAIR RECTOURETHRAL FISTULA,,,1115.54,8363.0,22
CPT,45825,REPAIR FISTULA W/COLOSTOMY,,,1343.57,8363.0,22
CPT,45900,HC REDUCTION OF PROCIDENTIA UNDER ANESTHESIA,2331.0,1282.05,699.3,4955.0,53
CPT,45905,HC DILATION ANAL SPHINCTER W ANES,5119.0,2815.45,1198.18,6766.0,212
CPT,45910,DILATION OF RECTAL NARROWING,,,1198.18,6766.0,22
CPT,45915,REMOVE RECTAL OBSTRUCTION,,,1198.18,6766.0,22
CPT,45990,SURG DX EXAM ANORECTAL,,,2786.82,6766.0,22
CPT,45999,HC ASPIR PERIRECTAL ABSCESS,1111.0,611.05,333.3,29323.0,53
CPT,45999,HC RMVL RECTAL FB WO ANESTHESIA,1111.0,611.05,333.3,29323.0,53
CPT,46020,HC PLACE SETON,6680.0,3674.0,1980.3,9469.0,106
CPT,46030,REMOVAL ANAL SETON OTH MRK,,,1198.18,6766.0,22
CPT,46040,HC INC & DRN RECTAL ABSCESS,7776.5,4277.075,1198.18,6954.6,318
CPT,46045,I&D ABSC TRANAL UNDER ANES,,,2786.82,9469.0,22
CPT,46050,HC INC & DRN PERIANAL ABSCESS,5002.5,2751.375,926.48,4955.0,265
CPT,46060,I&D ISCHIORECTAL/NTRMRL ABSC,,,2786.82,6766.0,22
CPT,46070,INCISION ANAL SEPTUM INFANT,,,2786.82,6766.0,22
CPT,46080,SPHNCTROTMY ANAL DIV SPHNCTR,,,2786.82,6766.0,22
CPT,46083,"HC INCISION THROMBOSED HEMORRHOID, EXTERNAL",674.0,370.70000000000005,191.1,4258.0,265
CPT,46200,REMOVAL OF ANAL FISSURE,,,2786.82,9469.0,22
CPT,46220,HC EXC SGL EXTERNAL PAPILLA TAG ANUS,4142.0,2278.1,860.7,6766.0,318
CPT,46221,HC HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS,2349.5,1292.225,666.6,4955.0,212
CPT,46230,HC EXC MULT EXTERNAL PAPILLAE TAGS ANUS,6301.5,3465.825,1800.9,6766.0,318
CPT,46250,"HC HEMORRHOIDECTOMY, EXTERNAL, 2 OR MORE COLUMNS/GROUPS",6827.0,3754.85,2048.1,9469.0,53
CPT,46255,REMOVE INT/EXT HEM 1 GROUP,,,2786.82,9469.0,22
CPT,46257,REMOVE IN/EX HEM GRP & FISS,,,2786.82,9469.0,22
CPT,46258,REMOVE IN/EX HEM GRP W/FISTU,,,2786.82,9469.0,22
CPT,46260,REMOVE IN/EX HEM GROUPS 2+,,,2786.82,9469.0,22
CPT,46261,REMOVE IN/EX HEM GRPS & FISS,,,2786.82,9469.0,22
CPT,46262,REMOVE IN/EX HEM GRPS W/FIST,,,2786.82,9469.0,22
CPT,46270,HC ANAL FISTULECTOMY FISTULOTOMY SUBQ,6690.0,3679.5,1848.9,9469.0,212
CPT,46275,REMOVE ANAL FIST INTER,,,2786.82,9469.0,22
CPT,46280,REMOVE ANAL FIST COMPLEX,,,2786.82,9469.0,22
CPT,46285,REMOVE ANAL FIST 2 STAGE,,,2786.82,9469.0,22
CPT,46288,REPAIR ANAL FISTULA,,,2786.82,14658.0,22
CPT,46320,"HC EXCISION THROMBOSED HEMORRHOID, EXTERNAL",4529.0,2490.95,1198.18,6766.0,159
CPT,46500,"HC INJECTION SCLEROSING SOLUTION, HEMORRHOIDS",2469.0,1357.95,740.7,4955.0,53
CPT,46505,HC CHEMODENERVATION OF INTERNAL ANAL SPHINCTER,3053.0,1679.15,915.9,6766.0,53
CPT,46600,"HC ANOSCOPY, DIAGNOSTIC, INCL COLLECTION OF SPECIMEN(S) BY BRUSING/WASHING",354.5,194.97500000000002,95.4,4258.0,477
CPT,46601,HC DIAGNOSTIC ANOSCOPY W HRA & CHEM AGENT ENHANCEMENT,446.0,245.3,133.8,4258.0,265
CPT,46604,ANOSCOPY AND DILATION,,,1198.18,6766.0,22
CPT,46606,HC ANOSCOPY W BX SGL OR MULT,3547.0,1950.85,860.7,6766.0,318
CPT,46607,HC DIAGNOSTIC ANOSCOPY W HRA & CHEM AGENT ENHANCE W BX,3190.0,1754.5,860.7,6766.0,265
CPT,46608,HC ANOSCOPY W REMOVAL OF FOREIGN BODY,2845.0,1564.75,853.5,6766.0,53
CPT,46610,HC ANSCPY REM SGL TUM PLYP LESN BX FORCP BPLR CAUT,7359.0,4047.45,2048.1,9469.0,212
CPT,46611,ANOSCOPY,,,926.48,6766.0,22
CPT,46612,ANOSCOPY REMOVE LESIONS,,,2786.82,9469.0,22
CPT,46614,HC ANOSCOPY CONTROL BLEED,2726.0,1499.3,817.8,6766.0,265
CPT,46615,ANOSCOPY,,,2786.82,9469.0,22
CPT,46700,REPAIR OF ANAL STRICTURE,,,2786.82,9469.0,22
CPT,46705,REPAIR OF ANAL STRICTURE,,,513.27,8363.0,22
CPT,46706,REPR OF ANAL FISTULA W/GLUE,,,2786.82,9469.0,22
CPT,46707,REPAIR ANORECTAL FIST W/PLUG,,,2786.82,14658.0,22
CPT,46710,REPR PER/VAG POUCH SNGL PROC,,,976.39,8363.0,22
CPT,46712,REPR PER/VAG POUCH DBL PROC,,,1924.54,8363.0,22
CPT,46715,REP PERF ANOPER FISTU,,,495.81,8363.0,22
CPT,46716,REP PERF ANOPER/VESTIB FISTU,,,1098.23,8363.0,22
CPT,46730,CONSTRUCTION OF ABSENT ANUS,,,1748.84,8363.0,22
CPT,46735,CONSTRUCTION OF ABSENT ANUS,,,2005.7,8363.0,22
CPT,46740,CONSTRUCTION OF ABSENT ANUS,,,1904.44,8363.0,22
CPT,46742,REPAIR OF IMPERFORATED ANUS,,,2191.81,8363.0,22
CPT,46744,REPAIR OF CLOACAL ANOMALY,,,2453.0,8363.0,22
CPT,46746,REPAIR OF CLOACAL ANOMALY,,,2453.0,8363.0,22
CPT,46748,REPAIR OF CLOACAL ANOMALY,,,2453.0,8363.0,22
CPT,46750,REPAIR OF ANAL SPHINCTER,,,2786.82,14658.0,22
CPT,46751,REPAIR OF ANAL SPHINCTER,,,596.75,8363.0,22
CPT,46753,RECONSTRUCTION OF ANUS,,,2786.82,9469.0,22
CPT,46754,REMOVAL OF SUTURE FROM ANUS,,,2786.82,6766.0,22
CPT,46760,REPAIR OF ANAL SPHINCTER,,,2786.82,14658.0,22
CPT,46761,REPAIR OF ANAL SPHINCTER,,,2786.82,14658.0,22
CPT,46900,HC DESTRUCT ANAL LESION(S) SIMPLE CHEMICAL,1022.5,562.375,258.0,4258.0,318
CPT,46910,DESTRUCTION ANAL LESION(S),,,1858.86,6766.0,22
CPT,46916,HC DESTRUCT ANAL LESION(S) SIMPLE CRYOSURGERY,487.0,267.85,146.1,4258.0,106
CPT,46917,LASER SURGERY ANAL LESIONS,,,2786.82,9469.0,22
CPT,46922,HC DESTRUCT ANAL LESION(S) SIMPLE SURG EXCISION,6827.0,3754.85,2048.1,9469.0,53
CPT,46924,DESTRUCTION ANAL LESION(S),,,2786.82,9469.0,22
CPT,46930,DESTROY INTERNAL HEMORRHOIDS,,,1198.18,5761.0,22
CPT,46940,TREATMENT OF ANAL FISSURE,,,2786.82,6766.0,22
CPT,46942,TREATMENT OF ANAL FISSURE,,,926.48,4955.0,22
CPT,46945,INT HRHC LIG 1 HROID W/O IMG,,,2786.82,9469.0,22
CPT,46946,"HC HEMORRHOIDECT, INT, LIGATION WO RUBBER BAND, 2/MORE COL/GRP, WO IMG GUID",8119.5,4465.725,2048.1,9469.0,212
CPT,46947,HEMORRHOIDOPEXY BY STAPLING,,,2786.82,14658.0,22
CPT,46948,INT HRHC TRANAL DARTLZJ 2+,,,2786.82,9469.0,22
CPT,46999,"HC BIOPSY, ANUS, WO SCOPE, UNLISTED",2349.0,1291.95,668.7,29323.0,159
CPT,47000,"HC BIOPSY LIVER, NEEDLE, PERCUTANEOUS",3312.0,1821.6,993.6,6766.0,212
CPT,47001,"HC BX LIVER, NEEDLE, WHEN DONE FOR INDICATED PURP AT TIME OF OTH MJR PROC",3241.0,1782.55,88.99,3533.0,53
CPT,47010,HEPATOT OPN DRG ABSC/CST 1/2,,,1063.6,5761.0,22
CPT,47015,LAPT ASPIR&/NJX HEP PRST CST,,,1019.39,6766.0,22
CPT,47100,WEDGE BIOPSY OF LIVER,,,749.42,9469.0,22
CPT,47120,PARTIAL REMOVAL OF LIVER,,,2033.97,8363.0,22
CPT,47122,EXTENSIVE REMOVAL OF LIVER,,,2453.0,8363.0,22
CPT,47125,PARTIAL REMOVAL OF LIVER,,,2453.0,8363.0,22
CPT,47130,PARTIAL REMOVAL OF LIVER,,,2453.0,8363.0,22
CPT,47133,REMOVAL OF DONOR LIVER,,,2453.0,8363.0,7
CPT,47135,TRANSPLANTATION OF LIVER,,,2453.0,24394.0,22
CPT,47140,PARTIAL REMOVAL DONOR LIVER,,,2453.0,8363.0,22
CPT,47141,PARTIAL REMOVAL DONOR LIVER,,,2453.0,8363.0,22
CPT,47142,PARTIAL REMOVAL DONOR LIVER,,,2453.0,8363.0,22
CPT,47143,PREP DONOR LIVER WHOLE,,,2453.0,8363.0,7
CPT,47144,PREP DONOR LIVER 3-SEGMENT,,,2453.0,8363.0,7
CPT,47145,PREP DONOR LIVER LOBE SPLIT,,,2453.0,8363.0,7
CPT,47146,PREP DONOR LIVER/VENOUS,,,279.79,8363.0,22
CPT,47147,PREP DONOR LIVER/ARTERIAL,,,326.59,8363.0,22
CPT,47300,SURGERY FOR LIVER LESION,,,994.03,8363.0,22
CPT,47350,REPAIR LIVER WOUND,,,1194.46,8363.0,22
CPT,47360,REPAIR LIVER WOUND,,,1625.91,8363.0,22
CPT,47361,REPAIR LIVER WOUND,,,2453.0,8363.0,22
CPT,47362,REPAIR LIVER WOUND,,,1246.44,8363.0,22
CPT,47370,LAPARO ABLATE LIVER TUMOR RF,,,10579.88,21512.0,22
CPT,47371,LAPARO ABLATE LIVER CRYOSURG,,,10579.88,21512.0,22
CPT,47379,UNLISTED LAPS PX LIVER,,,5928.88,16799.0,22
CPT,47380,OPEN ABLATE LIVER TUMOR RF,,,1264.14,8363.0,22
CPT,47381,OPEN ABLATE LIVER TUMOR CRYO,,,1289.54,8363.0,22
CPT,47382,"HC ABLATION, 1 OR MORE LIVER TUMOR(S), PERCUTANEOUS, READIOFREQUENCY",11246.0,6185.3,3373.8,17804.0,159
CPT,47383,"HC ABLATION, 1 OR MORE LIVER TUMORS, PERCUTANEOUS, CRYOABLATION",12236.0,6729.8,3670.8,17804.0,106
CPT,47399,"HC CHEMICAL ABLATION OF LIVER TUMOR(S), UNLISTED PX, LIVER",2932.0,1612.6,714.99,29323.0,53
CPT,47400,INCISION OF LIVER DUCT,,,1861.36,8363.0,22
CPT,47420,INCISION OF BILE DUCT,,,1166.13,8363.0,22
CPT,47425,INCISION OF BILE DUCT,,,1190.97,8363.0,22
CPT,47460,INCISE BILE DUCT SPHINCTER,,,1107.93,8363.0,22
CPT,47480,INCISION OF GALLBLADDER,,,777.16,8363.0,22
CPT,47490,HC PERCUTAN CHOLECYSTOSTOMY,6902.0,3796.1,2070.6,14658.0,53
CPT,47490,INCISION OF GALLBLADDER,,,6275.9,6275.9,1
CPT,47531,"HC INJ FOR CHOLANGIOGRAPHY, PERC, INCL IMAGE GUID, EXISTING ACCESS",4879.0,2683.45,1463.7,14658.0,106
CPT,47531,INJECTION FOR CHOLANGIOGRAM,,,6275.9,6275.9,1
CPT,47532,"HC INJ FOR CHOLANGIOGRAPHY, PERC, INCL IMAGE GUID, NEW ACCESS",7068.0,3887.4,2120.4,14658.0,106
CPT,47532,INJECTION FOR CHOLANGIOGRAM,,,6275.9,6275.9,1
CPT,47533,"HC PLACE BILIARY DRAIN CATH, PERC, INCL CHOLANGIO, IMAGE GUID, EXTERNAL",8205.0,4512.75,2461.5,14658.0,53
CPT,47533,PLMT BILIARY DRAINAGE CATH,,,6275.9,6275.9,1
CPT,47534,"HC PLACE BILIARY DRAIN CATH, PERC, INCL CHOLANGIO, IMAGE GUID, INTRN-EXTRN",6816.0,3748.8,2044.8,14658.0,53
CPT,47534,PLMT BILIARY DRAINAGE CATH,,,6275.9,6275.9,1
CPT,47535,CONVERSION EXT BIL DRG CATH,,,6275.9,6275.9,1
CPT,47535,"HC CONVERT EXT BIL DRN CATH TO INT-EXT BIL DRN CATH, PERC, INCL CHOLANGIO",5764.0,3170.2,1729.2,14658.0,53
CPT,47536,EXCHANGE BILIARY DRG CATH,,,6275.9,6275.9,1
CPT,47536,"HC EXCHANGE BILIARY DRAINAGE CATH, PERC, INCL CHOLANGIOGRAPHY, IMAGE GUID",6334.0,3483.7,1900.2,14658.0,53
CPT,47537,"HC REMOVE BILIARY DRAIN CATH, PERC, REQUIRING FLUORO GUID, INCL CHOLANGIO",1870.0,1028.5,561.0,6766.0,53
CPT,47537,REMOVAL BILIARY DRG CATH,,,1667.31,1667.31,1
CPT,47538,"HC PLACE STENT(S) BILE DUCT, PERC, EXIST ACCESS",16748.0,9211.4,5024.4,17804.0,53
CPT,47538,PERQ PLMT BILE DUCT STENT,,,10375.53,10375.53,1
CPT,47539,"HC PLACE STENT(S) BILE DUCT, PERC, EXIST ACCESS W/O SEP CATH",9960.0,5478.0,2988.0,17804.0,53
CPT,47539,PERQ PLMT BILE DUCT STENT,,,10375.53,10375.53,1
CPT,47540,"HC PLACE STENT(S) BILE DUCT, PERC, NEW ACCESS, WITH PLC SEP BIL DRN CATH",15950.0,8772.5,4785.0,17804.0,53
CPT,47540,PERQ PLMT BILE DUCT STENT,,,10375.53,10375.53,1
CPT,47541,HC PLACE ACCESS THRU BIL TREE INTO SM BOWEL TO ASSIST W ENDOSCOP BIL PROC,8234.0,4528.7,2470.2,14658.0,53
CPT,47541,PLMT ACCESS BIL TREE SM BWL,,,11096.46,11096.46,1
CPT,47542,DILATE BILIARY DUCT/AMPULLA,,,774.03,774.03,1
CPT,47542,"HC BAL DILATION BIL DUCT(S) OR AMPULLA, PERC, INCL IMG GUID, EA DUCT (ADD)",6964.0,3830.2,442.3,6023.86,53
CPT,47543,ENDOLUMINAL BX BILIARY TREE,,,611.34,611.34,1
CPT,47543,"HC ENDOLUMINAL BX BIL TREE, PERC, ANY METHOD, INCL IMG GUID, SGL/MULT (ADD)",5635.0,3099.25,349.34,4874.28,53
CPT,47544,"HC REM CALCULI BIL DUCT(S) AND/OR GALLBLAD, PERC, INCL DESTRUCT CALC (ADD)",6090.0,3349.5,738.55,5267.85,53
CPT,47544,REMOVAL DUCT GLBLDR CALCULI,,,1292.47,1292.47,1
CPT,47550,BILE DUCT ENDOSCOPY ADD-ON,,,139.96,8363.0,22
CPT,47552,BILIARY ENDO PERQ DX W/SPECI,,,6340.83,14658.0,22
CPT,47553,"HC BIL ENDOSC, PERC VIA T-TUBE/OTHER TRACT, W/ BIOPSY, SINGLE/MULTIPLE",8993.0,4946.15,2697.9,17804.0,53
CPT,47554,"HC BIL ENDOSC, PERC VIA T-TUBE/OTHER TRACT, W/ REM OF CALCULUS/CALCULI",15401.0,8470.55,4620.3,17804.0,53
CPT,47555,"HC BIL ENDOSC, PERC VIA T-TUBE/OTHER TRACT, W/ DILAT OF STRICTURES WO STENT",9546.0,5250.3,2863.8,14658.0,53
CPT,47556,"HC BIL ENDOSC, PERC VIA T-TUBE/OTHER TRACT, W/ DILAT OF STRICTURES W STENT",12236.0,6729.8,3670.8,17804.0,53
CPT,47562,LAPAROSCOPIC CHOLECYSTECTOMY,,,5928.88,17804.0,22
CPT,47563,LAPARO CHOLECYSTECTOMY/GRAPH,,,5928.88,17804.0,22
CPT,47564,LAPARO CHOLECYSTECTOMY/EXPLR,,,10315.0,17804.0,22
CPT,47570,LAPARO CHOLECYSTOENTEROSTOMY,,,680.44,16786.0,22
CPT,47579,UNLISTED LAPS PX BILIARY TRC,,,5928.88,16799.0,22
CPT,47600,CHOLECYSTECTOMY,,,940.0,16799.0,22
CPT,47605,CHOLECYSTECTOMY W/CHOLANG,,,987.22,8363.0,22
CPT,47610,REMOVAL OF GALLBLADDER,,,1095.38,8363.0,22
CPT,47612,REMOVAL OF GALLBLADDER,,,1107.92,8363.0,22
CPT,47620,REMOVAL OF GALLBLADDER,,,1194.9,8363.0,22
CPT,47700,EXPLORATION OF BILE DUCTS,,,928.79,8363.0,22
CPT,47701,BILE DUCT REVISION,,,1508.24,8363.0,22
CPT,47711,EXCISION OF BILE DUCT TUMOR,,,1355.32,8363.0,22
CPT,47712,EXCISION OF BILE DUCT TUMOR,,,1729.79,8363.0,22
CPT,47715,EXCISION OF BILE DUCT CYST,,,1161.47,8363.0,22
CPT,47720,FUSE GALLBLADDER & BOWEL,,,1011.5,8363.0,22
CPT,47721,FUSE UPPER GI STRUCTURES,,,1181.94,8363.0,22
CPT,47740,FUSE GALLBLADDER & BOWEL,,,1146.34,8363.0,22
CPT,47741,FUSE GALLBLADDER & BOWEL,,,1285.64,8363.0,22
CPT,47760,FUSE BILE DUCTS AND BOWEL,,,1954.52,8363.0,22
CPT,47765,FUSE LIVER DUCTS & BOWEL,,,2453.0,8363.0,22
CPT,47780,FUSE BILE DUCTS AND BOWEL,,,2146.05,8363.0,22
CPT,47785,FUSE BILE DUCTS AND BOWEL,,,2453.0,8363.0,22
CPT,47800,RECONSTRUCTION OF BILE DUCTS,,,1364.62,8363.0,22
CPT,47801,PLACEMENT BILE DUCT SUPPORT,,,971.95,8363.0,22
CPT,47802,OP Surgery - Grouper Table,,,8363.0,8363.0,1
CPT,47900,SUTURE BILE DUCT INJURY,,,1202.94,8363.0,22
CPT,47999,"HC EMBOLIZATION OF A BILE DUCT FISTULA, UNLISTED PX, BILIARY TRACT",5410.0,2975.5,952.75,29323.0,53
CPT,48000,DRAINAGE OF ABDOMEN,,,1632.32,8363.0,22
CPT,48001,PLACEMENT OF DRAIN PANCREAS,,,1993.76,8363.0,22
CPT,48020,REMOVAL OF PANCREATIC STONE,,,1031.82,8363.0,22
CPT,48100,BIOPSY OF PANCREAS OPEN,,,780.09,8363.0,22
CPT,48102,"HC BIOPSY PANCREAS, PERCUTANEOUS NEEDLE",3128.0,1720.4,938.4,6766.0,159
CPT,48105,RESECT/DEBRIDE PANCREAS,,,2453.0,8363.0,22
CPT,48120,REMOVAL OF PANCREAS LESION,,,971.57,8363.0,22
CPT,48140,PARTIAL REMOVAL OF PANCREAS,,,1367.21,8363.0,22
CPT,48145,PARTIAL REMOVAL OF PANCREAS,,,1419.47,8363.0,22
CPT,48146,PANCREATECTOMY,,,1639.49,8363.0,22
CPT,48148,REMOVAL OF PANCREATIC DUCT,,,1092.35,8363.0,22
CPT,48150,PARTIAL REMOVAL OF PANCREAS,,,2453.0,8363.0,22
CPT,48152,PANCREATECTOMY,,,2453.0,8363.0,22
CPT,48153,PANCREATECTOMY,,,2453.0,8363.0,22
CPT,48154,PANCREATECTOMY,,,2453.0,8363.0,22
CPT,48155,REMOVAL OF PANCREAS,,,1589.19,8363.0,22
CPT,48160,PANCREAS REMOVAL/TRANSPLANT,,,2453.0,8363.0,7
CPT,48400,INJECTION INTRAOP ADD-ON,,,91.03,4602.0,22
CPT,48500,SURGERY OF PANCREATIC CYST,,,1006.28,8363.0,22
CPT,48510,DRAIN PANCREATIC PSEUDOCYST,,,961.2,8363.0,22
CPT,48520,FUSE PANCREAS CYST AND BOWEL,,,959.31,8363.0,22
CPT,48540,FUSE PANCREAS CYST AND BOWEL,,,1136.88,8363.0,22
CPT,48545,PANCREATORRHAPHY,,,1174.66,8363.0,22
CPT,48547,DUODENAL EXCLUSION,,,1554.96,8363.0,22
CPT,48548,FUSE PANCREAS AND BOWEL,,,1451.98,8363.0,22
CPT,48550,DONOR PANCREATECTOMY,,,8363.0,8363.0,1
CPT,48551,PREP DONOR PANCREAS,,,8363.0,8363.0,1
CPT,48552,PREP DONOR PANCREAS/VENOUS,,,200.71,8363.0,16
CPT,48554,TRANSPL ALLOGRAFT PANCREAS,,,2333.05,24394.0,16
CPT,48556,REMOVAL ALLOGRAFT PANCREAS,,,1140.11,8363.0,16
CPT,48999,UNLISTED PROCEDURE PANCREAS,,,714.99,29323.0,22
CPT,49000,EXPLORATION OF ABDOMEN,,,677.94,14658.0,22
CPT,49002,REOPENING OF ABDOMEN,,,912.1,8363.0,22
CPT,49010,EXPLORATION BEHIND ABDOMEN,,,808.62,14658.0,22
CPT,49013,PRPERTL PEL PACK HEMRRG TRMA,,,390.1,8363.0,22
CPT,49014,REEXPLORATION PELVIC WOUND,,,326.5,8363.0,22
CPT,49020,DRAINAGE ABDOM ABSCESS OPEN,,,1397.73,8363.0,22
CPT,49040,DRAIN OPEN ABDOM ABSCESS,,,883.93,8363.0,22
CPT,49060,DRAIN OPEN RETROPERI ABSCESS,,,971.95,8363.0,22
CPT,49062,DRAIN TO PERITONEAL CAVITY,,,675.91,8363.0,22
CPT,49082,"HC ABDOMINAL PARACENTESIS (DIAGNOSTIC OR THERAPEUTIC), W/O IMAG GUID",2327.0,1279.85,698.1,6766.0,424
CPT,49083,ABD PARACENTESIS W/IMAGING,,,1667.31,1667.31,1
CPT,49083,"HC ABDOMINAL PARACENTESIS (DIAGNOSTIC OR THERAPEUTIC), W/ IMAG GUID",2959.0,1627.45,887.7,6766.0,742
CPT,49084,HC PERITONEAL LAVAGE W WO IMAG GUID,2340.0,1287.0,702.0,6766.0,159
CPT,49180,HC BX ABDOMINAL RETROPERITONEAL MASS PERCUT NDL,3185.0,1751.75,955.5,6766.0,371
CPT,49185,"HC SCLEROTHER FLD COLLECT, PERC, INCL CONTRAST/SCLEROSANT INJ, IMAG GUID",3259.0,1792.45,977.7,4955.0,159
CPT,49185,SCLEROTX FLUID COLLECTION,,,2881.35,2881.35,1
CPT,49186,OPN EXC/DSTR NTRA-ABD 5 CM/<,,,1164.25,9469.0,22
CPT,49187,OPN EXC/DSTR NTRA-ABD 5.1-10,,,1475.32,9469.0,22
CPT,49188,OPN EXC/DST NTRA-ABD 10.1-20,,,1763.48,9469.0,22
CPT,49189,OPN EXC/DST NTRA-ABD 20.1-30,,,2049.6,14658.0,22
CPT,49190,OPN EXC/DSTR NTRA-ABD >30 CM,,,2453.0,14658.0,22
CPT,49203,OP Surgery - Grouper Table,,,8363.0,8363.0,1
CPT,49204,OP Surgery - Grouper Table,,,8363.0,8363.0,1
CPT,49205,OP Surgery - Grouper Table,,,8363.0,8363.0,1
CPT,49215,EXCISE SACRAL SPINE TUMOR,,,1947.16,8363.0,22
CPT,49250,EXCISION OF UMBILICUS,,,3586.23,14658.0,22
CPT,49255,REMOVAL OF OMENTUM,,,706.16,9469.0,22
CPT,49320,HC LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX,14736.0,8104.8,4420.8,16799.0,53
CPT,49321,LAPAROSCOPY BIOPSY,,,5928.88,16799.0,22
CPT,49322,LAPAROSCOPY ASPIRATION,,,5928.88,16799.0,22
CPT,49323,LAPARO DRAIN LYMPHOCELE,,,5928.88,16799.0,22
CPT,49324,LAP INSERT TUNNEL IP CATH,,,5928.88,16799.0,22
CPT,49325,LAP REVISION PERM IP CATH,,,5928.88,16799.0,22
CPT,49326,LAP W/OMENTOPEXY ADD-ON,,,160.91,3533.0,21
CPT,49327,LAP INS DEVICE FOR RT,,,111.38,3533.0,21
CPT,49329,UNLSTD LAPS PX ABD PERTM&OMN,,,5928.88,16799.0,22
CPT,49400,AIR INJECTION INTO ABDOMEN,,,237.66,237.66,1
CPT,49400,HC INJ PERITONEAL CAVITY,658.0,361.9,135.81,3533.0,53
CPT,49402,REMOVE FOREIGN BODY ADBOMEN,,,3586.23,14658.0,22
CPT,49405,HC CATH PLACE DRAIN VISCERAL W IMAG PERCUTAN,4206.0,2313.3,1261.8,6766.0,212
CPT,49405,IMAGE CATH FLUID COLXN VISC,,,2881.35,2881.35,1
CPT,49406,HC CATH PLACE DRAIN PERITO-RETROPERITONEAL W IMAG PERCUTAN,4971.0,2734.05,1491.3,6766.0,265
CPT,49406,IMAGE CATH FLUID PERI/RETRO,,,2881.35,2881.35,1
CPT,49407,HC CATH PLC DRN PERITO-RETROPERITONEAL TRANSVAG-RECTAL W IMAG,2948.0,1621.4,884.4,6766.0,212
CPT,49407,IMAGE CATH FLUID TRNS/VGNL,,,2881.35,2881.35,1
CPT,49411,INS MARK ABD/PEL FOR RT PERQ,,,1390.43,6766.0,22
CPT,49412,INS DEVICE FOR RT GUIDE OPEN,,,70.34,8363.0,22
CPT,49418,HC INSERT TUNNELED INTRAPERITONEAL CATH PERCUTAN,6566.0,3611.3,1969.8,14658.0,53
CPT,49418,INSERT TUN IP CATH PERC,,,6275.9,6275.9,1
CPT,49419,INSERT TUN IP CATH W/PORT,,,5493.27,17804.0,22
CPT,49421,INS TUN IP CATH FOR DIAL OPN,,,3586.23,14658.0,22
CPT,49422,HC REM TUNNELED INTRAPERITONEAL CATH,7703.0,4236.65,2310.9,14658.0,477
CPT,49423,HC EXCHANGE PREVIOUSLY PLACED ABSCESS OR CYST DRAIN CATH UNDER RAD GUID,3513.0,1932.15,1053.9,6766.0,265
CPT,49424,ASSESS CYST CONTRAST INJECT,,,281.07,281.07,1
CPT,49424,HC CONTRAST INJ FOR ASSESS ABSCESS OR CYST VIA PREV PLACED DRAIN CATH/TUBE,1085.0,596.75,160.61,3533.0,159
CPT,49425,HC INSERT PERITONEAL-VENOUS SHUNT,5768.0,3172.4,687.05,8363.0,53
CPT,49426,HC REVISE PERITONEAL-VENOUS SHUNT,10404.0,5722.2,3121.2,14658.0,53
CPT,49427,HC INJ PROC FOR EVAL PREVIOUSLY PLACED PERITONEAL-VENOUS SHUNT,266.0,146.3,35.03,3533.0,53
CPT,49427,INJECTION ABDOMINAL SHUNT,,,61.3,61.3,1
CPT,49428,LIGATION OF SHUNT,,,378.09,8363.0,22
CPT,49429,HC REMOVE PERITONEAL-VENOUS SHUNT,6233.0,3428.15,1869.9,14658.0,53
CPT,49435,INSERT SUBQ EXTEN TO IP CATH,,,100.97,6766.0,21
CPT,49436,EMBEDDED IP CATH EXIT-SITE,,,1927.72,6766.0,22
CPT,49440,HC PLACE GASTROSTOMY TUBE PERCUTAN INCL FLUORO,2918.0,1604.9,875.4,6766.0,106
CPT,49440,PLACE GASTROSTOMY TUBE PERC,,,3373.51,3373.51,1
CPT,49441,"HC INSERT DUODENOSTOMY/JEJUNOSTOMY TUBE, PERC, UNDER FLUORO GUIDANCE",3705.0,2037.75,1111.5,6766.0,106
CPT,49441,PLACE DUOD/JEJ TUBE PERC,,,3373.51,3373.51,1
CPT,49442,"HC INSERT CECOSTOMY/OTHER COLONIC TUBE, PERC, UNDER FLUORO GUID",4242.0,2333.1,1198.18,6766.0,53
CPT,49442,PLACE CECOSTOMY TUBE PERC,,,2096.82,2096.82,1
CPT,49446,CHANGE G-TUBE TO G-J PERC,,,3373.51,3373.51,1
CPT,49446,"HC CONVERT G-TUBE TO G-JEJ TUBE, PERC, UNDER FLUORO GUID INCL CONTRAST INJ",3217.0,1769.35,965.1,6766.0,106
CPT,49450,"HC REPLACE GASTROSTOMY/CECOSTOMY TUBE, PERC",2167.0,1191.85,650.1,6766.0,212
CPT,49450,REPLACE G/C TUBE PERC,,,1667.31,1667.31,1
CPT,49451,"HC REPLACE DUOD OR JEJ TUBE, PERC, UNDER FLUORO GUID INCL CONTRAST INJ",1968.0,1082.4,590.4,6766.0,106
CPT,49451,REPLACE DUOD/JEJ TUBE PERC,,,1667.31,1667.31,1
CPT,49452,HC REPLC GASTRO-JEJ TUBE PERCUTAN FLUORO GUID,2067.0,1136.85,620.1,6766.0,106
CPT,49452,REPLACE G-J TUBE PERC,,,1667.31,1667.31,1
CPT,49460,FIX G/COLON TUBE W/DEVICE,,,1667.31,1667.31,1
CPT,49460,HC REM OBSTRUCTIVE MATERL FROM GI TUBE FLUORO GUID,1663.0,914.65,498.9,6766.0,53
CPT,49465,FLUORO EXAM OF G/COLON TUBE,,,429.86,429.86,1
CPT,49465,HC INJ CONTRAST FOR EVAL OF EXISTING GI TUBE,836.0,459.8,245.64,4258.0,106
CPT,49491,RPR HERN PREEMIE REDUC,,,5928.88,16786.0,22
CPT,49492,RPR ING HERN PREMIE BLOCKED,,,3586.23,14658.0,22
CPT,49495,RPR ING HERNIA BABY REDUC,,,3586.23,14658.0,22
CPT,49496,RPR ING HERNIA BABY BLOCKED,,,3586.23,14658.0,22
CPT,49500,RPR ING HERNIA INIT REDUCE,,,6340.83,14658.0,22
CPT,49501,RPR ING HERNIA INIT BLOCKED,,,3586.23,14658.0,22
CPT,49505,PRP I/HERN INIT REDUC >5 YR,,,3586.23,14658.0,22
CPT,49507,PRP I/HERN INIT BLOCK >5 YR,,,3586.23,14658.0,22
CPT,49520,REREPAIR ING HERNIA REDUCE,,,3586.23,14658.0,22
CPT,49521,REREPAIR ING HERNIA BLOCKED,,,6340.83,14658.0,22
CPT,49525,REPAIR ING HERNIA SLIDING,,,3586.23,14658.0,22
CPT,49540,REPAIR LUMBAR HERNIA,,,5928.88,16786.0,22
CPT,49550,RPR REM HERNIA INIT REDUCE,,,3586.23,14658.0,22
CPT,49553,RPR FEM HERNIA INIT BLOCKED,,,3586.23,14658.0,22
CPT,49555,REREPAIR FEM HERNIA REDUCE,,,3586.23,14658.0,22
CPT,49557,REREPAIR FEM HERNIA BLOCKED,,,3586.23,14658.0,22
CPT,49560,OP Surgery - Grouper Table,,,8363.0,8363.0,1
CPT,49561,OP Surgery - Grouper Table,,,8363.0,8363.0,1
CPT,49565,OP Surgery - Grouper Table,,,16786.0,16786.0,1
CPT,49566,OP Surgery - Grouper Table,,,16786.0,16786.0,1
CPT,49570,OP Surgery - Grouper Table,,,8363.0,8363.0,1
CPT,49572,OP Surgery - Grouper Table,,,8363.0,8363.0,1
CPT,49580,OP Surgery - Grouper Table,,,8363.0,8363.0,1
CPT,49582,OP Surgery - Grouper Table,,,8363.0,8363.0,1
CPT,49585,OP Surgery - Grouper Table,,,8363.0,8363.0,1
CPT,49587,OP Surgery - Grouper Table,,,8363.0,8363.0,1
CPT,49590,OP Surgery - Grouper Table,,,8363.0,8363.0,1
CPT,49591,RPR AA HRN 1ST < 3 CM RDC,,,3586.23,14658.0,22
CPT,49592,RPR AA HRN 1ST < 3 NCR/STRN,,,5928.88,17804.0,22
CPT,49593,RPR AA HRN 1ST 3-10 RDC,,,6340.83,14658.0,22
CPT,49594,RPR AA HRN 1ST 3-10 NCR/STRN,,,5928.88,17804.0,22
CPT,49595,RPR AA HRN 1ST > 10 RDC,,,6340.83,14658.0,22
CPT,49596,RPR AA HRN 1ST > 10 NCR/STRN,,,888.53,17804.0,22
CPT,49600,REPAIR UMBILICAL LESION,,,3586.23,14658.0,22
CPT,49605,REPAIR UMBILICAL LESION,,,2453.0,8363.0,22
CPT,49606,REPAIR UMBILICAL LESION,,,990.62,8363.0,22
CPT,49610,REPAIR UMBILICAL LESION,,,612.67,8363.0,22
CPT,49611,REPAIR UMBILICAL LESION,,,541.19,8363.0,22
CPT,49613,RPR AA HRN RCR < 3 RDC,,,3586.23,14658.0,22
CPT,49614,RPR AA HRN RCR < 3 NCR/STRN,,,5928.88,17804.0,22
CPT,49615,RPR AA HRN RCR 3-10 RDC,,,6340.83,14658.0,22
CPT,49616,RPR AA HRN RCR 3-10 NCR/STRN,,,742.74,17804.0,22
CPT,49617,RPR AA HRN RCR > 10 RDC,,,770.66,17804.0,22
CPT,49618,RPR AA HRN RCR > 10 NCR/STRN,,,1076.6,17804.0,22
CPT,49621,RPR PARASTOMAL HERNIA RDC,,,655.9,17804.0,22
CPT,49622,RPR PARASTOMAL HRNA NCR/STRN,,,812.62,17804.0,22
CPT,49623,RMVL NINFCT MESH HERNIA RPR,,,175.0,3533.0,21
CPT,49650,LAP ING HERNIA REPAIR INIT,,,5928.88,17804.0,22
CPT,49651,LAP ING HERNIA REPAIR RECUR,,,5928.88,17804.0,22
CPT,49652,OP Surgery - Grouper Table,,,16786.0,16786.0,1
CPT,49653,OP Surgery - Grouper Table,,,16786.0,16786.0,1
CPT,49654,OP Surgery - Grouper Table,,,19884.0,19884.0,1
CPT,49655,OP Surgery - Grouper Table,,,19884.0,19884.0,1
CPT,49656,OP Surgery - Grouper Table,,,19884.0,19884.0,1
CPT,49657,OP Surgery - Grouper Table,,,19884.0,19884.0,1
CPT,49659,UNLSTD LAPS PX HRNAP HRNRPHY,,,5928.88,16799.0,22
CPT,49900,REPAIR OF ABDOMINAL WALL,,,733.88,8363.0,22
CPT,49904,OMENTAL FLAP EXTRA-ABDOM,,,1220.08,8363.0,22
CPT,49905,OMENTAL FLAP INTRA-ABDOM,,,304.05,16799.0,22
CPT,49906,FREE OMENTAL FLAP MICROVASC,,,2453.0,8363.0,7
CPT,49999,"HC ABD WALL, PERITONEAL & RETROPERITONEAL MASS TX W/THERM ABLAT, CRYO OR RF",6176.0,3396.8,952.75,29323.0,53
CPT,50010,RENAL EXPLORATION,,,644.5,13936.0,22
CPT,50020,DRG PERIRNL/RENAL ABSC OPEN,,,2081.7,9469.0,22
CPT,50040,NFROS NFROT W/DRG,,,842.24,13936.0,22
CPT,50045,NEPHROTOMY W/EXPLORATION,,,848.53,13936.0,22
CPT,50060,NL REMOVAL CALCULUS,,,1032.97,13936.0,22
CPT,50065,NL SEC SURG OPERJ CALCULUS,,,1094.58,13936.0,22
CPT,50070,NL COMP CGEN KDN ABNORMALITY,,,1073.8,13936.0,22
CPT,50075,NL RMVL LG STAGHORN CALCULUS,,,1318.03,13936.0,22
CPT,50080,"HC PERC NEPHRO-PYELOLITH LITHOTRIP, STONE EXTRCT, IMG GUID, SIMPL UP TO 2CM",25712.0,14141.6,7713.6,22240.88,53
CPT,50081,PERQ NL/PL LITHOTRP CPLX>2CM,,,9396.95,19884.0,22
CPT,50100,TRNSXJ/REPOS ABRRNT RNL VSLS,,,947.95,13936.0,22
CPT,50120,PYELOTOMY W/EXPLORATION,,,863.23,13936.0,22
CPT,50125,PYELOTOMY W/DRG PYELOSTOMY,,,893.1,13936.0,22
CPT,50130,PYELOTOMY W/REMOVAL CALCULUS,,,937.98,13936.0,22
CPT,50135,OP Surgery - Grouper Table,,,13936.0,13936.0,1
CPT,50200,"HC RENAL BX, PERC, BY TROCAR/NEEDLE",2869.0,1577.95,860.7,6766.0,212
CPT,50205,RENAL BX SURG EXPOSURE KDN,,,665.71,13936.0,22
CPT,50220,REMOVE KIDNEY OPEN,,,948.68,13936.0,22
CPT,50225,REMOVAL KIDNEY OPEN COMPLEX,,,1075.08,13936.0,22
CPT,50230,REMOVAL KIDNEY OPEN RADICAL,,,1152.87,13936.0,22
CPT,50234,REMOVAL OF KIDNEY & URETER,,,1175.57,13936.0,22
CPT,50236,REMOVAL OF KIDNEY & URETER,,,1324.93,13936.0,22
CPT,50240,NEPHRECTOMY PARTIAL,,,1202.71,13936.0,22
CPT,50250,OPN ABLTJ 1/> RNL MAS CRYSRG,,,1103.32,13936.0,22
CPT,50280,EXC/UNROOFING CYST KIDNEY,,,860.38,13936.0,22
CPT,50290,EXCISION PERINEPHRIC CYST,,,818.16,13936.0,22
CPT,50300,REMOVE CADAVER DONOR KIDNEY,,,2453.0,13936.0,7
CPT,50320,REMOVE KIDNEY LIVING DONOR,,,1351.4,8363.0,22
CPT,50323,PREP CADAVER RENAL ALLOGRAFT,,,2453.0,8363.0,7
CPT,50325,PREP DONOR RENAL GRAFT,,,2453.0,8363.0,7
CPT,50327,PREP RENAL GRAFT/VENOUS,,,185.37,8363.0,22
CPT,50328,PREP RENAL GRAFT/ARTERIAL,,,162.76,8363.0,22
CPT,50329,PREP RENAL GRAFT/URETERAL,,,154.68,8363.0,22
CPT,50340,RECIPIENT NEPHRECTOMY,,,853.0,8363.0,22
CPT,50360,RNL ALTRNSPLJ W/O RCP NFRCT,,,2136.89,24394.0,22
CPT,50365,RNL ALTRNSPLJ W/RCP NFRCT,,,2453.0,24394.0,22
CPT,50370,RMVL TRANSPLANTED RNL ALGRFT,,,1079.06,8363.0,22
CPT,50380,RNL AUTOTRNSPLJ RIMPLTJ KDN,,,1807.16,24394.0,22
CPT,50382,CHANGE URETER STENT PERCUT,,,2081.7,9469.0,22
CPT,50384,HC REM (VIA SNARE/CAPTURE) INTERNALLY DWELL URET STENT PERC,3630.0,1996.5,1089.0,9469.0,53
CPT,50385,CHANGE STENT VIA TRANSURETH,,,2081.7,9469.0,22
CPT,50386,REMOVE STENT VIA TRANSURETH,,,2081.7,9469.0,22
CPT,50387,HC REM & REPLACE EXTERNALLY ACCESSIBLE NEPHURET CATH FLUORO GUID,5735.0,3154.25,1720.5,6766.0,53
CPT,50389,"HC REM NEPHROST TUBE, FLUORO GUID",1396.0,767.8,418.8,4955.0,106
CPT,50389,REMOVE RENAL TUBE W/FLUORO,,,1187.0,1187.0,1
CPT,50390,"HC ASPIR/INJ RENAL CYST/PELV BY NEEDLE, PERC",3011.0,1656.05,714.99,4955.0,159
CPT,50391,HC INSTILLATION OF THERAPEUTIC AGENT INTO RENAL PELVIS/URETER VIA TUBE,601.0,330.55,180.3,4258.0,106
CPT,50396,MEASURE KIDNEY PRESSURE,,,678.28,4955.0,22
CPT,50400,REVISION OF KIDNEY/URETER,,,1047.57,14658.0,22
CPT,50405,REVISION OF KIDNEY/URETER,,,1263.33,14658.0,22
CPT,50430,"HC INJ PROC ANTGRADE NEPHGR/URETGR, IMG GUID, NEW ACC",2581.0,1419.55,678.28,4955.0,106
CPT,50430,NJX PX NFROSGRM &/URTRGRM,,,1187.0,1187.0,1
CPT,50431,"HC INJ PROC ANTGRADE NEPHGR/URETGR, IMG GUID, EXIST ACC",2522.0,1387.1,678.28,4955.0,159
CPT,50431,NJX PX NFROSGRM &/URTRGRM,,,1187.0,1187.0,1
CPT,50432,"HC PLC NEPHROST CATH, NEPHGR/URETGR, IMG GUID",6279.0,3453.45,1883.7,9469.0,53
CPT,50432,PLMT NEPHROSTOMY CATHETER,,,3642.97,3642.97,1
CPT,50433,"HC PLC NEPHURET CATH, NEPHGR/URETGR, IMG GUID, NEW ACCESS",7779.0,4278.45,2333.7,9469.0,53
CPT,50433,PLMT NEPHROURETERAL CATHETER,,,6133.48,6133.48,1
CPT,50434,CONVERT NEPHROSTOMY CATHETER,,,3642.97,3642.97,1
CPT,50434,"HC CONV NEPHROST CATH TO NEPHURET CATH, IMG GUID, VIA EXIST NEPHROST TRACT",3630.0,1996.5,1089.0,5761.0,53
CPT,50435,EXCHANGE NEPHROSTOMY CATH,,,3642.97,3642.97,1
CPT,50435,"HC EXCHG NEPHROST CATH, NEPHGR/URETGR, IMG GUID",5961.0,3278.55,1788.3,5761.0,106
CPT,50436,DILAT XST TRC NDURLGC PX,,,3504.84,9469.0,23
CPT,50437,DILAT XST TRC NEW ACCESS RCS,,,3504.84,14658.0,23
CPT,50500,REPAIR OF KIDNEY WOUND,,,1124.34,13936.0,22
CPT,50520,CLOSE KIDNEY-SKIN FISTULA,,,1014.99,13936.0,22
CPT,50525,CLOSE NEPHROVISCERAL FISTULA,,,1282.82,13936.0,22
CPT,50526,CLOSE NEPHROVISCERAL FISTULA,,,1372.66,13936.0,22
CPT,50540,REVISION OF HORSESHOE KIDNEY,,,1039.8,13936.0,22
CPT,50541,LAPARO ABLATE RENAL CYST,,,9733.0,16799.0,22
CPT,50542,LAPARO ABLATE RENAL MASS,,,10579.88,21512.0,22
CPT,50543,LAPARO PARTIAL NEPHRECTOMY,,,10315.0,19884.0,22
CPT,50544,LAPAROSCOPY PYELOPLASTY,,,10315.0,19884.0,22
CPT,50545,LAPARO RADICAL NEPHRECTOMY,,,1206.07,16786.0,22
CPT,50546,LAPAROSCOPIC NEPHRECTOMY,,,1087.54,16786.0,22
CPT,50547,LAPARO REMOVAL DONOR KIDNEY,,,1436.86,16786.0,22
CPT,50548,LAPARO REMOVE W/URETER,,,1211.76,16786.0,22
CPT,50549,UNLISTED LAPS PX RENAL,,,5928.88,16799.0,22
CPT,50551,KIDNEY ENDOSCOPY,,,3917.0,13936.0,22
CPT,50553,KIDNEY ENDOSCOPY,,,5165.97,13936.0,22
CPT,50555,KIDNEY ENDOSCOPY & BIOPSY,,,3917.0,13936.0,22
CPT,50557,KIDNEY ENDOSCOPY & TREATMENT,,,5480.0,19884.0,22
CPT,50561,KIDNEY ENDOSCOPY & TREATMENT,,,5165.97,13936.0,22
CPT,50562,RENAL SCOPE W/TUMOR RESECT,,,2932.0,19884.0,22
CPT,50570,KIDNEY ENDOSCOPY,,,2932.0,8363.0,22
CPT,50572,KIDNEY ENDOSCOPY,,,678.28,4955.0,22
CPT,50574,KIDNEY ENDOSCOPY & BIOPSY,,,2932.0,5761.0,22
CPT,50575,KIDNEY ENDOSCOPY,,,5165.97,16799.0,22
CPT,50576,KIDNEY ENDOSCOPY & TREATMENT,,,3917.0,13936.0,22
CPT,50580,KIDNEY ENDOSCOPY & TREATMENT,,,3917.0,13936.0,22
CPT,50590,FRAGMENTING OF KIDNEY STONE,,,3504.84,21696.0,22
CPT,50592,"HC ABLAT, 1/MORE RENAL TUMOR(S), PERC, UNILAT, RADFREQ",7738.0,4255.9,2321.4,17804.0,53
CPT,50593,"HC ABLAT, RENAL TUMOR(S), UNILAT, PERC, CRYOTHER",14232.0,7827.6,4269.6,19884.0,106
CPT,50600,EXPLORATION OF URETER,,,851.41,8363.0,22
CPT,50605,INSERT URETERAL SUPPORT,,,885.7,8363.0,22
CPT,50606,ENDOLUMINAL BX URTR RNL PLVS,,,436.07,3533.0,22
CPT,50610,REMOVAL OF URETER STONE,,,857.82,8363.0,22
CPT,50620,REMOVAL OF URETER STONE,,,820.73,8363.0,22
CPT,50630,REMOVAL OF URETER STONE,,,810.92,8363.0,22
CPT,50650,REMOVAL OF URETER,,,941.51,8363.0,22
CPT,50660,REMOVAL OF URETER,,,1036.07,8363.0,22
CPT,50684,INJECTION FOR URETER X-RAY,,,115.21,3533.0,22
CPT,50686,MEASURE URETER PRESSURE,,,158.99,4258.0,22
CPT,50688,HC CHANGE URETEROSTOMY TUBE/EXTERN ACCESS URETERAL STENT VIA ILEAL CONDUIT,3706.0,2038.3,1111.8,6766.0,106
CPT,50690,HC INJ PROC FOR VISUALIZATION OF ILEAL CONDUIT AND/OR URETEROPYELOGRAPHY,709.0,389.95,108.25,3533.0,159
CPT,50690,INJECTION FOR URETER X-RAY,,,189.45,189.45,1
CPT,50693,"HC PLC URET STNT, INCL NEPH/URETGR, IMG GUID, EXIST NEPHROST TRACT",8690.0,4779.5,2607.0,14658.0,106
CPT,50693,PLMT URETERAL STENT PRQ,,,6133.48,6133.48,1
CPT,50694,"HC PLC URET STNT, INCL NEPH/URETGR, IMG GUID, NEW ACC, WO SEP NEPHROST CATH",5942.0,3268.1,1782.6,14658.0,53
CPT,50694,PLMT URETERAL STENT PRQ,,,6133.48,6133.48,1
CPT,50695,"HC PLC URET STNT, INCL NEPH/URETGR, IMG GUID, NEW ACC, W SEP NEPHROST CATH",9499.0,5224.45,2849.7,14658.0,53
CPT,50695,PLMT URETERAL STENT PRQ,,,6133.48,6133.48,1
CPT,50700,REVISION OF URETER,,,842.57,8363.0,22
CPT,50705,"HC URET EMBOLIZATION/OCCLUSION, IMG GUID (AD)",26590.0,14624.5,835.0,23000.35,53
CPT,50705,URETERAL EMBOLIZATION/OCCL,,,2852.39,2852.39,1
CPT,50706,BALLOON DILATE URTRL STRIX,,,1297.19,1297.19,1
CPT,50706,"HC BALLOON DILATION, URET STRICTURE, IMG GUID (AD)",5945.0,3269.75,741.25,5142.43,53
CPT,50715,RELEASE OF URETER,,,1078.74,8363.0,22
CPT,50722,RELEASE OF URETER,,,912.7,8363.0,22
CPT,50725,RELEASE/REVISE URETER,,,999.5,8363.0,22
CPT,50727,REVISE URETER,,,3504.84,9469.0,22
CPT,50728,REVISE URETER,,,640.34,8363.0,22
CPT,50740,FUSION OF URETER & KIDNEY,,,1070.73,8363.0,22
CPT,50750,FUSION OF URETER & KIDNEY,,,1045.34,8363.0,22
CPT,50760,URETEROURETEROSTOMY,,,1012.68,8363.0,22
CPT,50770,SPLICING OF URETERS,,,1045.34,8363.0,22
CPT,50780,REIMPLANT URETER IN BLADDER,,,1002.03,9469.0,22
CPT,50782,REIMPLANT URETER IN BLADDER,,,975.3,8363.0,22
CPT,50783,REIMPLANT URETER IN BLADDER,,,1021.78,8363.0,22
CPT,50785,REIMPLANT URETER IN BLADDER,,,1097.05,8363.0,22
CPT,50800,IMPLANT URETER IN BOWEL,,,839.89,8363.0,22
CPT,50810,FUSION OF URETER & BOWEL,,,1231.25,8363.0,22
CPT,50815,URINE SHUNT TO INTESTINE,,,1111.84,8363.0,22
CPT,50820,CONSTRUCT BOWEL BLADDER,,,1187.16,8363.0,22
CPT,50825,CONSTRUCT BOWEL BLADDER,,,1489.33,8363.0,22
CPT,50830,REVISE URINE FLOW,,,1627.4,8363.0,22
CPT,50840,REPLACE URETER BY BOWEL,,,1118.02,8363.0,22
CPT,50845,APPENDICO-VESICOSTOMY,,,1141.13,8363.0,22
CPT,50860,TRANSPLANT URETER TO SKIN,,,860.05,8363.0,22
CPT,50900,REPAIR OF URETER,,,768.27,8363.0,22
CPT,50920,CLOSURE URETER/SKIN FISTULA,,,803.02,8363.0,22
CPT,50930,CLOSURE URETER/BOWEL FISTULA,,,998.86,8363.0,22
CPT,50940,RELEASE OF URETER,,,808.25,8363.0,22
CPT,50945,LAPAROSCOPY URETEROLITHOTOMY,,,5928.88,17804.0,22
CPT,50947,LAPARO NEW URETER/BLADDER,,,10315.0,17804.0,22
CPT,50948,LAPARO NEW URETER/BLADDER,,,10315.0,19884.0,22
CPT,50949,UNLISTED LAPS PX URETER,,,5928.88,16799.0,22
CPT,50951,ENDOSCOPY OF URETER,,,2932.0,5761.0,22
CPT,50953,ENDOSCOPY OF URETER,,,3504.84,8363.0,22
CPT,50955,URETER ENDOSCOPY & BIOPSY,,,5165.97,13936.0,22
CPT,50957,URETER ENDOSCOPY & TREATMENT,,,5165.97,13936.0,22
CPT,50961,URETER ENDOSCOPY & TREATMENT,,,5165.97,13936.0,22
CPT,50970,URETER ENDOSCOPY,,,2932.0,5761.0,22
CPT,50972,URETER ENDOSCOPY & CATHETER,,,2932.0,8363.0,22
CPT,50974,URETER ENDOSCOPY & BIOPSY,,,3917.0,13936.0,22
CPT,50976,URETER ENDOSCOPY & TREATMENT,,,3917.0,13936.0,22
CPT,50980,URETER ENDOSCOPY & TREATMENT,,,5165.97,13936.0,22
CPT,51020,CYSTOTOMY/CYSTOSTOMY W/FULG,,,3504.84,9469.0,22
CPT,51030,OP Surgery - Grouper Table,,,8363.0,8363.0,1
CPT,51040,INCISE & DRAIN BLADDER,,,2081.7,9469.0,22
CPT,51045,INCISE BLADDER/DRAIN URETER,,,2081.7,5761.0,22
CPT,51050,REMOVAL OF BLADDER STONE,,,5165.97,13936.0,22
CPT,51060,REMOVAL OF URETER STONE,,,2081.7,16799.0,22
CPT,51065,REMOVE URETER CALCULUS,,,3504.84,9469.0,22
CPT,51080,DRAINAGE OF BLADDER ABSCESS,,,2908.42,8363.0,22
CPT,51100,DRAIN BLADDER BY NEEDLE,,,247.15,4258.0,22
CPT,51101,DRAIN BLADDER BY TROCAR/CATH,,,1033.87,6766.0,22
CPT,51102,"HC ASPIRATION OF BLADDER, WITH INSERTION OF SUPRAPUBIC CATH",5508.0,3029.4,1652.4,9469.0,159
CPT,51500,REMOVAL OF BLADDER CYST,,,5928.88,16786.0,22
CPT,51520,REMOVAL OF BLADDER LESION,,,3504.84,9469.0,22
CPT,51525,REMOVAL OF BLADDER LESION,,,780.08,14658.0,22
CPT,51530,REMOVAL OF BLADDER LESION,,,702.28,14658.0,22
CPT,51535,REPAIR OF URETER LESION,,,3504.84,9469.0,22
CPT,51550,PARTIAL REMOVAL OF BLADDER,,,870.28,8363.0,22
CPT,51555,PARTIAL REMOVAL OF BLADDER,,,1139.85,8363.0,22
CPT,51565,REVISE BLADDER & URETER(S),,,1168.05,8363.0,22
CPT,51570,REMOVAL OF BLADDER,,,1328.42,13936.0,22
CPT,51575,REMOVAL OF BLADDER & NODES,,,1639.54,13936.0,22
CPT,51580,REMOVE BLADDER/REVISE TRACT,,,1713.18,13936.0,22
CPT,51585,REMOVAL OF BLADDER & NODES,,,1904.52,13936.0,22
CPT,51590,REMOVE BLADDER/REVISE TRACT,,,1740.92,13936.0,22
CPT,51595,REMOVE BLADDER/REVISE TRACT,,,1969.83,13936.0,22
CPT,51596,REMOVE BLADDER/CREATE POUCH,,,2125.29,13936.0,22
CPT,51597,REMOVAL OF PELVIC STRUCTURES,,,2068.41,13936.0,22
CPT,51600,HC INJECTION PROCEDURE FOR CYSTOGRAPY OR VOIDING URETHROCYSTOGRAPY,476.0,261.8,142.8,3533.0,159
CPT,51600,INJECTION FOR BLADDER X-RAY,,,330.84,330.84,1
CPT,51605,PREPARATION FOR BLADDER XRAY,,,35.07,3533.0,22
CPT,51610,HC INJ PROC RETROGRADE URETHROCYSTOGRAPY,383.0,210.65,114.9,3533.0,159
CPT,51610,INJECTION FOR BLADDER X-RAY,,,204.89,204.89,1
CPT,51700,"HC BLADDER IRRIGATION, SIMPLE, LAVAGE AND/OR INSTILLATION",944.0,519.2,247.15,4258.0,901
CPT,51701,HC INSERTION NON-INDWELLING BLADDER CATHETER (STRAIGHT),470.0,258.5,130.99,4258.0,3339
CPT,51702,"HC INSERTION TEMPORARY INDWELLING BLADDER CATHETER, SIMPLE",623.5,342.925,130.99,4258.0,3392
CPT,51703,HC INSERT TEMP INDWELL BLADDER CATH COMPLX,1168.0,642.4,158.99,4258.0,424
CPT,51705,"HC CHANGE CYSTOSTOMY TUBE, SIMPLE",750.0,412.5,225.0,4258.0,371
CPT,51710,HC CHANGE CYSTOSTOMY TUBE COMPLEX,1984.0,1091.2,595.2,4955.0,212
CPT,51715,HC ENDOSCOPIC INJ IMPLANT,8476.0,4661.8,2542.8,14658.0,53
CPT,51720,HC BLADDER INSTILLATION OF ANTICARCINOGENIC AGENT (INCL RETENTION TIME),1192.5,655.875,351.0,4258.0,159
CPT,51721,INS TRURL ABLT TRNSDC THR US,,,498.54,19884.0,22
CPT,51725,HC SIMPLE CYSTOMETROGRAM,668.0,367.4,200.4,3533.0,53
CPT,51726,HC COMPLEX CYSTOMETROGRAM,601.0,330.55,180.3,3533.0,106
CPT,51727,HC CYSTOMETROGRAM W UP,1653.0,909.15,495.9,4955.0,53
CPT,51728,HC CYSTOMETROGRAM W VP,1661.0,913.55,498.3,4955.0,106
CPT,51729,HC CYSTOMETROGRAM W VP & UP,1592.0,875.6,477.6,4955.0,106
CPT,51736,URINE FLOW MEASUREMENT,,,130.99,3533.0,21
CPT,51741,HC COMPLEX ELECTRO-UROFLOWMETRY FIRST,380.5,209.275,112.8,3533.0,265
CPT,51784,HC EMG STUDY ANAL URETHRAL SPHINCTER OTH THAN NDL,421.0,231.55,126.3,3533.0,106
CPT,51785,HC NDL EMG STDY ANAL URETHRAL SPHINCTER ANY TECHNQ,1203.0,661.65,247.15,3533.0,106
CPT,51792,URINARY REFLEX STUDY,,,60.36,3533.0,21
CPT,51797,HC INTRAABDOMINAL PRESSURE TEST,729.0,400.95,153.85,3533.0,106
CPT,51798,"HC MEASURE POST-VOID RESID URINE AND/OR BLADDER CAPACITY BY US,NON-IMAG",378.5,208.175,60.36,3533.0,1219
CPT,51800,REVISION OF BLADDER/URETHRA,,,942.83,13936.0,22
CPT,51820,REVISION OF URINARY TRACT,,,986.24,13936.0,22
CPT,51840,ATTACH BLADDER/URETHRA,,,630.98,9469.0,22
CPT,51841,ATTACH BLADDER/URETHRA,,,733.19,9469.0,22
CPT,51845,REPAIR BLADDER NECK,,,5016.42,16799.0,22
CPT,51860,REPAIR OF BLADDER WOUND,,,5480.0,13936.0,22
CPT,51865,REPAIR OF BLADDER WOUND,,,810.0,14658.0,22
CPT,51880,REPAIR OF BLADDER OPENING,,,3504.84,9469.0,22
CPT,51900,REPAIR BLADDER/VAGINA LESION,,,752.0,14658.0,22
CPT,51920,CLOSE BLADDER-UTERUS FISTULA,,,697.32,9469.0,22
CPT,51925,HYSTERECTOMY/BLADDER REPAIR,,,965.03,16786.0,22
CPT,51940,CORRECTION OF BLADDER DEFECT,,,1482.8,13936.0,22
CPT,51960,REVISION OF BLADDER & BOWEL,,,1254.82,13936.0,22
CPT,51980,CONSTRUCT BLADDER OPENING,,,651.63,9469.0,22
CPT,51990,LAPARO URETHRAL SUSPENSION,,,5928.88,17804.0,22
CPT,51992,LAPARO SLING OPERATION,,,5928.88,17804.0,22
CPT,51999,UNLISTED LAPS PX BLADDER,,,5928.88,29323.0,22
CPT,52000,HC CYSTOSCOPY,1959.0,1077.45,587.7,4955.0,530
CPT,52001,HC CYSTOSCOPY REMOVAL OF CLOTS,6406.0,3523.3,1921.8,8363.0,106
CPT,52005,HC CYSTOSCOPY & URETER CATH,8699.0,4784.45,2081.7,9469.0,212
CPT,52007,CYSTO URTRL CATHJ BRUSH BX,,,3504.84,9469.0,22
CPT,52010,CYSTOSCOPY & DUCT CATHETER,,,678.28,4955.0,22
CPT,52204,HC CYSTOSCOPY W BX(S),4952.0,2723.6,1485.6,9469.0,53
CPT,52214,HC CYSTO W DESTRUCTION OF LESION,6192.0,3405.6,1615.2,9469.0,106
CPT,52224,HC CYSTOURETHSCP W/ FULGUR/TREAT MINOR (LESS THN 0.5 CM) LESION(S) W/W/O BX,5520.0,3036.0,1440.0,9469.0,159
CPT,52234,HC CYSTO W/ FULGRATION AND/OR RESECT SM BLADDER TUMOR(S) (0.5-2.0 CM),10457.5,5751.625,2542.8,10759.74,159
CPT,52235,HC CYSTO W REMOVAL OF BLADDER TUMOR MED,13257.0,7291.35,3504.84,11467.31,53
CPT,52240,CYSTOSCOPY AND TREATMENT,,,5165.97,13936.0,22
CPT,52250,CYSTOSCOPY AND RADIOTRACER,,,3504.84,9469.0,22
CPT,52260,CYSTOSCOPY AND TREATMENT,,,2081.7,6766.0,22
CPT,52265,CYSTOSCOPY AND TREATMENT,,,2081.7,5761.0,22
CPT,52270,CYSTOSCOPY & REVISE URETHRA,,,2081.7,6766.0,22
CPT,52275,CYSTOSCOPY & REVISE URETHRA,,,2081.7,9469.0,22
CPT,52276,CYSTOSCOPY AND TREATMENT,,,2081.7,9469.0,22
CPT,52277,CYSTOSCOPY AND TREATMENT,,,3504.84,9469.0,22
CPT,52281,HC CYSTO CALIBRATN DILAT URETHRAL STRICT STENOSIS,4831.0,2657.05,1449.3,6766.0,106
CPT,52282,CYSTOSCOPY IMPLANT STENT,,,3504.84,9469.0,22
CPT,52283,CYSTOSCOPY AND TREATMENT,,,2081.7,9469.0,22
CPT,52284,CYSTO RX BALO CATH URTL STRX,,,5165.97,13936.0,22
CPT,52285,CYSTOSCOPY AND TREATMENT,,,678.28,6766.0,22
CPT,52287,HC CYSTOURETHROSCOPY W INJ CHEMODENERVATN BLADDER,4952.0,2723.6,1485.6,6766.0,106
CPT,52290,CYSTOSCOPY AND TREATMENT,,,2081.7,9469.0,22
CPT,52300,CYSTOSCOPY AND TREATMENT,,,3504.84,9469.0,22
CPT,52301,CYSTOSCOPY AND TREATMENT,,,3504.84,9469.0,22
CPT,52305,CYSTOSCOPY AND TREATMENT,,,5165.97,13936.0,22
CPT,52310,HC CYSTO W REM FOREIGN BODY STONE STENT SIMPLE,5554.0,3054.7,1495.5,6766.0,318
CPT,52315,HC CYSTO W REM FOREIGN BODY STONE STENT COMPLEX,4952.0,2723.6,1485.6,9469.0,53
CPT,52317,"HC LITHOLAPAXY, CRUSHING/REMOVAL OF FRAGMENTS, SIMPLE/SM LESS THAN 2.5 CM",8476.0,4661.8,2542.8,9469.0,53
CPT,52318,REMOVE BLADDER STONE,,,3504.84,9469.0,22
CPT,52320,CYSTOSCOPY AND TREATMENT,,,3504.84,9469.0,22
CPT,52325,CYSTOSCOPY STONE REMOVAL,,,5165.97,13936.0,22
CPT,52327,CYSTOSCOPY INJECT MATERIAL,,,5165.97,16799.0,22
CPT,52330,CYSTOSCOPY AND TREATMENT,,,3504.84,9469.0,22
CPT,52332,HC CYSTO W INSERT INDWELLING URETERAL STENT,8476.0,4661.8,2542.8,9469.0,53
CPT,52334,CREATE PASSAGE TO KIDNEY,,,3504.84,9469.0,22
CPT,52341,HC CYSTO W URETER STRICTURE TX,8476.0,4661.8,2542.8,9469.0,53
CPT,52342,CYSTO W/UP STRICTURE TX,,,3504.84,9469.0,22
CPT,52343,CYSTO W/RENAL STRICTURE TX,,,3504.84,9469.0,22
CPT,52344,CYSTO/URETERO STRICTURE TX,,,3504.84,9469.0,22
CPT,52345,CYSTO/URETERO W/UP STRICTURE,,,3504.84,9469.0,22
CPT,52346,CYSTOURETERO W/RENAL STRICT,,,5165.97,13936.0,22
CPT,52351,HC CYSTOURETERO & OR PYELOSCOPE,6316.5,3474.075,1647.9,9469.0,159
CPT,52352,HC CYSTOURETERO W STONE REM,8476.0,4661.8,2542.8,9469.0,53
CPT,52353,CYSTOURETERO W/LITHOTRIPSY,,,5165.97,16799.0,22
CPT,52354,CYSTOURETERO W/BIOPSY,,,5165.97,13936.0,22
CPT,52355,CYSTOURETERO W/EXCISE TUMOR,,,5165.97,13936.0,22
CPT,52356,CYSTO/URETERO W/LITHOTRIPSY,,,5165.97,16799.0,22
CPT,52400,CYSTO CGEN POST URTL VALVES,,,3504.84,9469.0,22
CPT,52402,CYSTO TRURL RESCJ EJACUL DUX,,,3504.84,9469.0,22
CPT,52441,CYSTO INSJ TRNSPRSTC 1 IMPLT,,,835.0,8363.0,22
CPT,52442,CYSTO INS TRNSPRSTC IMPLT EA,,,756.88,8363.0,22
CPT,52450,TRANSURETHRAL INC PROSTATE,,,3504.84,9469.0,22
CPT,52500,TRURL RESECTION BLADDER NECK,,,3504.84,9469.0,22
CPT,52601,PROSTATECTOMY (TURP),,,5165.97,16799.0,22
CPT,52630,REMOVE PROSTATE REGROWTH,,,5165.97,16799.0,22
CPT,52640,RELIEVE BLADDER CONTRACTURE,,,3504.84,9469.0,22
CPT,52647,APC,,,5165.97,5320.95,15
CPT,52647,OP Surgery - Grouper Table,,,9733.0,16799.0,7
CPT,52648,LASER SURGERY OF PROSTATE,,,5165.97,16799.0,22
CPT,52649,PROSTATE LASER ENUCLEATION,,,5165.97,16799.0,22
CPT,52700,DRAINAGE OF PROSTATE ABSCESS,,,3504.84,9469.0,22
CPT,53000,INCISION OF URETHRA,,,2081.7,9469.0,22
CPT,53010,INCISION OF URETHRA,,,5165.97,13936.0,22
CPT,53020,HC INCISION OF URETHRA,7265.0,3995.75,2081.7,9469.0,106
CPT,53025,INCISION OF URETHRA,,,2081.7,9469.0,22
CPT,53040,DRAINAGE OF URETHRA ABSCESS,,,3504.84,9469.0,22
CPT,53060,DRAINAGE OF URETHRA ABSCESS,,,2081.7,9469.0,22
CPT,53080,DRAINAGE OF URINARY LEAKAGE,,,678.28,9469.0,22
CPT,53085,DRAINAGE OF URINARY LEAKAGE,,,2081.7,9469.0,22
CPT,53200,HC URETHRA BX,4952.0,2723.6,1485.6,9469.0,53
CPT,53210,REMOVAL OF URETHRA,,,3504.84,14658.0,22
CPT,53215,REMOVAL OF URETHRA,,,5165.97,13936.0,22
CPT,53220,TREATMENT OF URETHRA LESION,,,3504.84,14658.0,22
CPT,53230,REMOVAL OF URETHRA LESION,,,5165.97,14658.0,22
CPT,53235,REMOVAL OF URETHRA LESION,,,5165.97,13936.0,22
CPT,53240,SURGERY FOR URETHRA POUCH,,,3504.84,14658.0,22
CPT,53250,REMOVAL OF URETHRA GLAND,,,3504.84,9469.0,22
CPT,53260,TREATMENT OF URETHRA LESION,,,3504.84,9469.0,22
CPT,53265,TREATMENT OF URETHRA LESION,,,2081.7,9469.0,22
CPT,53270,REMOVAL OF URETHRA GLAND,,,3504.84,9469.0,22
CPT,53275,REPAIR OF URETHRA DEFECT,,,3504.84,9469.0,22
CPT,53400,REVISE URETHRA STAGE 1,,,5165.97,14658.0,22
CPT,53405,REVISE URETHRA STAGE 2,,,5165.97,14658.0,22
CPT,53410,RECONSTRUCTION OF URETHRA,,,5165.97,14658.0,22
CPT,53415,RECONSTRUCTION OF URETHRA,,,1024.36,16799.0,22
CPT,53420,RECONSTRUCT URETHRA STAGE 1,,,5165.97,14658.0,22
CPT,53425,RECONSTRUCT URETHRA STAGE 2,,,5165.97,14658.0,22
CPT,53430,RECONSTRUCTION OF URETHRA,,,5165.97,14658.0,22
CPT,53431,RECONSTRUCT URETHRA/BLADDER,,,5165.97,14658.0,22
CPT,53440,MALE SLING PROCEDURE,,,12463.0,21512.0,22
CPT,53442,REMOVE/REVISE MALE SLING,,,5165.97,14658.0,22
CPT,53444,INSERT TANDEM CUFF,,,12463.0,24394.0,22
CPT,53445,INSERT URO/VES NCK SPHINCTER,,,13725.0,24394.0,22
CPT,53446,REMOVE URO SPHINCTER,,,5165.97,17804.0,22
CPT,53447,REMOVE/REPLACE UR SPHINCTER,,,13725.0,24394.0,22
CPT,53448,REMOV/REPLC UR SPHINCTR COMP,,,1157.08,13936.0,22
CPT,53449,REPAIR URO SPHINCTER,,,8488.0,14658.0,22
CPT,53450,REVISION OF URETHRA,,,3504.84,14658.0,22
CPT,53451,TPRNL BALO CNTNC DEV BI,,,12463.0,24394.0,22
CPT,53452,TPRNL BALO CNTNC DEV UNI,,,5480.0,13936.0,22
CPT,53453,TPRNL BALO CNTNC DEV RMVL EA,,,3504.84,9469.0,22
CPT,53454,TPRNL BALO CNTNC DEV ADJMT,,,247.15,4258.0,22
CPT,53460,REVISION OF URETHRA,,,3504.84,9469.0,22
CPT,53500,URETHRLYS TRANSVAG W/ SCOPE,,,3504.84,14658.0,22
CPT,53502,REPAIR OF URETHRA INJURY,,,3504.84,9469.0,22
CPT,53505,REPAIR OF URETHRA INJURY,,,5165.97,14658.0,22
CPT,53510,REPAIR OF URETHRA INJURY,,,5165.97,13936.0,22
CPT,53515,REPAIR OF URETHRA INJURY,,,5165.97,14658.0,22
CPT,53520,REPAIR OF URETHRA DEFECT,,,5165.97,14658.0,22
CPT,53600,HC DILAT URETHRAL STRICT DILATOR MALE INIT,832.0,457.6,180.3,4258.0,212
CPT,53601,HC DILAT URETHRAL STRICT DILATOR MALE SUBSEQ,292.5,160.875,86.7,4258.0,159
CPT,53605,DILATE URETHRA STRICTURE,,,3504.84,6766.0,22
CPT,53620,DILATE URETHRA STRICTURE,,,678.28,4955.0,22
CPT,53621,DILATE URETHRA STRICTURE,,,247.15,4258.0,22
CPT,53660,HC DILAT FEMALE URETHRA W SUPPOSITORY INSTILL INIT,468.0,257.4,114.0,4258.0,159
CPT,53661,HC DILAT FEMALE URETHRA W SUPPOSIT INSTILL SUBSEQ,292.5,160.875,86.7,4258.0,159
CPT,53665,DILATION OF URETHRA,,,2081.7,9469.0,22
CPT,53850,PROSTATIC MICROWAVE THERMOTX,,,3504.84,8363.0,22
CPT,53852,PROSTATIC RF THERMOTX,,,3504.84,16799.0,22
CPT,53854,TRURL DSTRJ PRST8 TISS RF WV,,,3504.84,9469.0,22
CPT,53855,INSERT PROST URETHRAL STENT,,,2081.7,5761.0,22
CPT,53860,TRANSURETHRAL RF TREATMENT,,,2081.7,6766.0,22
CPT,53865,CYSTO INSJ DEV ISCHMC RMDLG,,,5480.0,9678.86,22
CPT,53866,CATHJ RMVL DEV ISCHMC RMDLG,,,247.15,4258.0,22
CPT,53899,UNLISTED PX URINARY SYSTEM,,,247.15,29323.0,22
CPT,54000,SLITTING OF PREPUCE,,,3504.84,9469.0,22
CPT,54001,HC SLITTING OF PREPUCE,4952.0,2723.6,1485.6,9469.0,53
CPT,54015,I&D PENIS DEEP,,,1646.49,6766.0,22
CPT,54050,HC DESTRUCT PENIS LESION(S) SIMPLE CHEMICAL,695.0,382.25,206.1,4258.0,318
CPT,54055,HC DESTRUCT PENIS LESION(S) SIMPLE ELECTRDESICCATN,4434.0,2438.7,1330.2,6766.0,53
CPT,54056,HC DESTRUCT PENIS LESION(S) SIMPLE CRYOSURGERY,487.0,267.85,146.1,4258.0,212
CPT,54057,LASER SURG PENIS LESION(S),,,1858.86,6766.0,22
CPT,54060,HC DESTRUCT PENIS LESION(S) SIMPLE SURG EXCISION,5194.5,2856.975,1330.2,6766.0,159
CPT,54065,HC DESTRUCT PENIS LESION(S) EXTENSIVE,4434.0,2438.7,1330.2,6766.0,106
CPT,54100,HC BX PENIS SEPARATE PROC,4106.5,2258.575,1182.6,6766.0,318
CPT,54105,BIOPSY OF PENIS,,,2908.42,9469.0,22
CPT,54110,TREATMENT OF PENIS LESION,,,3504.84,16799.0,22
CPT,54111,TREAT PENIS LESION GRAFT,,,5165.97,16799.0,22
CPT,54112,TREAT PENIS LESION GRAFT,,,9396.95,19884.0,22
CPT,54115,HC REM FOREIGN BODY DEEP PENILE TISSUE,6909.0,3799.95,2072.7,9469.0,53
CPT,54120,PARTIAL REMOVAL OF PENIS,,,3504.84,14658.0,22
CPT,54125,REMOVAL OF PENIS,,,752.57,8363.0,22
CPT,54130,REMOVE PENIS & NODES,,,1083.27,8363.0,22
CPT,54135,REMOVE PENIS & NODES,,,1366.85,8363.0,22
CPT,54150,"HC CIRCUMCISION, W/ CLAMP/OTHER DEVICE W/ REGIONAL DORSAL PENILE/RING BLOCK",4087.0,2247.85,1226.1,9469.0,53
CPT,54150,"HC NB CIRCUMCISION, W/ CLAMP/OTHER DEV W/ REGIONAL DORSAL PENILE/RING BLOCK",341.0,187.55,102.3,9469.0,106
CPT,54160,"HC CIRCUMCISION, SURG EXCISION, W/O CLAMP/DEVICE/DORSAL SLIT, NEONATE",325.0,178.75,97.5,9469.0,53
CPT,54161,"HC CIRCUMCISION, SURG EXC, W/O CLMP/DEV/DORS SLIT,OLDER TH AGE 28 DAYS, PED",325.0,178.75,97.5,9469.0,53
CPT,54161,"HC CIRCUMCISION, SURG EXCISION, W/O CLMP/DEV/DORS SLIT,OLDER TH AGE 28 DAYS",4952.0,2723.6,1485.6,9469.0,53
CPT,54162,HC LYSIS OR EXCISION OF PENILE POST-CIRCUMCISION ADHESIONS,4952.0,2723.6,1485.6,9469.0,53
CPT,54163,REPAIR OF CIRCUMCISION,,,2081.7,9469.0,22
CPT,54164,FRENULOTOMY OF PENIS,,,2081.7,9469.0,22
CPT,54200,HC INJ PROC PEYRONIE DISEASE,601.0,330.55,180.3,4258.0,106
CPT,54205,NJX PX PEYRONIE DS EXPS PLAQ,,,5165.97,14658.0,22
CPT,54220,HC IRRIGATION OF CORPORA CAVERNOSA FOR PRIAPISM,1127.0,619.85,247.15,4258.0,159
CPT,54230,NJX CORPORA CAVERNOSOGRAPY,,,98.61,3533.0,21
CPT,54231,DYNAMIC CAVERNOSOMETRY,,,247.15,6766.0,22
CPT,54235,HC INJECTION OF CORPORA CAVERNOSA WITH PHARMACOLOGIC AGENT(S),834.0,458.7,247.15,4258.0,265
CPT,54240,PENILE PLETHYSMOGRAPHY,,,316.44,4258.0,22
CPT,54250,NCTRNL PEN TMSCN&/RGDITY TST,,,247.15,4258.0,22
CPT,54300,REVISION OF PENIS,,,3504.84,16799.0,22
CPT,54304,REVISION OF PENIS,,,3504.84,16799.0,22
CPT,54308,RECONSTRUCTION OF URETHRA,,,5165.97,16799.0,22
CPT,54312,RECONSTRUCTION OF URETHRA,,,3504.84,14658.0,22
CPT,54316,RECONSTRUCTION OF URETHRA,,,8488.0,14658.0,22
CPT,54318,RECONSTRUCTION OF URETHRA,,,3504.84,14658.0,22
CPT,54322,RECONSTRUCTION OF URETHRA,,,3504.84,14658.0,22
CPT,54324,RECONSTRUCTION OF URETHRA,,,3504.84,16799.0,22
CPT,54326,RECONSTRUCTION OF URETHRA,,,3504.84,14658.0,22
CPT,54328,REVISE PENIS/URETHRA,,,3504.84,16799.0,22
CPT,54332,REVISE PENIS/URETHRA,,,3504.84,14658.0,22
CPT,54336,REVISE PENIS/URETHRA,,,3504.84,14658.0,22
CPT,54340,RPR HYPSPAD COMP SIMPLE,,,3504.84,14658.0,22
CPT,54344,RRP HYPSPAD COMP MOBLJ&URTP,,,8488.0,14658.0,22
CPT,54348,RPR HYPSPAD COMP DSJ & URTP,,,5165.97,14658.0,22
CPT,54352,REVJ PRIOR HYPSPAD REPAIR,,,5165.97,16799.0,22
CPT,54360,PENIS PLASTIC SURGERY,,,3504.84,16799.0,22
CPT,54380,REPAIR PENIS,,,2081.7,14658.0,22
CPT,54385,REPAIR PENIS,,,2081.7,14658.0,22
CPT,54390,REPAIR PENIS AND BLADDER,,,1126.4,16799.0,22
CPT,54400,INSERT SEMI-RIGID PROSTHESIS,,,12463.0,24394.0,22
CPT,54401,INSERT SELF-CONTD PROSTHESIS,,,13725.0,24394.0,22
CPT,54405,INSERT MULTI-COMP PENIS PROS,,,13725.0,24394.0,22
CPT,54406,REMOVE MUTI-COMP PENIS PROS,,,3504.84,14658.0,22
CPT,54408,REPAIR MULTI-COMP PENIS PROS,,,5165.97,16799.0,22
CPT,54410,REMOVE/REPLACE PENIS PROSTH,,,13725.0,24394.0,22
CPT,54411,REMOV/REPLC PENIS PROS COMP,,,835.0,24394.0,22
CPT,54415,REMOVE SELF-CONTD PENIS PROS,,,3504.84,14658.0,22
CPT,54416,REMV/REPL PENIS CONTAIN PROS,,,13725.0,24394.0,22
CPT,54417,REMV/REPLC PENIS PROS COMPL,,,2932.0,24394.0,22
CPT,54420,REVISION OF PENIS,,,3504.84,14658.0,22
CPT,54430,"HC CORPORA CAVERNOSA-CORPUS SPONGIOSUM SHUNT, UNILATERAL OR BILATERAL",4871.0,2679.05,584.87,8363.0,53
CPT,54435,REVISION OF PENIS,,,3504.84,14658.0,22
CPT,54437,REPAIR CORPOREAL TEAR,,,3504.84,9469.0,22
CPT,54438,OP Surgery - Grouper Table,,,24394.0,24394.0,1
CPT,54440,REPAIR OF PENIS,,,3504.84,14658.0,22
CPT,54450,PREPUTIAL STRETCHING,,,247.15,4258.0,22
CPT,54500,HC NDL BX TESTIS,4757.0,2616.35,1427.1,8363.0,53
CPT,54505,BIOPSY OF TESTIS,,,3504.84,9469.0,22
CPT,54512,EXCISE LESION TESTIS,,,3504.84,9469.0,22
CPT,54520,REMOVAL OF TESTIS,,,3504.84,14658.0,22
CPT,54522,ORCHIECTOMY PARTIAL,,,3504.84,9469.0,22
CPT,54530,REMOVAL OF TESTIS,,,3586.23,14658.0,22
CPT,54535,EXTENSIVE TESTIS SURGERY,,,3504.84,14658.0,22
CPT,54550,EXPLORATION FOR TESTIS,,,3586.23,14658.0,22
CPT,54560,EXPLORATION FOR TESTIS,,,2081.7,9469.0,22
CPT,54600,REDUCE TESTIS TORSION,,,3504.84,9469.0,22
CPT,54620,SUSPENSION OF TESTIS,,,3504.84,9469.0,22
CPT,54640,ORCHIOPEXY INGUN/SCROT APPR,,,3586.23,14658.0,22
CPT,54650,ORCHIOPEXY (FOWLER-STEPHENS),,,3586.23,14658.0,22
CPT,54660,REVISION OF TESTIS,,,5165.97,13936.0,22
CPT,54670,REPAIR TESTIS INJURY,,,3504.84,9469.0,22
CPT,54680,RELOCATION OF TESTIS(ES),,,3504.84,9469.0,22
CPT,54690,LAPAROSCOPY ORCHIECTOMY,,,5928.88,17804.0,22
CPT,54692,LAPAROSCOPY ORCHIOPEXY,,,5928.88,17804.0,22
CPT,54699,UNLISTED LAPS PX TESTIS,,,5928.88,29323.0,22
CPT,54700,HC DRAINAGE OF SCROTUM,7818.0,4299.9,2081.7,9469.0,53
CPT,54800,BIOPSY OF EPIDIDYMIS,,,1646.49,5761.0,22
CPT,54830,REMOVE EPIDIDYMIS LESION,,,3504.84,9469.0,22
CPT,54840,REMOVE EPIDIDYMIS LESION,,,2081.7,9469.0,22
CPT,54860,REMOVAL OF EPIDIDYMIS,,,3504.84,9469.0,22
CPT,54861,REMOVAL OF EPIDIDYMIS,,,3504.84,9469.0,22
CPT,54865,EXPLORE EPIDIDYMIS,,,3504.84,9469.0,22
CPT,54900,FUSION OF SPERMATIC DUCTS,,,2081.7,9469.0,22
CPT,54901,FUSION OF SPERMATIC DUCTS,,,3504.84,9469.0,22
CPT,55000,HC DRAINAGE OF HYDROCELE,1857.0,1021.35,557.1,4955.0,212
CPT,55040,REMOVAL OF HYDROCELE,,,3586.23,14658.0,22
CPT,55041,REMOVAL OF HYDROCELES,,,3586.23,14658.0,22
CPT,55060,REPAIR OF HYDROCELE,,,3504.84,9469.0,22
CPT,55100,HC DRAINAGE SCROTAL WALL ABSCESS,2602.0,1431.1,780.6,6766.0,159
CPT,55110,EXPLORE SCROTUM,,,3504.84,9469.0,22
CPT,55120,REMOVAL OF SCROTUM LESION,,,2081.7,9469.0,22
CPT,55150,REMOVAL OF SCROTUM,,,3504.84,9469.0,22
CPT,55175,HC SCROTOPLASTY SIMPLE,10017.0,5509.35,3005.1,16799.0,53
CPT,55180,REVISION OF SCROTUM,,,5165.97,13936.0,22
CPT,55200,INCISION OF SPERM DUCT,,,3504.84,9469.0,22
CPT,55250,"HC VASECTOMY, UNILAT OR BILAT",6103.0,3356.65,1830.9,9469.0,106
CPT,55300,PREPARE SPERM DUCT X-RAY,,,168.27,3533.0,21
CPT,55400,REPAIR OF SPERM DUCT,,,3504.84,9469.0,22
CPT,55500,REMOVAL OF HYDROCELE,,,3504.84,14658.0,22
CPT,55520,REMOVAL OF SPERM CORD LESION,,,3504.84,9469.0,22
CPT,55530,REVISE SPERMATIC CORD VEINS,,,3504.84,9469.0,22
CPT,55535,REVISE SPERMATIC CORD VEINS,,,6340.83,14658.0,22
CPT,55540,REVISE HERNIA & SPERM VEINS,,,3586.23,14658.0,22
CPT,55550,LAPARO LIGATE SPERMATIC VEIN,,,5928.88,17804.0,22
CPT,55559,UNLSTD LAPS PX SPRMATIC CORD,,,5928.88,16799.0,22
CPT,55600,VESICULOTOMY,,,2081.7,9469.0,22
CPT,55605,VESICULOTOMY COMPLICATED,,,481.26,5761.0,22
CPT,55650,REMOVE SPERM DUCT POUCH,,,655.67,5761.0,22
CPT,55680,REMOVE SPERM POUCH LESION,,,3504.84,9469.0,22
CPT,55700,HC PROSTATE BX,5427.0,2984.85,1415.7,6766.0,265
CPT,55705,BX PRST8 ANY APPROACH NONIMG,,,3504.84,6766.0,22
CPT,55706,BX PRST8 NDL SAT SAMPLING,,,3504.84,6766.0,22
CPT,55720,DRAINAGE OF PROSTATE ABSCESS,,,3504.84,9469.0,22
CPT,55725,DRAINAGE OF PROSTATE ABSCESS,,,3504.84,9469.0,22
CPT,55801,REMOVAL OF PROSTATE,,,995.42,8363.0,22
CPT,55810,EXTENSIVE PROSTATE SURGERY,,,1183.89,13936.0,22
CPT,55812,EXTENSIVE PROSTATE SURGERY,,,1454.65,13936.0,22
CPT,55815,EXTENSIVE PROSTATE SURGERY,,,1591.96,13936.0,22
CPT,55821,REMOVAL OF PROSTATE,,,763.01,8363.0,22
CPT,55831,REMOVAL OF PROSTATE,,,781.99,8363.0,22
CPT,55840,EXTENSIVE PROSTATE SURGERY,,,1061.76,13936.0,22
CPT,55842,EXTENSIVE PROSTATE SURGERY,,,1060.5,13936.0,22
CPT,55845,EXTENSIVE PROSTATE SURGERY,,,1232.66,13936.0,22
CPT,55860,SURGICAL EXPOSURE PROSTATE,,,5165.97,13936.0,22
CPT,55862,EXTENSIVE PROSTATE SURGERY,,,994.11,8363.0,22
CPT,55865,EXTENSIVE PROSTATE SURGERY,,,1209.89,13936.0,22
CPT,55866,LAPS SURG PRST8ECT RPBIC RAD,,,10579.88,21512.0,22
CPT,55867,LAPS SURG PRST8ECT SMPL STOT,,,10315.0,19884.0,22
CPT,55870,HC ELECTROEJACULATION,2046.0,1125.3,613.8,4955.0,106
CPT,55870,HC VIBRATORY STIMULATION,2046.0,1125.3,613.8,4955.0,53
CPT,55873,HC CRYOSURG ABLATION OF PROSTATE (INCL US GUID),22490.0,12369.5,6747.0,21512.0,106
CPT,55874,TPRNL PLMT BIODEGRDABL MATRL,,,5165.97,17804.0,22
CPT,55875,TRANSPERI NEEDLE PLACE PROS,,,5165.97,16799.0,22
CPT,55876,"HC PLACEMENT OF INTERSTITIAL DEVICE FOR RAD THERAPY GUID, SINGLE OR MULT",3369.0,1852.95,1010.7,6766.0,53
CPT,55880,ABLTJ MAL PRST8 TISS HIFU,,,5480.0,13936.0,22
CPT,55881,ABLT TRURL PRST8 TIS THRM US,,,2453.0,13936.0,22
CPT,55882,ABLT TRURL PRST8 TIS TRNSDCR,,,12463.0,24394.0,22
CPT,55899,HC SPERM RETRIEVAL NDL,951.0,523.05,247.15,29323.0,53
CPT,55920,PLACE NEEDLES PELVIC FOR RT,,,5016.42,14658.0,22
CPT,55970,SEX TRANSFORMATION M TO F,,,5016.42,5761.0,16
CPT,55980,SEX TRANSFORMATION F TO M,,,3504.84,8363.0,16
CPT,56405,HC INCISION AND DRAINAGE VULVA OR PERINEAL ABSCESS,945.25,519.89,278.25,4258.0,265
CPT,56420,HC INCISION AND DRAINAGE BARTHOLIN'S GLAND ABSCESS,538.0,295.9,161.4,4258.0,106
CPT,56440,HC MARSUPIALIZATION BARTHOLIN'S GLAND CYST,5645.0,3104.75,1693.5,9469.0,53
CPT,56441,HC LYSIS LABIAL ADHESIONS,4928.0,2710.4,1478.4,9469.0,53
CPT,56442,HYMENOTOMY,,,3231.04,9469.0,22
CPT,56501,"HC DESTRUCTION LESION(S), VULVA, SIMPLE",5768.5,3172.675,1330.2,6766.0,371
CPT,56501,"HC DESTRUCTION VULVA LESION(S), SIMPLE, TCA",109.0,59.95,32.7,6766.0,53
CPT,56515,HC DESTRUCT VULVA LESION(S) EXTENSIVE,6166.5,3391.575,1330.2,6832.64,265
CPT,56605,"HC BIOPSY VULVA OR PERINEUM (SEPARATE PROCEDURE), 1 LESION",1535.5,844.525,444.3,4955.0,530
CPT,56606,HC VULVA OR PERINEUM BX EA ADDL,522.0,287.1,34.12,3533.0,477
CPT,56620,"HC VULVECTOMY SIMPLE, PARTIAL",7131.0,3922.05,2139.3,9469.0,159
CPT,56625,VULVECTOMY SIMPLE COMPLETE,,,3231.04,9469.0,22
CPT,56630,VULVECTOMY RADICAL PARTIAL,,,868.28,14658.0,22
CPT,56631,VLVCTMY RAD PRTL UNI LYMPHAD,,,1073.33,21512.0,22
CPT,56632,VLVCTMY RAD PRTL BI LYMPHAD,,,1297.81,21512.0,22
CPT,56633,VULVECTOMY RADICAL COMPLETE,,,1041.84,21512.0,22
CPT,56634,VLVCTMY RAD COMP UNI LYMPHAD,,,1172.75,21512.0,22
CPT,56637,VLVCTMY RAD COMP BI LYMPHAD,,,1372.49,21512.0,22
CPT,56640,VLVCTMY RAD COMP W/LYMPHADEC,,,1378.42,13936.0,22
CPT,56700,HC PARTIAL HYMENECTOMY OR REVISION OF HYMENAL RING,7191.0,3955.05,2157.3,9469.0,53
CPT,56740,EXC BARTHOLINS GLAND/CYST,,,3231.04,9469.0,22
CPT,56800,PLASTIC REPAIR INTROITUS,,,3231.04,9469.0,22
CPT,56805,CLITOROPLASTY INTERSEX STATE,,,3231.04,9469.0,22
CPT,56810,"HC PERINEOPLASTY, REPAIR OF PERINEUM, NONOBSTETRICAL",8446.0,4645.3,2533.8,9469.0,53
CPT,56820,HC COLPOSCOPY VULVA,688.0,378.4,192.9,4258.0,424
CPT,56821,"HC COLPOSCOPY VULVA, WITH BIOPSY(S)",731.0,402.04999999999995,203.7,4258.0,371
CPT,57000,COLPOTOMY W/EXPLORATION,,,3231.04,9469.0,22
CPT,57010,COLPOTOMY DRG PEL ABSCESS,,,3231.04,9469.0,22
CPT,57020,HC COLPOCENTESIS SEPARATE PROCEDURE,12493.0,6871.15,3747.9,10806.45,53
CPT,57022,I&D VAGINAL HEMATOMA OB/PP,,,2908.42,6766.0,22
CPT,57023,I&D VAGINAL HEMATOMA NON-OB,,,2908.42,9469.0,22
CPT,57061,"HC DESTRUCTION VAGINAL LESION(S), SIMPLE, TCA",109.0,59.95,32.7,9469.0,53
CPT,57065,DESTRUCTION VAG LESION XTNSV,,,3231.04,9469.0,22
CPT,57100,"HC BIOPSY VAGINAL MUCOSA, SIMPLE (SEPARATE PROCEDURE)",2124.0,1168.1999999999998,613.8,4955.0,424
CPT,57105,BIOPSY VAGINAL MUCOSA XTNSV,,,3231.04,9469.0,22
CPT,57106,VAGNC PRTL RMVL VAG WALL,,,3231.04,9469.0,22
CPT,57107,VAGNC COMPL RMVL PARAVAG TIS,,,3231.04,9469.0,22
CPT,57109,VAGNC BI TOTAL PEL LYMPHADEC,,,3231.04,9469.0,22
CPT,57110,VAGNC COMPL RMVL VAG WALL,,,812.07,13936.0,22
CPT,57111,VAGNC COMPL RMVL PARAVAG TIS,,,1562.3,14658.0,22
CPT,57120,COLPOCLEISIS LE FORT TYPE,,,5016.42,14658.0,22
CPT,57130,EXCISION VAGINAL SEPTUM,,,3231.04,9469.0,22
CPT,57135,HC EXISION VAGINAL CYST OR TUMOR,6842.5,3763.375,1966.2,9469.0,371
CPT,57150,TREAT VAGINA INFECTION,,,60.36,4258.0,22
CPT,57155,HC INSERT UTER TANDEM &/ VAG OVOIDS FOR CLINICAL BRACHYTHERAPY,12801.0,7040.55,2932.0,11072.87,53
CPT,57156,HC INS VAG BRACHYTX DEVICE,1600.0,880.0,309.12,4258.0,53
CPT,57160,HC INSERT PESSARY OTHER DEVICE,568.0,312.4,161.4,4258.0,265
CPT,57170,HC FITTING OF DIAPHRAGM CAP,363.0,199.65,108.9,4258.0,53
CPT,57180,HC INTRO HEMOSTATIC AGT PACK NON-OB VAG HEMORRHAGE,508.0,279.4,152.4,4258.0,53
CPT,57200,"HC COLPORRHAPHY, SUTURE OF INJURY OF VAGINA",4876.0,2681.8,1462.8,9469.0,53
CPT,57210,REPAIR VAGINA/PERINEUM,,,3231.04,9469.0,22
CPT,57220,REVISION OF URETHRA,,,5016.42,16799.0,22
CPT,57230,REPAIR OF URETHRAL LESION,,,3231.04,9469.0,22
CPT,57240,ANTERIOR COLPORRHAPHY,,,5016.42,14658.0,22
CPT,57250,REPAIR RECTUM & VAGINA,,,5016.42,14658.0,22
CPT,57260,CMBN ANT PST COLPRHY,,,5016.42,14658.0,22
CPT,57265,CMBN AP COLPRHY W/NTRCL RPR,,,5016.42,16799.0,22
CPT,57267,INSERT MESH/PELVIC FLR ADDON,,,223.04,3533.0,21
CPT,57268,REPAIR OF BOWEL BULGE,,,5016.42,9469.0,22
CPT,57270,REPAIR OF BOWEL POUCH,,,731.43,13936.0,22
CPT,57280,SUSPENSION OF VAGINA,,,869.76,13936.0,22
CPT,57282,COLPOPEXY EXTRAPERITONEAL,,,7514.61,19884.0,22
CPT,57283,COLPOPEXY INTRAPERITONEAL,,,7514.61,19884.0,22
CPT,57284,REPAIR PARAVAG DEFECT OPEN,,,5016.42,16799.0,22
CPT,57285,REPAIR PARAVAG DEFECT VAG,,,7514.61,19884.0,22
CPT,57287,HC REMOVAL OR REVISION OF SLING FOR STRESS INCONTINENCE,7444.0,4094.2,2233.2,14658.0,53
CPT,57288,REPAIR BLADDER DEFECT,,,5016.42,16799.0,22
CPT,57289,REPAIR BLADDER & VAGINA,,,7514.61,19884.0,22
CPT,57291,CONSTRUCTION OF VAGINA,,,5016.42,9469.0,22
CPT,57292,CONSTRUCT VAGINA WITH GRAFT,,,5016.42,14658.0,22
CPT,57295,REVISE VAG GRAFT VIA VAGINA,,,3231.04,9469.0,22
CPT,57296,REVISE VAG GRAFT OPEN ABD,,,858.88,13936.0,22
CPT,57300,REPAIR RECTUM-VAGINA FISTULA,,,3231.04,9469.0,22
CPT,57305,REPAIR RECTUM-VAGINA FISTULA,,,870.94,13936.0,22
CPT,57307,FISTULA REPAIR & COLOSTOMY,,,981.93,13936.0,22
CPT,57308,FISTULA REPAIR TRANSPERINE,,,607.05,13936.0,22
CPT,57310,REPAIR URETHROVAGINAL LESION,,,7514.61,19884.0,22
CPT,57311,REPAIR URETHROVAGINAL LESION,,,510.16,14658.0,22
CPT,57320,REPAIR BLADDER-VAGINA LESION,,,5016.42,14658.0,22
CPT,57330,REPAIR BLADDER-VAGINA LESION,,,7514.61,19884.0,22
CPT,57335,REPAIR VAGINA,,,5016.42,9469.0,22
CPT,57400,DILATION OF VAGINA,,,3231.04,9469.0,22
CPT,57410,PELVIC EXAMINATION,,,3231.04,9469.0,22
CPT,57415,HC REMOVAL IMPACTED VAG FB SPX W/ANES OTH/THN LOCAL,7602.0,4181.1,2280.6,9469.0,53
CPT,57420,"HC COLPOSCOPY ENTIRE VAGINA, W/ CERVIX IF PRESENT",1038.0,570.9,301.5,4258.0,371
CPT,57421,"HC COLPOSCOPY ENTIRE VAGINA, W/ CERVIX IF PRESENT, W/ BX(S) VAGINA/CERVIX",1539.0,846.45,452.1,4955.0,477
CPT,57423,REPAIR PARAVAG DEFECT LAP,,,10315.0,19884.0,22
CPT,57425,LAPAROSCOPY SURG COLPOPEXY,,,10315.0,19884.0,22
CPT,57426,REVISE PROSTH VAG GRAFT LAP,,,7514.61,19884.0,22
CPT,57452,HC COLPOSCOPY CERVIX INCLUDING UPPER/ADJACENT VAGINA,763.5,419.925,204.43,4258.0,424
CPT,57454,"HC COLPOSCOPY CERVX INCL UPR/ADJACENT VAG, W BX(S) CERVX ENDOCERV CURETTAGE",1282.5,705.375,309.12,4258.0,530
CPT,57455,"HC COLPOSCOPY CERVIX INCL UPPER/ADJACENT VAGINA, W/ BX(S) CERVIX",1297.0,713.35,309.12,4258.0,424
CPT,57456,"HC COLPOSCOPY CERVIX INCL UPPER/ADJACENT VAGINA, W/ ENDOCERV CURETTAGE",1297.0,713.35,309.12,4258.0,424
CPT,57460,"HC COLPOSCOPY CERVIX INCL UPPER/ADJACENT VAGINA, W/ LOOP ELCTR BX(S) CERVX",4535.0,2494.25,1202.7,9469.0,318
CPT,57461,"HC COLPOSCOPY CERVIX INCL UPPER/ADJACENT VAGINA, W/ LOOP ELCTR CONIZ CERVX",4442.5,2443.375,1202.7,9469.0,371
CPT,57465,CAM CERVIX UTERI DRG COLP,,,49.17,3533.0,21
CPT,57500,"HC BIOPSY CERVIX, SGL/MULT, OR LOCAL EXCISION LESION, W/ OR W/O FULGURATION",2073.0,1140.15,613.8,4955.0,636
CPT,57505,HC ENDOCERVICAL CURETTAGE,2361.0,1298.55,708.3,4955.0,424
CPT,57510,"HC CAUTERIZATION CERVIX, ELECTRO OR THERMAL",5773.0,3175.15,1731.9,9469.0,106
CPT,57511,HC CRYOCAUTERY OF CERVIX,660.0,363.0,198.0,4258.0,53
CPT,57513,"HC CAUTERY OF CERVIX, LASER ABLATION",4885.0,2686.75,1465.5,9469.0,53
CPT,57520,"HC CONIZATION OF CERVIX W/WO FULGURATION, D&C, OR REPR, COLD KNIFE OR LASER",6911.0,3801.05,2073.3,9469.0,53
CPT,57522,HC CONIZATION CERVIX LOOP ELECTRODE EXC,7536.0,4144.8,2257.8,9469.0,318
CPT,57530,REMOVAL OF CERVIX,,,5016.42,9469.0,22
CPT,57531,REMOVAL OF CERVIX RADICAL,,,1562.21,13936.0,22
CPT,57540,REMOVAL OF RESIDUAL CERVIX,,,710.8,13936.0,22
CPT,57545,REMOVE CERVIX/REPAIR PELVIS,,,748.19,13936.0,22
CPT,57550,REMOVAL OF RESIDUAL CERVIX,,,5016.42,9469.0,22
CPT,57555,REMOVE CERVIX/REPAIR VAGINA,,,5016.42,14658.0,22
CPT,57556,REMOVE CERVIX REPAIR BOWEL,,,5016.42,16799.0,22
CPT,57558,D&C OF CERVICAL STUMP,,,3231.04,9469.0,22
CPT,57700,REVISION OF CERVIX,,,3231.04,9469.0,22
CPT,57720,REVISION OF CERVIX,,,3231.04,9469.0,22
CPT,57800,HC DILAT CERVICAL CANAL,7169.0,3942.95,2150.7,9469.0,53
CPT,58100,"HC ENDOMETRIAL SAMPLING (BX) W/ OR W/O ENDOCERV SAMPL (BX), W/O CERV DILAT",730.5,401.775,204.43,4258.0,530
CPT,58110,HC ENDOMTERIAL SAMPL W COLPOSCOPY IN AD PRIM PROC,359.5,197.72500000000002,44.87,3533.0,424
CPT,58120,HC DILAT & CURETT DX THER NON-OB,7169.0,3942.95,2150.7,9469.0,265
CPT,58140,MYOMECTOMY ABDOM METHOD,,,826.08,14658.0,22
CPT,58145,"HC MYOMECTOMY, 1-4 MYOMAS W/250 GM OR LESS, VAGINAL APPR",7067.0,3886.85,2120.1,9469.0,106
CPT,58146,MYOMECTOMY ABDOM COMPLEX,,,1032.89,14658.0,22
CPT,58150,TOTAL HYSTERECTOMY,,,915.69,16786.0,22
CPT,58152,TOTAL HYSTERECTOMY,,,1107.53,16786.0,22
CPT,58180,PARTIAL HYSTERECTOMY,,,863.38,16786.0,22
CPT,58200,EXTENSIVE HYSTERECTOMY,,,1214.79,16786.0,22
CPT,58210,EXTENSIVE HYSTERECTOMY,,,1637.15,16786.0,22
CPT,58240,REMOVAL OF PELVIS CONTENTS,,,2453.0,13936.0,22
CPT,58260,VAGINAL HYSTERECTOMY,,,5016.42,14658.0,22
CPT,58262,VAG HYST INCLUDING T/O,,,5016.42,14658.0,22
CPT,58263,VAG HYST W/T/O & VAG REPAIR,,,5016.42,14658.0,22
CPT,58267,VAG HYST W/URINARY REPAIR,,,958.7,14658.0,22
CPT,58270,VAG HYST W/ENTEROCELE REPAIR,,,5016.42,14658.0,22
CPT,58275,HYSTERECTOMY/REVISE VAGINA,,,890.51,16786.0,22
CPT,58280,HYSTERECTOMY/REVISE VAGINA,,,949.67,16786.0,22
CPT,58285,EXTENSIVE HYSTERECTOMY,,,1282.37,16786.0,22
CPT,58290,VAG HYST COMPLEX,,,7514.61,19884.0,22
CPT,58291,VAG HYST INCL T/O COMPLEX,,,5016.42,16799.0,22
CPT,58292,VAG HYST T/O & REPAIR COMPL,,,7514.61,19884.0,22
CPT,58294,VAG HYST W/ENTEROCELE COMPL,,,5016.42,16799.0,22
CPT,58300,HC INSERTION INTRAUTERINE DEVICE (IUD),190.0,104.5,57.0,4258.0,477
CPT,58301,HC REMOVAL INTRAUTERINE DEVICE (IUD),845.0,464.75,252.3,4258.0,477
CPT,58321,HC ARTIFICIAL INSEMINATION IC,867.0,476.85,260.1,4258.0,53
CPT,58322,HC ARTIFICIAL INSEMINATION IU,619.0,340.45,185.7,4258.0,53
CPT,58323,SPERM WASHING,,,204.43,4258.0,22
CPT,58340,CATHETER FOR HYSTEROGRAPHY,,,374.95,374.95,1
CPT,58340,HC CATH AND INTRO SALINE/CONTR MATERIAL FOR SIS/HYSTEROSALPINGOGRAPHY,619.5,340.725,148.5,3533.0,318
CPT,58345,REOPEN FALLOPIAN TUBE,,,3231.04,9469.0,22
CPT,58346,INSERT HEYMAN UTERI CAPSULE,,,5016.42,9469.0,22
CPT,58350,REOPEN FALLOPIAN TUBE,,,5016.42,14658.0,22
CPT,58353,ENDOMETR ABLATE THERMAL,,,5016.42,14658.0,22
CPT,58356,ENDOMETRIAL CRYOABLATION,,,5016.42,16799.0,22
CPT,58400,SUSPENSION OF UTERUS,,,419.57,14658.0,22
CPT,58410,SUSPENSION OF UTERUS,,,732.07,13936.0,22
CPT,58520,REPAIR OF RUPTURED UTERUS,,,717.05,13936.0,22
CPT,58540,REVISION OF UTERUS,,,822.46,13936.0,22
CPT,58541,LSH UTERUS 250 G OR LESS,,,10315.0,17804.0,22
CPT,58542,LSH W/T/O UT 250 G OR LESS,,,10315.0,19884.0,22
CPT,58543,LSH UTERUS ABOVE 250 G,,,10315.0,19884.0,22
CPT,58544,LSH W/T/O UTERUS ABOVE 250 G,,,10315.0,19884.0,22
CPT,58545,LAPAROSCOPIC MYOMECTOMY,,,5928.88,16799.0,22
CPT,58546,LAPARO-MYOMECTOMY COMPLEX,,,10315.0,19884.0,22
CPT,58548,LAP RADICAL HYST,,,1691.86,16799.0,22
CPT,58550,LAPARO-ASST VAG HYSTERECTOMY,,,5928.88,17804.0,22
CPT,58552,LAPARO-VAG HYST INCL T/O,,,10315.0,19884.0,22
CPT,58553,LAPARO-VAG HYST COMPLEX,,,10315.0,19884.0,22
CPT,58554,LAPARO-VAG HYST W/T/O COMPL,,,10315.0,19884.0,22
CPT,58555,HC HYSTEROSCOPY DX SEP PROC,7203.0,3961.65,2160.9,9469.0,106
CPT,58558,HC HYSTEROSCOPY BX,11677.0,6422.35,3231.04,10100.61,106
CPT,58559,HC HYSTEROSCOPY SURG LYSIS INTRAUTERINE ADHESIONS,7579.0,4168.45,2273.7,13936.0,106
CPT,58560,HC HYSTEROSCOPY SURG DIV OR RESECT INTRUTER SEPTUM,9125.0,5018.75,2737.5,14658.0,53
CPT,58561,"HC HYSTEROSCOPY, SURGICAL; WITH REMOVAL OF LEIOMYOMATA",15249.0,8386.95,4574.7,14658.0,106
CPT,58562,"HC HYSTEROSCOPY, SURGICAL, WITH REMOVAL OF IMPACTED FOREIGN BODY",4928.0,2710.4,1478.4,9469.0,53
CPT,58563,HC HYSTEROSCOPY SURG W ENDOMETRIAL ABLATION,13917.0,7654.35,4175.1,14658.0,53
CPT,58565,HC HYSTRSC W BILAT TUBE CANNULT OCCL PLC PERM IMPL,13881.0,7634.55,4164.3,16799.0,53
CPT,58570,TLH UTERUS 250 G OR LESS,,,10315.0,19884.0,22
CPT,58571,TLH W/T/O 250 G OR LESS,,,10315.0,19884.0,22
CPT,58572,TLH UTERUS OVER 250 G,,,10315.0,19884.0,22
CPT,58573,TLH W/T/O UTERUS OVER 250 G,,,10315.0,19884.0,22
CPT,58575,LAPS TOT HYST RESJ MAL,,,1737.54,14658.0,22
CPT,58578,UNLISTED LAPS PX UTERUS,,,5928.88,16799.0,22
CPT,58579,UNLISTED HYSTSC PX UTERUS,,,204.43,4258.0,22
CPT,58580,TRANSCRV ABLTJ UTRN FIBRD RF,,,7514.61,19884.0,22
CPT,58600,DIVISION OF FALLOPIAN TUBE,,,3231.04,9469.0,22
CPT,58605,DIVISION OF FALLOPIAN TUBE,,,304.34,13936.0,22
CPT,58611,LIGATE OVIDUCT(S) ADD-ON,,,66.81,13936.0,22
CPT,58615,OCCLUDE FALLOPIAN TUBE(S),,,3231.04,9469.0,22
CPT,58660,LAPAROSCOPY LYSIS,,,5928.88,17804.0,22
CPT,58661,LAPAROSCOPY REMOVE ADNEXA,,,5928.88,17804.0,22
CPT,58662,LAPAROSCOPY EXCISE LESIONS,,,5928.88,17804.0,22
CPT,58670,LAPAROSCOPY TUBAL CAUTERY,,,5928.88,17804.0,22
CPT,58671,LAPAROSCOPY TUBAL BLOCK,,,5928.88,17804.0,22
CPT,58672,LAPAROSCOPY FIMBRIOPLASTY,,,5928.88,17804.0,22
CPT,58673,LAPAROSCOPY SALPINGOSTOMY,,,10315.0,17804.0,22
CPT,58674,LAPS ABLTJ UTERINE FIBROIDS,,,10315.0,19884.0,22
CPT,58679,UNLISTED LAPS PX OVIDCT OVRY,,,5928.88,16799.0,22
CPT,58700,REMOVAL OF FALLOPIAN TUBE,,,718.85,14658.0,22
CPT,58720,REMOVAL OF OVARY/TUBE(S),,,684.52,16799.0,22
CPT,58740,ADHESIOLYSIS TUBE OVARY,,,809.52,13936.0,22
CPT,58750,REPAIR OVIDUCT,,,815.75,14658.0,22
CPT,58752,REVISE OVARIAN TUBE(S),,,813.28,14658.0,22
CPT,58760,FIMBRIOPLASTY,,,736.49,14658.0,22
CPT,58770,CREATE NEW TUBAL OPENING,,,3231.04,9469.0,22
CPT,58800,HC DRN OVARIAN CYST UNILAT BILAT VAGINAL APPROACH,7144.0,3929.2,2143.2,9469.0,53
CPT,58805,DRAINAGE OF OVARIAN CYST(S),,,3231.04,9469.0,22
CPT,58820,DRAIN OVARY ABSCESS OPEN,,,3231.04,9469.0,22
CPT,58822,DRAIN OVARY ABSCESS PERCUT,,,642.5,14658.0,22
CPT,58825,TRANSPOSITION OVARY(S),,,637.5,14658.0,22
CPT,58900,BIOPSY OF OVARY(S),,,3231.04,9469.0,22
CPT,58920,PARTIAL REMOVAL OF OVARY(S),,,7514.61,19884.0,22
CPT,58925,REMOVAL OF OVARIAN CYST(S),,,5016.42,14658.0,22
CPT,58940,REMOVAL OF OVARY(S),,,500.3,14658.0,22
CPT,58943,REMOVAL OF OVARY(S),,,1083.39,14658.0,22
CPT,58950,RESECT OVARIAN MALIGNANCY,,,1038.7,14658.0,22
CPT,58951,RESECT OVARIAN MALIGNANCY,,,1297.8,13936.0,22
CPT,58952,RESECT OVARIAN MALIGNANCY,,,1479.91,13936.0,22
CPT,58953,TAH RAD DISSECT FOR DEBULK,,,1798.28,13936.0,22
CPT,58954,TAH RAD DEBULK/LYMPH REMOVE,,,1945.06,13936.0,22
CPT,58956,BSO OMENTECTOMY W/TAH,,,1224.79,13936.0,22
CPT,58957,OP Surgery - Grouper Table,,,13936.0,13936.0,1
CPT,58958,RESC RECR OVR TBL PP UTR MAL,,,1480.84,13936.0,22
CPT,58960,EXPLORATION OF ABDOMEN,,,901.61,17804.0,22
CPT,58970,HC RETRIEVAL OF OOCYTE,1583.0,870.65,474.9,4955.0,53
CPT,58974,HC EMBRYO TRANSFER INTRA UTERINE,1315.0,723.25,394.5,4955.0,53
CPT,58974,HC EMBRYO TRANSFER MOCK,1315.0,723.25,394.5,4955.0,53
CPT,58976,TRANSFER OF EMBRYO,,,309.12,4258.0,22
CPT,58999,HC ASPIR OF FLUID UTERINE CA,245.0,134.75,73.5,29323.0,53
CPT,58999,HC INTRALESION INJ FOR VULVAR VESTIBULITIS,502.0,276.1,150.6,29323.0,53
CPT,58999,HC TRANSVAGINAL CORE BIOPSY W/ US GUID,1531.0,842.05,204.43,29323.0,53
CPT,59000,HC AMNIOCENTESIS DIAGNOSTIC,1982.0,1090.1,594.6,4955.0,106
CPT,59000,HC AMNIOCENTESIS DIAGNOSTIC EA ADDL GEST,1982.0,1090.1,594.6,4955.0,53
CPT,59001,HC AMNIOCENTESIS THERAPEUTIC,1662.0,914.1,309.12,4258.0,53
CPT,59012,HC FETAL CORD PUNCTURE PRENATAL,1022.0,562.1,306.6,4258.0,53
CPT,59015,HC CHORION BX,1823.0,1002.65,546.9,4955.0,53
CPT,59015,HC CHORION BX EA ADDL GEST,1823.0,1002.65,546.9,4955.0,53
CPT,59020,FETAL CONTRACT STRESS TEST,,,204.43,3533.0,21
CPT,59025,HC FETAL NON-STRESS TEST,538.0,295.9,161.4,3533.0,159
CPT,59025,HC FETAL NON-STRESS TEST EA ADDL GEST,538.0,295.9,161.4,3533.0,106
CPT,59030,FETAL SCALP BLOOD SAMPLING,,,309.12,3533.0,21
CPT,59050,FETAL MONITOR W/REPORT,,,42.2,3533.0,21
CPT,59051,FETAL MONITOR/INTERPRET ONLY,,,35.27,4602.0,21
CPT,59070,HC TRANSABDOM AMNIOINFUS W US,1022.0,562.1,306.6,4258.0,53
CPT,59072,UMBILICAL CORD OCCLUD W/US,,,309.12,4258.0,22
CPT,59074,HC FETAL FLUID DRAINAGE W US,964.0,530.2,289.2,4258.0,53
CPT,59076,FETAL SHUNT PLACEMENT W/US,,,309.12,4258.0,22
CPT,59100,REMOVE UTERUS LESION,,,5016.42,9469.0,22
CPT,59120,TREAT ECTOPIC PREGNANCY,,,703.85,14658.0,22
CPT,59121,TREAT ECTOPIC PREGNANCY,,,703.85,14658.0,22
CPT,59130,TREAT ECTOPIC PREGNANCY,,,815.21,13936.0,22
CPT,59135,OP Surgery - Grouper Table,,,13936.0,13936.0,1
CPT,59136,TREAT ECTOPIC PREGNANCY,,,773.62,13936.0,22
CPT,59140,"HC SURGICAL TREATMENT OF ECTOPIC PREGNANCY; CERVICAL, WITH EVACUATION",4888.0,2688.4,363.09,13936.0,53
CPT,59150,TREAT ECTOPIC PREGNANCY,,,5928.88,17804.0,22
CPT,59151,TREAT ECTOPIC PREGNANCY,,,5928.88,17804.0,22
CPT,59160,HC POSTPARTUM CURETTAGE,7975.0,4386.25,2392.5,9469.0,106
CPT,59200,HC INSERT CERVICAL DILATOR,660.0,363.0,198.0,4258.0,53
CPT,59300,HC EPISIOTOMY OR VAGINAL REPAIR,5542.0,3048.1,1662.6,9469.0,106
CPT,59320,REVISION OF CERVIX,,,3231.04,9469.0,22
CPT,59325,REVISION OF CERVIX,,,204.66,13936.0,22
CPT,59350,REPAIR OF UTERUS,,,234.67,13936.0,16
CPT,59400,OBSTETRICAL CARE,,,2101.95,8363.0,16
CPT,59409,HC OBSTETRICAL CARE,3818.0,2099.9,1145.4,9469.0,53
CPT,59410,OBSTETRICAL CARE,,,928.17,8363.0,16
CPT,59412,HC EXTERNAL CEPHALIC VERSION,6240.0,3432.0,1872.0,9469.0,53
CPT,59414,HC DELIVER PLACENTA,6240.0,3432.0,1872.0,9469.0,159
CPT,59425,ANTEPARTUM CARE ONLY,,,492.93,507.72,15
CPT,59426,ANTEPARTUM CARE ONLY,,,900.67,927.69,15
CPT,59430,CARE AFTER DELIVERY,,,231.61,238.56,15
CPT,59510,CESAREAN DELIVERY,,,2312.03,8363.0,16
CPT,59514,HC CESAREAN DELIVERY ONLY,5438.0,2990.9,768.55,24494.0,53
CPT,59515,CESAREAN DELIVERY,,,1140.71,8363.0,16
CPT,59525,REMOVE UTERUS AFTER CESAREAN,,,405.49,5761.0,16
CPT,59610,VBAC DELIVERY,,,2177.41,8363.0,16
CPT,59612,VBAC DELIVERY ONLY,,,3231.04,9469.0,22
CPT,59614,VBAC CARE AFTER DELIVERY,,,990.11,8363.0,16
CPT,59618,ATTEMPTED VBAC DELIVERY,,,2333.51,8363.0,16
CPT,59620,ATTEMPTED VBAC DELIVERY ONLY,,,792.11,5761.0,16
CPT,59622,ATTEMPTED VBAC AFTER CARE,,,1180.33,8363.0,16
CPT,59812,HC TREATMENT OF MISCARRIAGE,5645.0,3104.75,1693.5,9469.0,106
CPT,59820,HC CARE OF MISCARRIAGE,5927.0,3259.85,1778.1,9469.0,53
CPT,59821,TREATMENT OF MISCARRIAGE,,,3231.04,9469.0,22
CPT,59830,TREAT UTERUS INFECTION,,,403.18,5761.0,22
CPT,59840,HC INDUCED ABORTION BY DILATION & CURRETTAGE,5645.0,3104.75,1693.5,9469.0,53
CPT,59841,INDUCED ABORTION DILAT&EVAC,,,3231.04,9469.0,22
CPT,59850,INDUCED ABORTION 1+ NJX,,,340.13,5761.0,22
CPT,59851,INDUCED ABORTION 1+NJX D&C,,,373.9,5761.0,22
CPT,59852,INDUCED ABORTION 1+NJX HYST,,,512.24,5761.0,22
CPT,59855,INDUCED ABORTION 1+VAG SUPP,,,367.86,5761.0,22
CPT,59856,INDUCED AB 1+VAG SUPP D&C,,,429.55,6766.0,22
CPT,59857,INDUCED AB 1+VAG SUPP HYST,,,499.15,5761.0,22
CPT,59866,ABORTION (MPR),,,309.12,4258.0,22
CPT,59870,EVACUATE MOLE OF UTERUS,,,3231.04,9469.0,22
CPT,59871,HC REMOVE CERCLAGE SUTURE UNDER ANESTHESIA,7377.0,4057.35,2213.1,14658.0,53
CPT,59897,"HC ULTRASOUND GUIDED INJECTION OF PREGNANCY, UNLISTED FETAL INVASIVE PX",548.0,301.4,164.4,4258.0,53
CPT,59898,UNLSTD LAPS PX MAT CARE&DLVR,,,5928.88,16799.0,22
CPT,59899,UNLISTED PX MAT CARE&DLVR,,,204.43,29323.0,22
CPT,60000,HC INCISION & DRAINAGE OF THYROGLOSSAL DUCT CYST INFECTED,3890.0,2139.5,1167.0,6766.0,53
CPT,60100,"HC BIOPSY THYROID, PERCUTANEOUS CORE NEEDLE",1901.0,1045.55,570.3,4955.0,106
CPT,60200,REMOVE THYROID LESION,,,5928.88,17804.0,22
CPT,60210,PARTIAL THYROID EXCISION,,,5928.88,17804.0,22
CPT,60212,PARTIAL THYROID EXCISION,,,5928.88,17804.0,22
CPT,60220,PARTIAL REMOVAL OF THYROID,,,5928.88,17804.0,22
CPT,60225,PARTIAL REMOVAL OF THYROID,,,5928.88,17804.0,22
CPT,60240,REMOVAL OF THYROID,,,5928.88,17804.0,22
CPT,60252,REMOVAL OF THYROID,,,6011.49,16799.0,22
CPT,60254,EXTENSIVE THYROID SURGERY,,,1479.36,13936.0,22
CPT,60260,REPEAT THYROID SURGERY,,,6011.49,16799.0,22
CPT,60270,REMOVAL OF THYROID,,,1205.34,13936.0,22
CPT,60271,REMOVAL OF THYROID,,,6011.49,16799.0,22
CPT,60280,REMOVE THYROID DUCT LESION,,,5928.88,17804.0,22
CPT,60281,REMOVE THYROID DUCT LESION,,,5928.88,17804.0,22
CPT,60300,HC ASPIR INJ THYROID CYST,2112.0,1161.6,565.2,4955.0,318
CPT,60500,EXPLORE PARATHYROID GLANDS,,,6011.49,16799.0,22
CPT,60502,RE-EXPLORE PARATHYROIDS,,,6011.49,16799.0,22
CPT,60505,EXPLORE PARATHYROID GLANDS,,,1265.91,13936.0,22
CPT,60512,AUTOTRANSPLANT PARATHYROID,,,210.72,3533.0,21
CPT,60520,REMOVAL OF THYMUS GLAND,,,6011.49,16799.0,22
CPT,60521,REMOVAL OF THYMUS GLAND,,,974.97,13936.0,22
CPT,60522,REMOVAL OF THYMUS GLAND,,,1177.01,13936.0,22
CPT,60540,EXPLORE ADRENAL GLAND,,,955.51,13936.0,22
CPT,60545,EXPLORE ADRENAL GLAND,,,1096.28,13936.0,22
CPT,60600,REMOVE CAROTID BODY LESION,,,1169.35,13936.0,22
CPT,60605,REMOVE CAROTID BODY LESION,,,1381.49,13936.0,22
CPT,60650,LAPAROSCOPY ADRENALECTOMY,,,1051.48,16799.0,22
CPT,60659,UNLISTED LAPS PX ENDOC SYS,,,5928.88,16799.0,22
CPT,60660,ABLTJ 1/+THYR NDUL 1LOBE PRQ,,,1646.49,16786.0,23
CPT,60661,ABLTJ 1/+THYR NDUL ADDL PRQ,,,362.29,3533.0,22
CPT,60699,HC ENDOCRINE THERAPY,8018.0,4409.9,2405.4,29323.0,53
CPT,60699,"HC RADIOFREQUENCY ABLATION (RFA) THYROID NODULES, UNLISTED PROC, ENDOCRINE",7738.0,4255.9,2321.4,29323.0,106
CPT,61000,REMOVE CRANIAL CAVITY FLUID,,,703.74,4955.0,22
CPT,61001,REMOVE CRANIAL CAVITY FLUID,,,703.74,4955.0,22
CPT,61020,REMOVE BRAIN CAVITY FLUID,,,904.71,4955.0,22
CPT,61026,INJECTION INTO BRAIN CANAL,,,703.74,4955.0,22
CPT,61050,HC CISTERNAL OR LATERAL CERVICAL (C1-C2) PUNCT WO INJ,2726.0,1499.3,299.97,4258.0,53
CPT,61055,INJECTION INTO BRAIN CANAL,,,299.97,4258.0,22
CPT,61070,HC PUNCTURE OF SHUNT TUBING OR RESERVOIR FOR ASPIR OR INJ PROC,1992.0,1095.6,597.6,4955.0,371
CPT,61105,TDH SDRL/VENTR PNXR,,,408.6,5761.0,22
CPT,61107,"HC TWIST DRILL HOLE FOR SUBDURAL, INTRACEREBRAL, OR VENTRICULAR PUNCTURE",4701.0,2585.55,258.26,5761.0,106
CPT,61108,TDH PNXR EVAC&/DRG SDRL HMTA,,,787.73,8363.0,22
CPT,61120,BURR HOLE FOR VENTR PUNCTURE,,,650.92,8363.0,22
CPT,61140,BURR HOLE/TREPH BX BRAIN/LES,,,1091.57,8363.0,22
CPT,61150,BUR HOL/TRPH DRG BRN ABS/CST,,,1151.97,8363.0,22
CPT,61151,BURR HOLE/TREPH SBSQ TAPPING,,,852.8,5761.0,22
CPT,61154,BURR HOLE W/EVAC&/DRG HMTMA,,,1099.27,8363.0,22
CPT,61156,BURR HOL ASPIR HMTM/CST ICER,,,1058.19,8363.0,22
CPT,61210,"HC BURR HOLE, IMPLANT VENTRICULAR CATH, RESERVOIR, EEG ELECTRODE, OTH DEV",12242.0,6733.1,302.6,10589.33,53
CPT,61215,INS SUBQ RSVR PMP/NFS SYS,,,6507.82,16799.0,22
CPT,61250,BURR HOLE/TREPH STTL EXPL,,,748.99,5761.0,22
CPT,61253,BURR HOLE TREPH ITTL UNI/BI,,,852.8,5761.0,22
CPT,61304,CRNEC/CRNOT EXPL SUPRATNTORL,,,1395.69,18485.0,22
CPT,61305,CRNEC/CRNOT EXPL INFRATNTORL,,,1700.74,18485.0,22
CPT,61312,CRNEC/CRNOT STTL XDRL/SDRL,,,1749.3,18485.0,22
CPT,61313,CRNEC/CRNOT STTL ICERE,,,1687.58,18485.0,22
CPT,61314,CRNEC/CRNOT ITTL XDRL/SDRL,,,1553.83,18485.0,22
CPT,61315,CRNEC/CRNOT ITTL NTRACEREBLR,,,1751.61,18485.0,22
CPT,61316,INC&SUBQ PLMT CRNL BONE GRF,,,72.22,18485.0,22
CPT,61320,CRNEC/CRNOT DRG ICR ABS STTL,,,1607.48,18485.0,22
CPT,61321,CRNEC/CRNOT DRG ICR ABS ITTL,,,1798.7,18485.0,22
CPT,61322,CRNEC/CRNOT DCMPRV W/O LOBEC,,,2015.88,18485.0,22
CPT,61323,CRNEC/CRNOT DCMPRV W/LOBEC,,,2004.23,18485.0,22
CPT,61330,DCMPRN ORBIT ONLY TRANSCRNL,,,3295.61,16799.0,22
CPT,61333,EXPL ORBIT W/REMOVAL LESION,,,1705.02,13936.0,22
CPT,61340,SUBTEMPORAL CRANIAL DCMPRN,,,1229.06,18485.0,22
CPT,61343,CRNEC SOPL CRV LAM DCMPRN,,,1857.08,18485.0,22
CPT,61345,OTH CRANIAL DCMPRN PST FOSSA,,,1731.79,18485.0,22
CPT,61450,CRNEC STPL SCTJ CMPRN/DCMPRN,,,1625.08,18485.0,22
CPT,61458,CRNEC SOPL XPL/DCMPR CRL NRV,,,1710.84,18485.0,22
CPT,61460,CRNEC SOPL SCTJ 1+CRNL NRV,,,1783.91,18485.0,22
CPT,61500,CRNEC EXC TUM/BONE LES SKULL,,,1134.39,18485.0,22
CPT,61501,CRANIECTOMY F/OSTEOMYELITIS,,,996.77,18485.0,22
CPT,61510,CRNEC TREPH EXC BRN TUM STTL,,,1874.37,18485.0,22
CPT,61512,CRNEC TREPH EXC MNGIOMA STTL,,,2156.34,18485.0,22
CPT,61514,CRNEC TREPH EXC BRN ABS STTL,,,1627.87,18485.0,22
CPT,61516,CRNEC TREPH EXC CYST STTL,,,1590.07,18485.0,22
CPT,61517,IMPLT BRN INTRCV CHEMOTX AGT,,,71.9,5761.0,22
CPT,61518,REMOVAL OF BRAIN LESION,,,2342.92,18485.0,22
CPT,61519,REMOVE BRAIN LINING LESION,,,2453.0,18485.0,22
CPT,61520,REMOVAL OF BRAIN LESION,,,2453.0,18485.0,22
CPT,61521,REMOVAL OF BRAIN LESION,,,2453.0,18485.0,22
CPT,61522,REMOVAL OF BRAIN ABSCESS,,,1851.55,18485.0,22
CPT,61524,REMOVAL OF BRAIN LESION,,,1765.82,18485.0,22
CPT,61526,REMOVAL OF BRAIN LESION,,,2453.0,18485.0,22
CPT,61530,REMOVAL OF BRAIN LESION,,,2453.0,18485.0,22
CPT,61531,IMPLANT BRAIN ELECTRODES,,,1056.06,18485.0,22
CPT,61533,IMPLANT BRAIN ELECTRODES,,,1301.32,18485.0,22
CPT,61534,REMOVAL OF BRAIN LESION,,,1408.55,18485.0,22
CPT,61535,REMOVE BRAIN ELECTRODES,,,869.81,18485.0,22
CPT,61536,REMOVAL OF BRAIN LESION,,,2172.66,18485.0,22
CPT,61537,REMOVAL OF BRAIN TISSUE,,,2065.54,18485.0,22
CPT,61538,REMOVAL OF BRAIN TISSUE,,,2235.59,18485.0,22
CPT,61539,REMOVAL OF BRAIN TISSUE,,,1993.96,18485.0,22
CPT,61540,REMOVAL OF BRAIN TISSUE,,,1840.65,18485.0,22
CPT,61541,INCISION OF BRAIN TISSUE,,,1820.7,18485.0,22
CPT,61543,REMOVAL OF BRAIN TISSUE,,,1839.96,18485.0,22
CPT,61544,REMOVE & TREAT BRAIN LESION,,,1607.95,18485.0,22
CPT,61545,EXCISION OF BRAIN TUMOR,,,2453.0,18485.0,22
CPT,61546,REMOVAL OF PITUITARY GLAND,,,1950.57,18485.0,22
CPT,61548,REMOVAL OF PITUITARY GLAND,,,1348.87,18485.0,22
CPT,61550,RELEASE OF SKULL SEAMS,,,1035.5,18485.0,22
CPT,61552,RELEASE OF SKULL SEAMS,,,1273.16,18485.0,22
CPT,61556,INCISE SKULL/SUTURES,,,1454.09,18485.0,22
CPT,61557,INCISE SKULL/SUTURES,,,1441.63,18485.0,22
CPT,61558,EXCISION OF SKULL/SUTURES,,,1601.87,18485.0,22
CPT,61559,EXCISION OF SKULL/SUTURES,,,2036.9,18485.0,22
CPT,61563,EXCISION OF SKULL TUMOR,,,1679.69,18485.0,22
CPT,61564,EXCISION OF SKULL TUMOR,,,2035.54,18485.0,22
CPT,61566,REMOVAL OF BRAIN TISSUE,,,1893.51,18485.0,22
CPT,61567,INCISION OF BRAIN TISSUE,,,2156.78,18485.0,22
CPT,61570,REMOVE FOREIGN BODY BRAIN,,,1590.12,18485.0,22
CPT,61571,INCISE SKULL FOR BRAIN WOUND,,,1689.77,18485.0,22
CPT,61575,SKULL BASE/BRAINSTEM SURGERY,,,2112.35,18485.0,22
CPT,61576,SKULL BASE/BRAINSTEM SURGERY,,,2453.0,18485.0,22
CPT,61580,CRANIOFACIAL APPROACH SKULL,,,2211.74,18485.0,22
CPT,61581,CRANIOFACIAL APPROACH SKULL,,,2446.18,18485.0,22
CPT,61582,CRANIOFACIAL APPROACH SKULL,,,2453.0,18485.0,22
CPT,61583,CRANIOFACIAL APPROACH SKULL,,,2453.0,18485.0,22
CPT,61584,ORBITOCRANIAL APPROACH/SKULL,,,2453.0,18485.0,22
CPT,61585,ORBITOCRANIAL APPROACH/SKULL,,,2453.0,18485.0,22
CPT,61586,RESECT NASOPHARYNX SKULL,,,2173.29,18485.0,22
CPT,61590,INFRATEMPORAL APPROACH/SKULL,,,2453.0,18485.0,22
CPT,61591,INFRATEMPORAL APPROACH/SKULL,,,2453.0,18485.0,22
CPT,61592,ORBITOCRANIAL APPROACH/SKULL,,,2453.0,18485.0,22
CPT,61595,TRANSTEMPORAL APPROACH/SKULL,,,2102.56,18485.0,22
CPT,61596,TRANSCOCHLEAR APPROACH/SKULL,,,2198.15,18485.0,22
CPT,61597,TRANSCONDYLAR APPROACH/SKULL,,,2453.0,18485.0,22
CPT,61598,TRANSPETROSAL APPROACH/SKULL,,,2422.69,18485.0,22
CPT,61600,RESECT/EXCISE CRANIAL LESION,,,1879.4,18485.0,22
CPT,61601,RESECT/EXCISE CRANIAL LESION,,,2071.98,18485.0,22
CPT,61605,RESECT/EXCISE CRANIAL LESION,,,1953.26,18485.0,22
CPT,61606,RESECT/EXCISE CRANIAL LESION,,,2453.0,18485.0,22
CPT,61607,RESECT/EXCISE CRANIAL LESION,,,2453.0,18485.0,22
CPT,61608,RESECT/EXCISE CRANIAL LESION,,,2453.0,18485.0,22
CPT,61611,TRANSECT ARTERY SINUS,,,384.91,5761.0,22
CPT,61613,REMOVE ANEURYSM SINUS,,,2453.0,18485.0,22
CPT,61615,RESECT/EXCISE LESION SKULL,,,2393.02,18485.0,22
CPT,61616,RESECT/EXCISE LESION SKULL,,,2453.0,18485.0,22
CPT,61618,REPAIR DURA,,,1120.23,18485.0,22
CPT,61619,REPAIR DURA,,,1250.73,18485.0,22
CPT,61623,EVASC TEMP BALO ARTL OCC H/N,,,20167.5,20167.5,1
CPT,61623,HC IN TEMP BALOON OCC HEAD NECK,14487.0,7967.85,4346.1,21512.0,53
CPT,61624,HC IN SG EMBO IC ANEURYSM,25665.0,14115.75,983.96,22200.23,53
CPT,61624,HC IN SG EMBO IC AVM,25665.0,14115.75,983.96,22200.23,53
CPT,61624,HC IN SG EMBO IC FISTULA,25665.0,14115.75,983.96,22200.23,53
CPT,61624,HC IN SG EMBO IC TUMOR,25665.0,14115.75,983.96,22200.23,53
CPT,61624,HC IN SG EMBO SPINAL AVM,25665.0,14115.75,983.96,22200.23,53
CPT,61624,HC IN SG EMBO SPINAL TUMOR,25665.0,14115.75,983.96,22200.23,53
CPT,61626,HC IN SG EMBO EC AVM,21188.0,11653.4,6356.4,21512.0,53
CPT,61626,HC IN SG EMBO EC FISTULA,21188.0,11653.4,6356.4,21512.0,53
CPT,61626,HC IN SG EMBO EC TUMOR,21188.0,11653.4,6356.4,21512.0,53
CPT,61626,"HC TRANSCATH PERMANENT OCCLUSION, PERCUTANEOUS, NON CNS, HEAD NECK",21188.0,11653.4,6356.4,21512.0,53
CPT,61630,HC IN PTA INTRACRANIAL,6108.0,3359.4,1169.85,18485.0,53
CPT,61635,HC IN STENT PLACE IC WO + W PTA,7904.0,4347.2,1278.86,18485.0,53
CPT,61640,HC IN PTA IC VASOSPASM INIT VESSEL,6398.0,3518.9,416.6,18485.0,53
CPT,61641,HC IN PTA IC VASOSPASM ADDL VES,1884.0,1036.2,146.38,18485.0,53
CPT,61642,DILAT IC VSPSM EA DIFF TER,,,292.75,18485.0,22
CPT,61645,"HC IN, PERC ART TRNLUM MECH THROMBECT/INFUS THROMBLYS, INTRCRAN",44722.0,24597.1,721.28,38684.53,53
CPT,61645,PERQ ART M-THROMBECT &/NFS,,,1262.24,1262.24,1
CPT,61650,EVASC PRLNG ADMN RX AGNT 1ST,,,863.15,863.15,1
CPT,61650,"HC IN ENDOVASCULAR INTRACRANIAL INFUSION, INITIAL VASCULAR TERRITORY",5780.0,3179.0,493.23,17386.0,53
CPT,61651,EVASC PRLNG ADMN RX AGNT ADD,,,368.47,368.47,1
CPT,61651,"HC IN ENDOVASCULAR INTRACRANIAL INFUSION, EA ADDL VASCULAR TERRITORY (AD)",5780.0,3179.0,210.55,17386.0,53
CPT,61680,INTRACRANIAL VESSEL SURGERY,,,1913.58,18485.0,22
CPT,61682,INTRACRANIAL VESSEL SURGERY,,,2453.0,18485.0,22
CPT,61684,INTRACRANIAL VESSEL SURGERY,,,2393.98,18485.0,22
CPT,61686,INTRACRANIAL VESSEL SURGERY,,,2453.0,18485.0,22
CPT,61690,INTRACRANIAL VESSEL SURGERY,,,1848.15,18485.0,22
CPT,61692,INTRACRANIAL VESSEL SURGERY,,,2453.0,18485.0,22
CPT,61697,BRAIN ANEURYSM REPR COMPLX,,,2453.0,18485.0,22
CPT,61698,BRAIN ANEURYSM REPR COMPLX,,,2453.0,18485.0,22
CPT,61700,BRAIN ANEURYSM REPR SIMPLE,,,2453.0,18485.0,22
CPT,61702,INNER SKULL VESSEL SURGERY,,,2453.0,18485.0,22
CPT,61703,CLAMP NECK ARTERY,,,1163.37,18485.0,22
CPT,61705,REVISE CIRCULATION TO HEAD,,,2192.54,18485.0,22
CPT,61708,REVISE CIRCULATION TO HEAD,,,2145.85,18485.0,22
CPT,61710,REVISE CIRCULATION TO HEAD,,,1811.96,18485.0,22
CPT,61711,FUSION OF SKULL ARTERIES,,,2198.28,18485.0,22
CPT,61715,HC MRI GUID HIGH INTENS FOC US STRTCTC ABLT TRGT ICR INCL NAV AND FRM PLCMT,35358.0,19446.9,10607.4,30584.67,53
CPT,61720,INCISE SKULL/BRAIN SURGERY,,,6507.82,16799.0,22
CPT,61735,INCISE SKULL/BRAIN SURGERY,,,1360.18,18485.0,22
CPT,61736,LITT ICR 1 TRAJ 1 SMPL LES,,,1017.33,13936.0,22
CPT,61737,LITT ICR MLT TRJ MLT/CPLX LS,,,1206.41,13936.0,22
CPT,61750,INCISE SKULL/BRAIN BIOPSY,,,1201.48,18485.0,22
CPT,61751,BRAIN BIOPSY W/CT/MR GUIDE,,,1190.47,18485.0,22
CPT,61760,IMPLANT BRAIN ELECTRODES,,,1349.51,18485.0,22
CPT,61770,INCISE SKULL FOR TREATMENT,,,6507.82,16799.0,22
CPT,61781,SCAN PROC CRANIAL INTRA,,,194.33,3533.0,21
CPT,61782,SCAN PROC CRANIAL EXTRA,,,154.54,3533.0,21
CPT,61783,SCAN PROC SPINAL,,,193.84,3533.0,21
CPT,61790,TREAT TRIGEMINAL NERVE,,,1984.4,9469.0,22
CPT,61791,TREAT TRIGEMINAL TRACT,,,1984.4,9469.0,22
CPT,61796,SRS CRANIAL LESION SIMPLE,,,874.93,85455.0,22
CPT,61797,SRS CRAN LES SIMPLE ADDL,,,180.5,85455.0,22
CPT,61798,SRS CRANIAL LESION COMPLEX,,,1175.95,85455.0,22
CPT,61799,SRS CRAN LES COMPLEX ADDL,,,249.32,85455.0,22
CPT,61800,APPLY SRS HEADFRAME ADD-ON,,,124.82,85455.0,22
CPT,61850,IMPLANT NEUROELECTRODES,,,847.51,8363.0,22
CPT,61860,IMPLANT NEUROELECTRODES,,,1328.46,18485.0,22
CPT,61863,IMPLANT NEUROELECTRODE,,,1287.56,18485.0,22
CPT,61864,IMPLANT NEUROELECTRDE ADDL,,,233.04,5761.0,22
CPT,61867,IMPLANT NEUROELECTRODE,,,1927.64,18485.0,22
CPT,61868,IMPLANT NEUROELECTRDE ADDL,,,410.66,5761.0,22
CPT,61880,REVISE/REMOVE NEUROELECTRODE,,,3494.72,14658.0,22
CPT,61885,INSRT/REDO NEUROSTIM 1 ARRAY,,,16700.0,28824.0,22
CPT,61886,IMPLANT NEUROSTIM ARRAYS,,,19979.0,34485.0,22
CPT,61888,REVISE/REMOVE NEURORECEIVER,,,8488.0,19884.0,22
CPT,61889,INS SK-MNT CRNL NSTM PG/RCVR,,,1147.48,24394.0,22
CPT,61891,REV/RPLCMT SK-MNT CRNL NSTM,,,12463.0,24394.0,22
CPT,61892,RMV SK-MNT CRNL NSTM PG/RCVR,,,3297.17,14658.0,22
CPT,62000,TREAT SKULL FRACTURE,,,3295.61,16799.0,22
CPT,62005,TREAT SKULL FRACTURE,,,1088.19,18485.0,22
CPT,62010,TREATMENT OF HEAD INJURY,,,1311.9,18485.0,22
CPT,62100,REPAIR BRAIN FLUID LEAKAGE,,,1357.55,18485.0,22
CPT,62115,REDUCTION OF SKULL DEFECT,,,1445.35,18485.0,22
CPT,62117,REDUCTION OF SKULL DEFECT,,,1662.42,18485.0,22
CPT,62120,REPAIR SKULL CAVITY LESION,,,1784.86,18485.0,22
CPT,62121,INCISE SKULL REPAIR,,,1368.0,18485.0,22
CPT,62140,CRNOP SKULL DEFECT<5 CM DIAM,,,888.21,8363.0,22
CPT,62141,CRNOP SKULL DEFECT>5 CM DIAM,,,987.3,8363.0,22
CPT,62142,RMVL B1 FLP/PROSTC PLATE SKL,,,775.53,8363.0,22
CPT,62143,RPL B1 FLP/PROSTC PLATE SKL,,,900.91,8363.0,22
CPT,62145,REPAIR OF SKULL & BRAIN,,,1198.93,18485.0,22
CPT,62146,CRNOP W/AUTOGRAFT<5 CM DIAM,,,1069.89,18485.0,22
CPT,62147,CRNOP W/AUTOGRAFT>5 CM DIAM,,,1222.36,18485.0,22
CPT,62148,RETR BONE FLAP TO FIX SKULL,,,103.81,5761.0,22
CPT,62160,NEUROENDOSCOPY ADD-ON,,,155.09,3533.0,21
CPT,62161,DISSECT BRAIN W/SCOPE,,,1300.63,18485.0,22
CPT,62162,REMOVE COLLOID CYST W/SCOPE,,,1605.53,18485.0,22
CPT,62164,REMOVE BRAIN TUMOR W/SCOPE,,,1782.45,18485.0,22
CPT,62165,REMOVE PITUIT TUMOR W/SCOPE,,,1323.89,18485.0,22
CPT,62180,ESTABLISH BRAIN CAVITY SHUNT,,,1361.98,18485.0,22
CPT,62190,ESTABLISH BRAIN CAVITY SHUNT,,,804.53,8363.0,22
CPT,62192,ESTABLISH BRAIN CAVITY SHUNT,,,855.92,8363.0,22
CPT,62194,REPLACE/IRRIGATE CATHETER,,,1984.4,9469.0,22
CPT,62200,ESTABLISH BRAIN CAVITY SHUNT,,,1174.44,18485.0,22
CPT,62201,BRAIN CAVITY SHUNT W/SCOPE,,,1047.11,8363.0,22
CPT,62220,ESTABLISH BRAIN CAVITY SHUNT,,,836.71,8363.0,22
CPT,62223,ESTABLISH BRAIN CAVITY SHUNT,,,893.96,8363.0,22
CPT,62225,REPLACE/IRRIGATE CATHETER,,,3917.0,13936.0,22
CPT,62230,REPLACE/REVISE BRAIN SHUNT,,,6507.82,16799.0,22
CPT,62252,HC CSF SHUNT REPROGRAM,777.0,427.35,233.1,4258.0,53
CPT,62256,REMOVE BRAIN CAVITY SHUNT,,,533.85,6766.0,22
CPT,62258,REPLACE BRAIN CAVITY SHUNT,,,955.81,13936.0,22
CPT,62263,EPIDURAL LYSIS MULT SESSIONS,,,904.71,4955.0,22
CPT,62264,EPIDURAL LYSIS ON SINGLE DAY,,,904.71,4955.0,22
CPT,62267,"HC PERC ASPIR W/N NUCLEUS PULPOSUS, INTERVERT DISC, OR PARAVERT TISS FOR DX",2263.0,1244.65,678.9,4955.0,106
CPT,62268,"HC PERCUTANEOUS ASPIRATION, SPINAL CORD CYST OR SYRINX",2724.0,1498.2,817.2,4955.0,53
CPT,62269,NEEDLE BIOPSY SPINAL CORD,,,1646.49,6766.0,22
CPT,62270,DX LMBR SPI PNXR,,,1231.54,1231.54,1
CPT,62270,"HC IN SG, SPINAL PUNCTURE, LUMBAR, DIAGNOTIC",1868.0,1027.4,560.4,4955.0,53
CPT,62270,"HC SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC",1868.0,1027.4,560.4,4955.0,583
CPT,62272,"HC IN SG, SPINAL PUNCTURE, THERAPEUTIC, FOR DRAINAGE CSF",2097.0,1153.35,629.1,4955.0,53
CPT,62272,"HC SPINAL PUNCTURE, THERAPEUTIC, FOR DRAINAGE CSF",2097.0,1153.35,629.1,4955.0,159
CPT,62273,HC INJ EPIDURAL BLOOD PATCH,2750.0,1512.5,703.74,4955.0,53
CPT,62273,"HC INJECTION, EPIDURAL, BLOOD OR CLOT PATCH",2750.0,1512.5,703.74,4955.0,159
CPT,62280,TREAT SPINAL CORD LESION,,,904.71,4955.0,23
CPT,62281,TREAT SPINAL CORD LESION,,,904.71,4955.0,23
CPT,62282,TREAT SPINAL CANAL LESION,,,904.71,4955.0,23
CPT,62284,HC INJ PROC FOR MYELOGRAPHY-CT LUMBAR,1275.0,701.25,169.16,3533.0,159
CPT,62284,INJECTION FOR MYELOGRAM,,,296.03,296.03,1
CPT,62287,DCMPRN PQ NUC PUL 1/MLT LMBR,,,1984.4,14658.0,23
CPT,62290,NJX PX DISCOGRAPHY LUMBAR,,,311.77,3533.0,22
CPT,62291,NJX PX DISCOGRAPHY CRV/THRC,,,280.57,3533.0,22
CPT,62292,NJX CHEMONUCLEOLYSIS LMBR,,,1984.4,9469.0,23
CPT,62294,INJECTION INTO SPINAL ARTERY,,,904.71,4955.0,22
CPT,62302,"HC MYELOGRAPHY VIA LUMBAR INJECTION, CERVICAL",2712.0,1491.6,802.86,4955.0,53
CPT,62302,MYELOGRAPHY LUMBAR INJECTION,,,1405.0,1405.0,1
CPT,62303,HC MYELOGRAPHY VIA LUMBAR INJECTION THORACIC,2712.0,1491.6,802.86,4955.0,53
CPT,62303,MYELOGRAPHY LUMBAR INJECTION,,,1405.0,1405.0,1
CPT,62304,HC MYELOGRAPHY VIA LUMBAR INJECTION LUMBOSACRAL,2849.0,1566.95,802.86,4955.0,53
CPT,62304,MYELOGRAPHY LUMBAR INJECTION,,,1405.0,1405.0,1
CPT,62305,"HC MYELOGRAPHY VIA LUMBAR INJECTION, 2 OR MORE REGIONS",2243.0,1233.65,672.9,4955.0,106
CPT,62305,MYELOGRAPHY LUMBAR INJECTION,,,1405.0,1405.0,1
CPT,62320,"HC INJ DX/THER SUBST, INTERLAMINAR, CERV/THOR W/O IMAG GUID",1890.0,1039.5,567.0,4955.0,53
CPT,62320,"HC INJ DX/THER SUBST, INTERLAMINAR, CERVICAL/THORACIC, W/O IMAG GUID",1909.0,1049.95,567.0,4955.0,318
CPT,62321,"HC INJ DX/THER SUBST, INTERLAMINAR, CERVICAL/THORACIC, W/ IMAG GUID",3183.0,1750.65,703.74,4955.0,106
CPT,62321,"HC INJ DX/THER SUBST, INTERLAMINAR, CERVICAL/THROACIC, W/ IMAG GUID",2545.0,1399.75,703.74,4955.0,53
CPT,62321,NJX INTERLAMINAR CRV/THRC,,,1231.54,1231.54,1
CPT,62322,"HC INJ DX/THER SUBST, INTERLAMINAR, LUMBAR/SACRAL, W/O IMAG GUID",2743.5,1508.925,771.0,4955.0,212
CPT,62323,"HC INJ DX/THER SUBST, INTERLAMINAR, LUMBAR/SACRAL, W/ IMAG GUID",2541.5,1397.825,629.4,4955.0,424
CPT,62323,NJX INTERLAMINAR LMBR/SAC,,,1231.54,1231.54,1
CPT,62324,"HC INJ CONT INFUSN DX/THER SUBST, INTERLAMINAR, CERV/THOR, W/O IMAG GUID",3120.0,1716.0,904.71,4955.0,53
CPT,62325,"HC INJ CONT INFUSN DX/THER SUBST, INTERLAMINAR, CERV/THOR, W/ IMAG GUID",2462.0,1354.1,738.6,4955.0,53
CPT,62325,NJX INTERLAMINAR CRV/THRC,,,1583.25,1583.25,1
CPT,62326,"HC INJ CONT INFUSN DX/THER SUBST, INTERLAMINAR, LUMB/SACRAL, W/O IMAG GUID",3085.0,1696.75,904.71,4955.0,53
CPT,62327,"HC INJ CONT INFUSN DX/THER SUBST, INTERLAMINAR, LUMB/SACRAL, W/ IMAG GUID",2462.0,1354.1,738.6,4955.0,53
CPT,62327,NJX INTERLAMINAR LMBR/SAC,,,1583.25,1583.25,1
CPT,62328,DX LMBR SPI PNXR W/FLUOR/CT,,,1231.54,1231.54,1
CPT,62328,HC DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/ FLUOROSCOPIC OR CT GUIDANCE,2617.0,1439.35,703.74,4955.0,106
CPT,62329,HC THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF W/ FLUOROSCOPIC OR CT GUIDANCE,2489.0,1368.95,703.74,4955.0,106
CPT,62329,THER SPI PNXR CSF FLUOR/CT,,,1231.54,1231.54,1
CPT,62350,IMPLANT SPINAL CANAL CATH,,,6507.82,16799.0,22
CPT,62351,IMPLANT SPINAL CANAL CATH,,,7259.46,18485.0,22
CPT,62355,REMOVE SPINAL CANAL CATHETER,,,1984.4,9469.0,22
CPT,62360,INSERT SPINE INFUSION DEVICE,,,9733.0,24394.0,22
CPT,62361,IMPLANT SPINE INFUSION PUMP,,,16700.0,28824.0,22
CPT,62362,IMPLANT SPINE INFUSION PUMP,,,16700.0,28824.0,22
CPT,62365,REMOVE SPINE INFUSION DEVICE,,,6507.82,17804.0,22
CPT,62367,HC ELECT ANLY IMPL INTRTHECAL EPIDRL PUMP WO REPRG,807.0,443.85,242.1,4258.0,53
CPT,62368,HC ELECT ANLY IMPL INTRTHECAL EPIDRL PUMP W REPRG,1171.0,644.05,304.77,4258.0,53
CPT,62369,HC ELC ANLY IMPL ITHCL EPIDRL PUMP W REPRG & REFIL,1170.0,643.5,304.77,4258.0,106
CPT,62370,HC ELC ANLY IMPL ITHCL EPD PUMP W REPRG&REFIL PHYS,1297.0,713.35,304.77,4258.0,106
CPT,62380,NDSC DCMPRN 1 NTRSPC LUMBAR,,,7259.46,18485.0,22
CPT,63001,REMOVE SPINE LAMINA 1/2 CRVL,,,7259.46,18485.0,22
CPT,63003,REMOVE SPINE LAMINA 1/2 THRC,,,7259.46,18485.0,22
CPT,63005,REMOVE SPINE LAMINA 1/2 LMBR,,,7259.46,18485.0,22
CPT,63011,REMOVE SPINE LAMINA 1/2 SCRL,,,7259.46,18485.0,22
CPT,63012,REMOVE LAMINA/FACETS LUMBAR,,,7259.46,18485.0,22
CPT,63015,REMOVE SPINE LAMINA >2 CRVCL,,,7259.46,18485.0,22
CPT,63016,REMOVE SPINE LAMINA >2 THRC,,,7259.46,18485.0,22
CPT,63017,REMOVE SPINE LAMINA >2 LMBR,,,7259.46,18485.0,22
CPT,63020,LAMOT DCMPRN NRV RT 1 CERV,,,7259.46,18485.0,22
CPT,63030,LAMOT DCMPRN NRV RT 1 LMBR,,,7259.46,18485.0,22
CPT,63035,LAMOT DCMPRN NRV RT EA ADDL,,,197.75,3533.0,21
CPT,63040,LAMINOTOMY SINGLE CERVICAL,,,7259.46,18485.0,22
CPT,63042,LAMINOTOMY SINGLE LUMBAR,,,7259.46,18485.0,22
CPT,63043,LAMINOTOMY ADDL CERVICAL,,,8488.0,14658.0,6
CPT,63044,LAMINOTOMY ADDL LUMBAR,,,8488.0,14658.0,6
CPT,63045,LAM FACETEC & FORAMOT CRV,,,7259.46,18485.0,22
CPT,63046,LAM FACETEC & FORAMOT THRC,,,7259.46,18485.0,22
CPT,63047,LAM FACETEC & FORAMOT LUMBAR,,,7259.46,18485.0,22
CPT,63048,LAM FACETEC &FORAMOT EA ADDL,,,178.5,3533.0,21
CPT,63050,CERVICAL LAMINOPLSTY 2/> SEG,,,1299.34,18485.0,22
CPT,63051,C-LAMINOPLASTY W/GRAFT/PLATE,,,1476.26,18485.0,22
CPT,63052,LAM FACETC/FRMT ARTHRD LUM 1,,,218.7,3533.0,21
CPT,63053,LAM FACTC/FRMT ARTHRD LUM EA,,,194.34,3533.0,21
CPT,63055,DECOMPRESS SPINAL CORD THRC,,,7259.46,18485.0,22
CPT,63056,DECOMPRESS SPINAL CORD LMBR,,,7259.46,18485.0,22
CPT,63057,DECOMPRESS SPINE CORD ADD-ON,,,270.81,3533.0,21
CPT,63064,DECOMPRESS SPINAL CORD THRC,,,7259.46,18485.0,22
CPT,63066,DECOMPRESS SPINE CORD ADD-ON,,,169.12,3533.0,21
CPT,63075,NECK SPINE DISK SURGERY,,,7259.46,18485.0,22
CPT,63076,NECK SPINE DISK SURGERY,,,207.01,3533.0,21
CPT,63077,SPINE DISK SURGERY THORAX,,,1307.05,18485.0,22
CPT,63078,SPINE DISK SURGERY THORAX,,,170.19,5761.0,22
CPT,63081,REMOVE VERT BODY DCMPRN CRVL,,,1523.35,18485.0,22
CPT,63082,REMOVE VERTEBRAL BODY ADD-ON,,,224.44,5761.0,22
CPT,63085,REMOVE VERT BODY DCMPRN THRC,,,1664.55,18485.0,22
CPT,63086,REMOVE VERTEBRAL BODY ADD-ON,,,161.56,5761.0,22
CPT,63087,REMOV VERTBR DCMPRN THRCLMBR,,,2088.77,18485.0,22
CPT,63088,REMOVE VERTEBRAL BODY ADD-ON,,,218.08,5761.0,22
CPT,63090,REMOVE VERT BODY DCMPRN LMBR,,,1699.42,18485.0,22
CPT,63091,REMOVE VERTEBRAL BODY ADD-ON,,,150.43,5761.0,22
CPT,63101,REMOVE VERT BODY DCMPRN THRC,,,1993.06,18485.0,22
CPT,63102,REMOVE VERT BODY DCMPRN LMBR,,,1983.62,18485.0,22
CPT,63103,REMOVE VERTEBRAL BODY ADD-ON,,,247.93,5761.0,22
CPT,63170,INCISE SPINAL CORD TRACT(S),,,1361.3,18485.0,22
CPT,63172,DRAINAGE OF SPINAL CYST,,,1207.57,18485.0,22
CPT,63173,DRAINAGE OF SPINAL CYST,,,1470.01,18485.0,22
CPT,63185,INCISE SPINE NRV HALF SEGMNT,,,1058.25,21512.0,22
CPT,63190,INCISE SPINE NRV >2 SEGMNTS,,,1113.9,21512.0,22
CPT,63191,INCISE SPINE ACCESSORY NERVE,,,1184.5,21512.0,22
CPT,63194,OP Surgery - Grouper Table,,,18485.0,18485.0,1
CPT,63197,LAM W/CORDOTOMY 1STG THRC,,,1458.41,18485.0,22
CPT,63200,RELEASE SPINAL CORD LUMBAR,,,1324.34,21512.0,22
CPT,63250,REVISE SPINAL CORD VSLS CRVL,,,2453.0,18485.0,22
CPT,63251,REVISE SPINAL CORD VSLS THRC,,,2453.0,18485.0,22
CPT,63252,REVISE SPINE CORD VSL THRLMB,,,2549.26,21512.0,22
CPT,63265,EXCISE INTRASPINL LESION CRV,,,7259.46,18485.0,22
CPT,63266,EXCISE INTRSPINL LESION THRC,,,7259.46,18485.0,22
CPT,63267,EXCISE INTRSPINL LESION LMBR,,,5480.0,18485.0,22
CPT,63268,EXCISE INTRSPINL LESION SCRL,,,7259.46,18485.0,22
CPT,63270,EXCISE INTRSPINL LESION CRVL,,,1761.04,18485.0,22
CPT,63271,EXCISE INTRSPINL LESION THRC,,,1762.58,18485.0,22
CPT,63272,EXCISE INTRSPINL LESION LMBR,,,1619.12,21512.0,22
CPT,63273,EXCISE INTRSPINL LESION SCRL,,,1588.41,18485.0,22
CPT,63275,BX/EXC XDRL SPINE LESN CRVL,,,1539.79,18485.0,22
CPT,63276,BX/EXC XDRL SPINE LESN THRC,,,1530.14,18485.0,22
CPT,63277,BX/EXC XDRL SPINE LESN LMBR,,,1348.73,21512.0,22
CPT,63278,BX/EXC XDRL SPINE LESN SCRL,,,1362.5,18485.0,22
CPT,63280,BX/EXC IDRL SPINE LESN CRVL,,,1797.6,18485.0,22
CPT,63281,BX/EXC IDRL SPINE LESN THRC,,,1783.04,18485.0,22
CPT,63282,BX/EXC IDRL SPINE LESN LMBR,,,1688.26,21512.0,22
CPT,63283,BX/EXC IDRL SPINE LESN SCRL,,,1621.16,18485.0,22
CPT,63285,BX/EXC IDRL IMED LESN CERVL,,,2207.63,18485.0,22
CPT,63286,BX/EXC IDRL IMED LESN THRC,,,2184.33,18485.0,22
CPT,63287,BX/EXC IDRL IMED LESN THRLMB,,,2312.72,21512.0,22
CPT,63290,BX/EXC XDRL/IDRL LSN ANY LVL,,,2351.12,21512.0,22
CPT,63295,REPAIR LAMINECTOMY DEFECT,,,272.7,18485.0,22
CPT,63300,REMOVE VERT XDRL BODY CRVCL,,,1567.51,18485.0,22
CPT,63301,REMOVE VERT XDRL BODY THRC,,,1816.83,18485.0,22
CPT,63302,REMOVE VERT XDRL BODY THRLMB,,,1848.99,18485.0,22
CPT,63303,REMOV VERT XDRL BDY LMBR/SAC,,,1956.1,18485.0,22
CPT,63304,REMOVE VERT IDRL BODY CRVCL,,,1989.27,18485.0,22
CPT,63305,REMOVE VERT IDRL BODY THRC,,,2113.29,18485.0,22
CPT,63306,REMOV VERT IDRL BDY THRCLMBR,,,2077.66,18485.0,22
CPT,63307,REMOV VERT IDRL BDY LMBR/SAC,,,2032.48,18485.0,22
CPT,63308,REMOVE VERTEBRAL BODY ADD-ON,,,268.01,5761.0,22
CPT,63600,REMOVE SPINAL CORD LESION,,,1984.4,9469.0,22
CPT,63610,STIMULATION OF SPINAL CORD,,,1984.4,6766.0,22
CPT,63620,SRS SPINAL LESION,,,963.38,85455.0,22
CPT,63621,SRS SPINAL LESION ADDL,,,207.62,85455.0,22
CPT,63650,"HC PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODE ARRAY, EPIDURAL",18476.0,10161.8,5542.8,19884.0,53
CPT,63655,IMPLANT NEUROELECTRODES,,,12463.0,24394.0,22
CPT,63661,HC REMOVAL OF SPINAL NEUROSTIM ELECTRODE PERC ARRAY(S) INCL FLUOROSCOPY,5216.0,2868.8,1564.8,9469.0,106
CPT,63662,REMOVE SPINE ELTRD PLATE,,,3494.72,14658.0,22
CPT,63663,HC REV REPL SPNL NEURSTIM ELCTRD ARRAY INCL FLUORO,18476.0,10161.8,5542.8,19884.0,53
CPT,63664,REVISE SPINE ELTRD PLATE,,,10315.0,24394.0,22
CPT,63685,"HC INSERT/REPLC SPINAL NRSTIM PLS GEN/RECVR, W PKT CREATION & CONN",83887.0,46137.85,16700.0,72562.26,53
CPT,63688,"HC REV/REM IMPL SPINAL NRSTIM PLS GEN/RECVR, W/ DETACH CONN TO ELECTR ARRAY",9192.0,5055.6,2757.6,14658.0,53
CPT,63700,REPAIR OF SPINAL HERNIATION,,,1129.83,8363.0,22
CPT,63702,REPAIR OF SPINAL HERNIATION,,,1231.08,8363.0,22
CPT,63704,REPAIR OF SPINAL HERNIATION,,,1432.12,18485.0,22
CPT,63706,REPAIR OF SPINAL HERNIATION,,,1583.89,18485.0,22
CPT,63707,REPAIR SPINAL FLUID LEAKAGE,,,827.84,8363.0,22
CPT,63709,REPAIR SPINAL FLUID LEAKAGE,,,975.81,8363.0,22
CPT,63710,GRAFT REPAIR OF SPINE DEFECT,,,956.5,8363.0,22
CPT,63740,INSTALL SPINAL SHUNT,,,855.07,8363.0,22
CPT,63741,INSTALL SPINAL SHUNT,,,6507.82,16799.0,22
CPT,63744,REVISION OF SPINAL SHUNT,,,6507.82,16799.0,22
CPT,63746,REMOVAL OF SPINAL SHUNT,,,1984.4,9469.0,22
CPT,64400,"HC INJ(S), ANES AGENT(S)/STEROID, TRIGEMINAL NERVE, EA BRANCH",1351.0,743.05,299.97,4258.0,265
CPT,64405,"HC INJ(S), ANES AGENT(S)/STEROID, GREATER OCCIPITAL NERVE",1937.0,1065.35,299.97,4258.0,318
CPT,64408,"HC INJECTION, ANESTHETIC AGENTS AND/OR STEROID, VAGUS NERVE",720.0,396.0,216.0,4258.0,53
CPT,64415,"HC INJ, ANES AGT/STEROID, BRACH PLEXUS, INCL IMG GUID",2462.0,1354.1,738.6,4955.0,106
CPT,64416,"HC INJ, ANES AGT/STEROID, BRACH PLEXUS, CONT INFUS BY CATH, INCL IMG GUID",5718.0,3144.9,904.71,4955.0,53
CPT,64417,"HC INJ, ANES AGT/STEROID, AXILLARY NERVE, INCL IMG GUID",3196.0,1757.8,789.6,4955.0,106
CPT,64418,"HC INJ(S), ANES AGENT(S)/STEROID, SUPRASCAPULAR NERVE",1868.0,1027.4,560.4,4955.0,212
CPT,64420,"HC INJ(S), ANES AGENT(S)/STEROID, INTERCOSTAL NERVE, SINGLE LEVEL",1868.0,1027.4,560.4,4955.0,212
CPT,64421,"HC INJ(S), ANES AGENT(S)/STEROID, INTERCOSTAL NERVE, EA ADL LEVEL (AD)",2462.0,1354.1,738.6,4955.0,265
CPT,64425,"HC INJ(S), ANES AGENT(S)/STEROID, ILIOINGUINAL, ILIOHYPOGASTRIC NERVES",1542.0,848.1,462.6,4955.0,371
CPT,64430,"HC INJ(S), ANES AGENT(S)/STEROID, PUDENDAL NERVE",2462.0,1354.1,738.6,4955.0,106
CPT,64435,"HC INJ(S), ANES AGENT(S)/STEROID, PARACERVICAL (UTERINE) NERVE",1748.0,961.4,524.4,4955.0,159
CPT,64445,"HC INJ, ANES AGT/STEROID, SCIATIC NERVE, INCL IMG GUID",2515.0,1383.25,703.74,4955.0,212
CPT,64446,"HC INJ, ANES AGT/STEROID, SCIATIC NERVE, CONT INFUS BY CATH, INCL IMG GUID",5640.0,3102.0,904.71,4955.0,159
CPT,64447,"HC INJ, ANES AGT/STEROID, FEMORAL NERVE, INCL IMG GUID",4579.0,2518.45,703.74,4955.0,159
CPT,64448,"HC INJ, ANES AGT/STEROID, FEMORAL NERVE, CONT INFUS BY CATH, INCL IMG GUID",7977.0,4387.35,904.71,6900.11,53
CPT,64449,"HC INJ(S), ANES AGENT(S)/STEROID, LUMB PLEXUS, POST APPR, SGL INFUS BY CATH",2686.0,1477.3,805.8,4955.0,53
CPT,64449,"HC INJ(S), ANES AGENT(S)/STEROID, LUMB PLEXUS, POST APPR,CONT INFUS BY CATH",2686.0,1477.3,805.8,4955.0,53
CPT,64450,"HC INJ(S), ANES AGENT(S)/STEROID, OTHER PERIPHERAL NERVE/BRANCH",2186.5,1202.575,655.5,4955.0,583
CPT,64451,"HC INJ(S) ANES AGENT/STEROID, NERVES INNERVATING SI JOINT, W/ IMG GUID",3145.0,1729.75,703.74,4955.0,53
CPT,64451,NJX AA&/STRD NRV NRVTG SI JT,,,1231.54,1231.54,1
CPT,64454,"HC INJ(S) ANES AGENT/STEROID, GENICULAR NERVE BRANCHES, W/ IMG GUID",2661.5,1463.8249999999998,703.74,4955.0,159
CPT,64454,NJX AA&/STRD GNCLR NRV BRNCH,,,1231.54,1231.54,1
CPT,64455,"HC INJ(S), ANES AGENT/STEROID, PLANTAR COMMON DIGITAL NERVE(S)",800.0,440.0,240.0,4258.0,159
CPT,64461,"HC PVB THORACIC SINGLE INJ SITE, INCL IMAGE GUID WHEN PERFORMED",2333.0,1283.15,699.9,4955.0,106
CPT,64462,"HC PVB THORACIC 2ND AND ANY ADDL INJ SITE(S), INCL IMAGE GUID (ADD ON CODE)",1753.0,964.15,65.23,3533.0,106
CPT,64463,"HC PVB THORACIC CONTINUOUS INFUSION BY CATHETER, INCL IMAGE GUID",2304.0,1267.2,691.2,4955.0,53
CPT,64466,THRC FASCIAL PLN BLK UNI NJX,,,113.89,3533.0,21
CPT,64467,THRC FASCIAL PLN BLK UNI NFS,,,211.54,3533.0,21
CPT,64468,THRC FASCIAL PLN BLK BI NJX,,,131.57,3533.0,21
CPT,64469,THRC FASCIAL PLN BLK BI NFS,,,323.41,3533.0,21
CPT,64473,LWR XTR FSCL PLN BLK UNI NJX,,,107.58,3533.0,21
CPT,64474,LWR XTR FSCL PLN BLK UNI NFS,,,208.96,3533.0,21
CPT,64479,"HC INJ(S), ANES AGENT/STEROID, TFE, W/ IMG GUID, C-T, SINGLE LEVEL",3022.0,1662.1,904.71,4955.0,212
CPT,64480,"HC INJ(S), ANES AGENT/STEROID, TFE, W/ IMG GUID, C-T, EA ADL LEVEL (AD)",805.0,442.75,123.37,3533.0,212
CPT,64483,"HC INJ(S), ANES AGENT/STEROID, TFE, W/ IMG GUID, L-S, SINGLE LEVEL",3266.0,1796.3,904.71,4955.0,106
CPT,64484,"HC INJ(S), ANES AGENT/STEROID, TFE, W/ IMG GUID, L-S, EA ADL LEVEL (AD)",949.0,521.95,101.31,3533.0,106
CPT,64486,"HC NERVE BLOCK INJ, TAP UNILATERAL",1312.0,721.6,100.56,3533.0,53
CPT,64486,"HC UNILAT, TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK, BY INJECTIONS",2103.0,1156.65,100.56,3533.0,53
CPT,64487,"HC NERVE BLOCK, TAP UNILATERAL, CONTINUOUS INFUSION(S)",2216.0,1218.8,188.75,3533.0,53
CPT,64488,"HC BILAT, TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK, BY INJECTIONS",2103.0,1156.65,116.33,3533.0,53
CPT,64488,"HC NERVE BLOCK INJ, TAP BILATERAL",1172.0,644.6,116.33,3533.0,106
CPT,64489,"HC NERVE BLOCK, TAP BILATERAL, CONTINUOUS INFUSION(S)",2327.0,1279.85,308.13,3533.0,53
CPT,64490,"HC INJ, DX/THER AGENT, PV FACET JT IMG GUID, C-T, SINGLE LEVEL",3084.0,1696.2,904.71,4955.0,106
CPT,64491,"HC INJ, DX/THER AGENT, PV FACET JT IMG GUID, C-T, 2ND LEVEL (AD)",819.0,450.45,89.68,3533.0,106
CPT,64492,"HC INJ, DX/THER AGENT, PV FACET JT IMG GUID, C-T, 3RD/ANY ADL LEVEL (AD)",803.0,441.65,89.57,3533.0,53
CPT,64493,"HC INJ, DX/THER AGENT, PV FACET JT IMG GUID, L-S, SINGLE LEVEL",3821.0,2101.55,904.71,4955.0,159
CPT,64494,"HC INJ, DX/THER AGENT, PV FACET JT IMG GUID, L-S, 2ND LEVEL (AD)",1017.0,559.35,83.57,3533.0,159
CPT,64495,"HC INJ, DX/THER AGENT, PV FACET JT IMG GUID, L-S, 3RD/ANY ADL LEVEL (AD)",1066.0,586.3,83.04,3533.0,106
CPT,64505,"HC INJ, ANES AGENT, SPHENOPALATINE GANGLION",1080.0,594.0,299.97,4258.0,53
CPT,64510,"HC INJ, ANES AGENT, STELLATE GANGLION (CERVICAL SYMPATHETIC)",2462.0,1354.1,738.6,4955.0,53
CPT,64517,"HC INJ, ANES AGENT, SUPERIOR HYPOGASTRIC PLEXUS",3084.0,1696.2,904.71,4955.0,53
CPT,64520,"HC INJ, ANES AGENT, LUMBAR OR THORACIC (PARAVERTEBRAL SYMPATHETIC)",3546.0,1950.3,904.71,4955.0,53
CPT,64530,"HC INJ, ANES AGENT, CELIAC PLEXUS, W/WO RAD MONITOR",3084.0,1696.2,904.71,4955.0,53
CPT,64553,IMPLANT NEUROELECTRODES,,,10315.0,19884.0,22
CPT,64555,IMPLANT NEUROELECTRODES,,,6669.22,19884.0,22
CPT,64561,"HC PERC IMPLANTATION NEUROSTIM ELECTRODE ARRAY, SACRAL NERVE INCL IMG GUID",19624.0,10793.2,5887.2,19884.0,106
CPT,64566,HC POSTERIOR TIB NEUROSTIM PERCUTAN NDL ELECTRODE,766.0,421.3,229.8,4258.0,106
CPT,64568,OPN IMPLTJ CRNL NRV NEA&PG,,,19979.0,34485.0,22
CPT,64569,REVISE/REPL VAGUS N ELTRD,,,10315.0,19884.0,22
CPT,64570,REMOVE VAGUS N ELTRD,,,6507.82,17804.0,22
CPT,64575,OPN IMPLTJ NEA PERPH NERVE,,,12463.0,24394.0,22
CPT,64580,OPN IMPLTJ NEA NEUROMUSCULAR,,,12463.0,24394.0,22
CPT,64581,OPN IMPLTJ NEA SACRAL NERVE,,,6669.22,21512.0,22
CPT,64582,OPN MPLTJ HPGLSL NSTM ARY PG,,,16700.0,31896.28,22
CPT,64583,REV/RPLCT HPGLSL NSTM ARY PG,,,12463.0,21512.0,22
CPT,64584,RMVL HPGLSL NSTIM ARY PG,,,6507.82,17804.0,22
CPT,64585,HC REVISION OR REMOVAL OF PERIPHERAL NEUROSTIMULATOR ELECTRODE ARRAY,9454.0,5199.7,2836.2,14658.0,106
CPT,64590,INS/RPL PRPH SAC/GSTR NPG/R,,,16700.0,28824.0,22
CPT,64595,REV/RMV PRPH SAC/GSTR NPG/R,,,3494.72,14658.0,22
CPT,64596,INS/RPLCMT PRQ ELTRD RA PN 1,,,12463.0,21512.0,22
CPT,64597,INS/RPLCM PRQ ELTRD RA PN EA,,,835.0,3533.0,6
CPT,64598,REVJ/RMVL NEA PN W/INT NSTIM,,,3494.72,14658.0,22
CPT,64600,INJECTION TREATMENT OF NERVE,,,904.71,4955.0,22
CPT,64605,INJECTION TREATMENT OF NERVE,,,1984.4,9469.0,22
CPT,64610,"HC DESTRUCT NEUROLYT AGENT, TRIGEMNL NERVE, 2ND-3RD DIV BRNCH AT FORAMEN OV",5393.0,2966.15,1617.9,9469.0,53
CPT,64611,HC CHEMODENERV PAROTID SUBMANDIBULAR GLANDS BILAT,798.5,439.175,239.1,4258.0,318
CPT,64612,HC CHEMODENERV MUSCL INNERV BY FACIAL NERVE UNILAT,1032.5,567.875,285.0,4258.0,318
CPT,64615,HC CHEMODENERV MUSC INRV FACL TRIGM CERV MIGRAINE,886.0,487.3,265.8,4258.0,212
CPT,64616,HC CHEMODENERVATION NECK MUSCLE EXCL LARYNX UNILAT,1102.0,606.1,299.97,4258.0,477
CPT,64617,HC CHEMODENERERVATION MUSCLE LARYNX PERC EMG GUIDE,1681.0,924.55,504.3,4955.0,53
CPT,64620,"HC DESTRUCTION BY NEUROLYTIC AGENT, INTERCOSTAL NERVE",3326.0,1829.3,904.71,4955.0,53
CPT,64624,DSTRJ NULYT AGT GNCLR NRV,,,3472.71,3472.71,1
CPT,64624,HC DESTRUCTION NEUROLYTIC AGENT GENICULAR NERVE W/ IMAGE GUIDANCE,5410.0,2975.5,1623.0,9469.0,106
CPT,64625,HC RADIOFREQUENCY ABLATION NERVES INNERVATING SI JT W/ IMAGE GUIDANCE,4786.0,2632.3,1435.8,9469.0,53
CPT,64625,RF ABLTJ NRV NRVTG SI JT,,,3472.71,3472.71,1
CPT,64628,HC DESTR THERMAL BASIVERTEBRAL NERVE LUMBAR/SACRAL,33567.0,18461.85,10070.1,29035.46,53
CPT,64628,TRML DSTRJ IOS BVN 1ST 2 L/S,,,22881.71,22881.71,1
CPT,64629,HC DESTR THERMAL BASIVERTEBRAL NERVE EACH ADDL BODY,33567.0,18461.85,176.7,29035.46,53
CPT,64629,TRML DSTRJ IOS BVN EA ADDL,,,309.22,309.22,1
CPT,64630,"HC DESTRUCTION BY NEUROLYTIC AGENT, PUDENDAL NERVE",3084.0,1696.2,904.71,4955.0,106
CPT,64632,N BLOCK INJ COMMON DIGIT,,,299.97,4258.0,22
CPT,64633,"HC DESTR BY NEUROLYT AGENT, PV FACET JT NRV(S), IMG GUID, C-T, SINGLE",5532.0,3042.6,1659.6,9469.0,106
CPT,64634,"HC DESTR BY NEUROLYT AGENT, PV FACET JT NRV(S), IMG GUID, C-T, EA AD (AD)",819.0,450.45,230.13,3533.0,53
CPT,64635,"HC DESTR BY NEUROLYT AGENT, PV FACET JT NRV(S), IMG GUID, L-S, SINGLE",5275.0,2901.25,1582.5,9469.0,53
CPT,64636,"HC DESTR BY NEUROLYT AGENT, PV FACET JT NRV(S), IMG GUID, L-S, EA AD (AD)",1506.0,828.3,215.87,3533.0,53
CPT,64640,"HC DESTR BY NEUROLYT AGENT, OTHER PERIPHERAL NERVE/BRANCH",4137.0,2275.35,904.71,4955.0,159
CPT,64642,"HC CHEMODENERVATION ONE EXTREMITY, 1 - 4 MUSCLES",1855.0,1020.25,556.5,4955.0,159
CPT,64643,"HC CHEMODENERVATION EA ADDL EXTREMITY, 1 - 4 MUSCLES",857.0,471.35,84.02,3533.0,159
CPT,64644,"HC CHEMODENERVATION ONE EXTREMITY, 5 OR MORE MUSCLES",1185.0,651.75,355.5,4955.0,106
CPT,64645,"HC CHEMODENERVATION EA ADDL EXTREMITY, 5 OR MORE MUSCLES",996.0,547.8,107.62,3533.0,53
CPT,64646,"HC CHEMODENERVATION OF TRUNK MUSCLE(S), 1-5 MUSCLE(S)",1855.0,1020.25,556.5,4955.0,265
CPT,64647,"HC CHEMODENERVATION OF TRUNK MUSCLE(S), 6 OR MORE MUSCLES",1855.0,1020.25,556.5,4955.0,106
CPT,64650,HC CHEMODENERVATION ECCRINE GLANDS BOTH AXILLAE,688.0,378.4,206.4,4258.0,106
CPT,64653,"HC CHEMODENERVATION ECCRINE GLANDS, OTHER AREA(S), PER DAY",800.0,440.0,240.0,4258.0,106
CPT,64680,"HC DESTRUCT BY NEUROLYTIC AGENT, W/WO RAD MONITOR, CELIAC PLEXUS",4181.0,2299.55,904.71,4955.0,53
CPT,64681,"HC DESTRUCT BY NEUROLYTIC AGENT, W/WO RAD MONITOR, SUP HYPOGASTRIC PLEXUS",2462.0,1354.1,738.6,4955.0,53
CPT,64702,REVISE FINGER/TOE NERVE,,,1984.4,9469.0,22
CPT,64704,REVISE HAND/FOOT NERVE,,,1984.4,9469.0,22
CPT,64708,HC NEUROPLASTY MAJOR PERIPHERAL NERVE ARM OR LEG OPEN; OTHER THAN SPECIFIED,6962.0,3829.1,1984.4,9469.0,106
CPT,64712,REVISION OF SCIATIC NERVE,,,1984.4,9469.0,22
CPT,64713,REVISION OF ARM NERVE(S),,,1984.4,9469.0,22
CPT,64714,REVISE LOW BACK NERVE(S),,,1984.4,9469.0,22
CPT,64716,REVISION OF CRANIAL NERVE,,,1984.4,9469.0,22
CPT,64718,REVISE ULNAR NERVE AT ELBOW,,,1984.4,9469.0,22
CPT,64719,REVISE ULNAR NERVE AT WRIST,,,1984.4,9469.0,22
CPT,64721,CARPAL TUNNEL SURGERY,,,1984.4,9469.0,22
CPT,64722,DECOMPRESSION UNSPEC NERVE,,,1984.4,9469.0,22
CPT,64726,DCMPRN PLANTAR DIGITAL NERVE,,,1984.4,9469.0,22
CPT,64727,INTERNAL NEUROLYSIS,,,163.43,3533.0,21
CPT,64732,INCISION OF BROW NERVE,,,1984.4,6766.0,22
CPT,64734,INCISION OF CHEEK NERVE,,,1984.4,6766.0,22
CPT,64736,INCISION OF CHIN NERVE,,,1984.4,6766.0,22
CPT,64738,INCISION OF JAW NERVE,,,1984.4,6766.0,22
CPT,64740,INCISION OF TONGUE NERVE,,,1984.4,9469.0,22
CPT,64742,INCISION OF FACIAL NERVE,,,1984.4,9469.0,22
CPT,64744,INCISE NERVE BACK OF HEAD,,,1984.4,9469.0,22
CPT,64746,INCISE DIAPHRAGM NERVE,,,1984.4,6766.0,22
CPT,64755,INCISION OF STOMACH NERVES,,,805.8,13936.0,22
CPT,64760,INCISION OF VAGUS NERVE,,,463.05,5761.0,22
CPT,64763,INCISE HIP/THIGH NERVE,,,1984.4,6766.0,22
CPT,64766,INCISE HIP/THIGH NERVE,,,1984.4,14658.0,22
CPT,64771,SEVER CRANIAL NERVE,,,1984.4,9469.0,22
CPT,64772,INCISION OF SPINAL NERVE,,,1984.4,9469.0,22
CPT,64774,REMOVE SKIN NERVE LESION,,,1984.4,9469.0,22
CPT,64776,REMOVE DIGIT NERVE LESION,,,1984.4,9469.0,22
CPT,64778,DIGIT NERVE SURGERY ADD-ON,,,158.11,3533.0,21
CPT,64782,REMOVE LIMB NERVE LESION,,,1984.4,9469.0,22
CPT,64783,LIMB NERVE SURGERY ADD-ON,,,188.82,3533.0,21
CPT,64784,REMOVE NERVE LESION,,,1984.4,9469.0,22
CPT,64786,REMOVE SCIATIC NERVE LESION,,,6507.82,16799.0,22
CPT,64787,IMPLANT NERVE END,,,208.8,3533.0,21
CPT,64788,HC EXC NEUROFIBROMA CUTANEOUS NERVE,6962.0,3829.1,1984.4,9469.0,106
CPT,64790,HC EXCISION OF NEUROFIBROMA OR NEUROLEMMOMA; MAJOR PERIPHERAL NERVE,6962.0,3829.1,1984.4,9469.0,106
CPT,64792,REMOVAL OF NERVE LESION,,,6507.82,16799.0,22
CPT,64795,BIOPSY OF NERVE,,,1984.4,9469.0,22
CPT,64802,SYMPATHECTOMY CERVICAL,,,1984.4,6766.0,22
CPT,64804,SYMPATHECTOMY CERVICOTHORAC,,,1984.4,6766.0,22
CPT,64809,SYMPATHECTOMY THORACOLUMBAR,,,936.21,13936.0,22
CPT,64818,SYMPATHECTOMY LUMBAR,,,703.26,13936.0,22
CPT,64820,SYMPATHECTOMY DIGITAL ARTERY,,,1984.4,9469.0,22
CPT,64821,SYMPATHECTOMY RADIAL ARTERY,,,3297.17,14658.0,22
CPT,64822,SYMPATHECTOMY ULNAR ARTERY,,,3297.17,14658.0,22
CPT,64823,SYMPATHECTOMY SUPFC PALMAR,,,3297.17,14658.0,22
CPT,64831,"HC SUTURE OF DIGITAL NERVE, HAND OR FOOT, 1 NERVE",11853.0,6519.15,1984.4,14658.0,53
CPT,64832,REPAIR NERVE ADD-ON,,,293.26,3533.0,21
CPT,64834,REPAIR OF HAND OR FOOT NERVE,,,6507.82,16799.0,22
CPT,64835,REPAIR OF HAND OR FOOT NERVE,,,6507.82,16799.0,22
CPT,64836,REPAIR OF HAND OR FOOT NERVE,,,6507.82,16799.0,22
CPT,64837,REPAIR NERVE ADD-ON,,,318.33,3533.0,21
CPT,64840,REPAIR OF LEG NERVE,,,6507.82,16799.0,22
CPT,64856,REPAIR/TRANSPOSE NERVE,,,6507.82,16799.0,22
CPT,64857,REPAIR ARM/LEG NERVE,,,6507.82,16799.0,22
CPT,64858,HC SUTURE OF SCIATIC NERVE,13285.0,7306.75,1984.4,14658.0,106
CPT,64859,NERVE SURGERY,,,216.33,3533.0,21
CPT,64861,REPAIR OF ARM NERVES,,,1984.4,14658.0,22
CPT,64862,REPAIR OF LOW BACK NERVES,,,6507.82,16799.0,22
CPT,64864,REPAIR OF FACIAL NERVE,,,6507.82,16799.0,22
CPT,64865,REPAIR OF FACIAL NERVE,,,6507.82,16799.0,22
CPT,64866,FUSION OF FACIAL/OTHER NERVE,,,1119.71,13936.0,22
CPT,64868,FUSION OF FACIAL/OTHER NERVE,,,900.49,13936.0,22
CPT,64872,SUBSEQUENT REPAIR OF NERVE,,,101.47,3533.0,21
CPT,64874,REPAIR & REVISE NERVE ADD-ON,,,151.52,3533.0,21
CPT,64876,REPAIR NERVE/SHORTEN BONE,,,171.5,3533.0,21
CPT,64885,NERVE GRAFT HEAD/NECK <4 CM,,,6507.82,16799.0,22
CPT,64886,NERVE GRAFT HEAD/NECK >4 CM,,,6507.82,16799.0,22
CPT,64890,NRV GRF 1STRND HND/FOOT <4CM,,,6507.82,16799.0,22
CPT,64891,NRV GRF 1STRND HND/FOOT >4CM,,,6507.82,16799.0,22
CPT,64892,NRV GRF 1STRND ARM/LEG <4CM,,,6507.82,16799.0,22
CPT,64893,NRV GRF 1STRND ARM/LEG >4 CM,,,6507.82,16799.0,22
CPT,64895,NRV GRF MLTST HND/FOOT <4 CM,,,6507.82,16799.0,22
CPT,64896,NRV GRF MLTST HND/FOOT >4 CM,,,6507.82,16799.0,22
CPT,64897,NRV GRF MLTST ARM/LEG <4 CM,,,6507.82,16799.0,22
CPT,64898,NRV GRF MLTST ARM/LEG >4 CM,,,6507.82,16799.0,22
CPT,64901,NERVE GRAFT ADD-ON,,,519.58,3533.0,21
CPT,64902,NERVE GRAFT ADD-ON,,,601.6,3533.0,21
CPT,64905,NERVE PEDICLE TRANSFER,,,6507.82,16799.0,22
CPT,64907,NERVE PEDICLE TRANSFER,,,6507.82,16799.0,22
CPT,64910,NERVE REPAIR W/ALLOGRAFT,,,6507.82,16799.0,22
CPT,64911,NEURORRAPHY W/VEIN AUTOGRAFT,,,6507.82,16799.0,22
CPT,64912,NRV RPR W/NRV ALGRFT 1ST,,,6507.82,16799.0,22
CPT,64913,NRV RPR W/NRV ALGRFT EA ADDL,,,151.62,3533.0,21
CPT,64999,"HC ANES PENG NERVE BLOCKS, CATHETER/CONTINUOUS, UNLISTED PX NERVOUS SYSTEM",7977.0,4387.35,299.97,29323.0,53
CPT,64999,"HC ANES PENG NERVE BLOCKS, SINGLE SHOT, UNLISTED PX NERVOUS SYSTEM",4579.0,2518.45,299.97,29323.0,53
CPT,64999,"HC ASPIRATION/INJECTION SYNOVIAL CYST, UNLISTED PROCEDURE, NERVOUS SYSTEM",3084.0,1696.2,299.97,29323.0,53
CPT,64999,"HC CERVICAL PLEXUS INJECTION, UNLISTED PROCEDURE NERVOUS SYSTEM",2563.0,1409.65,299.97,29323.0,265
CPT,64999,HC CHEMODENERV MUSC INRV FACL TRIGM CERV FOR TX OF NONMIGRAINE RELATED COND,1000.0,550.0,299.97,29323.0,106
CPT,64999,HC CHEMODENERVATION EXTREMITY SYMPATHETIC NERVES,906.0,498.3,271.8,29323.0,53
CPT,64999,"HC FASCIA ILIACA NERVE BLOCK, SS/CATH/CONT, UNLIST NERV SYS",7229.0,3975.95,299.97,29323.0,53
CPT,64999,"HC INJ, ANES AGENT, PHRENIC NERVE, UNLISTED PROCEDURE NERVOUS SYSTEM",2775.0,1526.25,299.97,29323.0,53
CPT,64999,"HC INJ, ANES AGENT, SPHENOPALATINE GANGLION, TX INTRACT MIGRANE HEADACHE",2226.0,1224.3,299.97,29323.0,159
CPT,64999,"HC NERVE BLOCK INJ FACIAL, UNLISTED PROCEDURE, NERVOUS SYSTEM",823.0,452.65,246.9,29323.0,53
CPT,64999,"HC PECS SAP ESP IPACK SPANK NERVE BLOCK, SS/CATH/CONT, UNLIST NERV SYS",2347.0,1290.85,299.97,29323.0,53
CPT,64999,"HC QUADRATUS LUMBORUM NERVE BLOCK, UNLISTED PROCEDURE NERVOUS SYSTEM",1803.0,991.65,299.97,29323.0,53
CPT,64999,"HC SYMPATHETIC BLOCK, UNLISTED PROCEDURE, NERVOUS SYSTEM",3546.0,1950.3,299.97,29323.0,53
CPT,64999,"HC UNLIST PROC, SYMPATHETIC NEUROLYSIS",4256.0,2340.8,299.97,29323.0,53
CPT,65091,REVISE EYE,,,3832.09,14658.0,22
CPT,65093,REVISE EYE WITH IMPLANT,,,3832.09,14658.0,22
CPT,65101,REMOVAL OF EYE,,,3832.09,14658.0,22
CPT,65103,REMOVE EYE/INSERT IMPLANT,,,3832.09,14658.0,22
CPT,65105,REMOVE EYE/ATTACH IMPLANT,,,3832.09,14658.0,22
CPT,65110,REMOVAL OF EYE,,,3832.09,14658.0,22
CPT,65112,REMOVE EYE/REVISE SOCKET,,,3832.09,14658.0,22
CPT,65114,REMOVE EYE/REVISE SOCKET,,,3832.09,14658.0,22
CPT,65125,REVISE OCULAR IMPLANT,,,2370.75,9469.0,22
CPT,65130,INSERT OCULAR IMPLANT,,,3832.09,14658.0,22
CPT,65135,INSERT OCULAR IMPLANT,,,3832.09,14658.0,22
CPT,65140,ATTACH OCULAR IMPLANT,,,3832.09,14658.0,22
CPT,65150,REVISE OCULAR IMPLANT,,,3832.09,14658.0,22
CPT,65155,REINSERT OCULAR IMPLANT,,,3832.09,14658.0,22
CPT,65175,REMOVAL OF OCULAR IMPLANT,,,3832.09,14658.0,22
CPT,65205,"HC REMOVAL FOREIGN BODY, EXTERNAL EYE, CONJUCTIVAL SUPERFICIAL",307.0,168.85,92.1,4258.0,159
CPT,65210,"HC REMOV FOR BODY, EXT EYE, CONJUCTV EMBED, SUBCONJUNCT, OR SCLERAL NONPERF",453.0,249.15,135.9,4258.0,159
CPT,65220,"HC REMOVAL FOREIGN BODY, EXTERNAL EYE, CORNEAL, WITHOUT SLIT LAMP",473.0,260.15,141.9,4258.0,159
CPT,65222,"HC REMOVAL FOREIGN BODY, EXTERNAL EYE, CORNEAL, WITH SLIT LAMP",411.0,226.05,123.3,4258.0,159
CPT,65235,REMOVE FOREIGN BODY FROM EYE,,,2317.68,9469.0,22
CPT,65260,REMOVE FOREIGN BODY FROM EYE,,,835.0,5761.0,22
CPT,65265,REMOVE FOREIGN BODY FROM EYE,,,2317.68,9469.0,22
CPT,65270,HC REPR LACERATION CONJUCTIVA DIR CLOSURE,6092.0,3350.6,1827.6,9469.0,53
CPT,65272,REPAIR OF EYE WOUND,,,2370.75,9469.0,22
CPT,65273,REPAIR OF EYE WOUND,,,347.02,5761.0,22
CPT,65275,REPAIR OF EYE WOUND,,,3832.09,14658.0,22
CPT,65280,REPAIR OF EYE WOUND,,,5243.3,13936.0,22
CPT,65285,REPAIR OF EYE WOUND,,,5243.3,13936.0,22
CPT,65286,HC REPR LACERATION CORNEA SCLERA APPL TISSUE GLUE,2770.0,1523.5,831.0,6766.0,159
CPT,65290,REPAIR OF EYE SOCKET WOUND,,,3832.09,14658.0,22
CPT,65400,HC REMOVAL OF EYE LESION,4227.0,2324.85,984.23,6766.0,106
CPT,65410,BIOPSY OF CORNEA,,,2370.75,5761.0,22
CPT,65420,REMOVAL OF EYE LESION,,,2370.75,9469.0,22
CPT,65426,REMOVAL OF EYE LESION,,,2370.75,9469.0,22
CPT,65430,HC CORNEAL SMEAR,670.0,368.5,201.0,4258.0,106
CPT,65435,"HC REMOVAL OF CORNEAL EPITHELIUM, W/ OR W/O CHEMOCAUTERIZATION",3179.0,1748.45,953.7,6766.0,159
CPT,65436,HC CURETTE TREAT CORNEA W AGENT,6222.0,3422.1,1866.6,9469.0,106
CPT,65450,TREATMENT OF CORNEAL LESION,,,303.77,4258.0,22
CPT,65600,REVISION OF CORNEA,,,2370.75,9469.0,22
CPT,65710,CORNEAL TRANSPLANT,,,5243.3,16799.0,22
CPT,65730,CORNEAL TRANSPLANT,,,4088.03,16799.0,22
CPT,65750,CORNEAL TRANSPLANT,,,5243.3,16799.0,22
CPT,65755,CORNEAL TRANSPLANT,,,4088.03,16799.0,22
CPT,65756,CORNEAL TRNSPL ENDOTHELIAL,,,4088.03,16799.0,22
CPT,65757,PREP CORNEAL ENDO ALLOGRAFT,,,835.0,3533.0,6
CPT,65760,KERATOMILEUSIS,,,5480.0,9469.0,7
CPT,65765,KERATOPHAKIA,,,5480.0,9469.0,7
CPT,65767,EPIKERATOPLASTY,,,5480.0,9469.0,7
CPT,65770,KERATOPROSTHESIS,,,10315.0,19884.0,22
CPT,65771,RADIAL KERATOTOMY,,,5480.0,9469.0,7
CPT,65772,HC CORRECTION OF ASTIGMATISM,4454.0,2449.7,984.23,6766.0,106
CPT,65775,CORRECTION OF ASTIGMATISM,,,2370.75,9469.0,22
CPT,65778,HC COVER EYE W MEMBRANE WO SUTURES,4218.0,2319.9,984.23,6766.0,106
CPT,65779,COVER EYE W/MEMBRANE SUTURE,,,3832.09,14658.0,22
CPT,65780,OCULAR RECONST TRANSPLANT,,,3832.09,14658.0,22
CPT,65781,OCULAR RECONST TRANSPLANT,,,5243.3,16799.0,22
CPT,65782,OCULAR RECONST TRANSPLANT,,,3832.09,14658.0,22
CPT,65785,IMPLTJ NTRSTRML CRNL RNG SEG,,,4088.03,16799.0,22
CPT,65800,HC PARACENTESIS ANTERIOR EYE CHAMBER W REM AQUEOUS,6238.0,3430.9,835.0,5761.0,159
CPT,65810,DRAINAGE OF EYE,,,2317.68,9469.0,22
CPT,65815,HC PARACENTESIS ANTERIOR EYE CHAMBER W REM BLOOD,8672.0,4769.6,2317.68,9469.0,159
CPT,65820,GONIOTOMY,,,4088.03,13936.0,22
CPT,65850,TRABECULOTOMY AB EXTERNO,,,2317.68,9469.0,22
CPT,65855,HC TRABECULOPLASTY BY LASER SURGERY,1791.0,985.05,537.3,4955.0,106
CPT,65860,SEVERING ADS ANT SGM LASER,,,557.49,4955.0,22
CPT,65865,INCISE INNER EYE ADHESIONS,,,2317.68,9469.0,22
CPT,65870,INCISE INNER EYE ADHESIONS,,,2317.68,9469.0,22
CPT,65875,INCISE INNER EYE ADHESIONS,,,2317.68,9469.0,22
CPT,65880,INCISE INNER EYE ADHESIONS,,,4088.03,13936.0,22
CPT,65900,REMOVE EYE LESION,,,2317.68,9469.0,22
CPT,65920,"HC REMOVAL OF IMPLANTED MATERIAL, ANTERIOR SEGMENT OF EYE",7753.0,4264.15,2317.68,9469.0,53
CPT,65930,REMOVE BLOOD CLOT FROM EYE,,,2317.68,9469.0,22
CPT,66020,HC AIR LIQUID INJ EYE ANT CHAMBER,5890.0,3239.5,1767.0,6766.0,106
CPT,66030,HC MEDICATION INJ EYE ANT CHAMBER,5887.0,3237.85,1766.1,6766.0,106
CPT,66130,REMOVE EYE LESION,,,2370.75,9469.0,22
CPT,66150,GLAUCOMA SURGERY,,,4088.03,13936.0,22
CPT,66155,GLAUCOMA SURGERY,,,4088.03,13936.0,22
CPT,66160,GLAUCOMA SURGERY,,,2317.68,9469.0,22
CPT,66170,GLAUCOMA SURGERY,,,2317.68,9469.0,22
CPT,66172,INCISION OF EYE,,,2317.68,9469.0,22
CPT,66174,TRLUML DIL AQ O/F CAN W/O ST,,,4088.03,16799.0,22
CPT,66175,TRLUML DIL AQ O/F CAN W/ST,,,5243.3,16799.0,22
CPT,66179,AQUEOUS SHUNT EYE W/O GRAFT,,,5243.3,16799.0,22
CPT,66180,AQUEOUS SHUNT EYE W/GRAFT,,,5243.3,16799.0,22
CPT,66183,INSERT ANT DRAINAGE DEVICE,,,4088.03,16799.0,22
CPT,66184,REVISION OF AQUEOUS SHUNT,,,2317.68,9469.0,22
CPT,66185,REVISE AQUEOUS SHUNT EYE,,,2317.68,9469.0,22
CPT,66225,REPAIR/GRAFT EYE LESION,,,5243.3,13936.0,22
CPT,66250,HC REVISE REPR ANT SEGMENT OPERATIVE WND,8736.0,4804.8,2370.75,9469.0,106
CPT,66500,INCISION OF IRIS,,,835.0,5761.0,22
CPT,66505,INCISION OF IRIS,,,2317.68,6766.0,22
CPT,66600,REMOVE IRIS AND LESION,,,4088.03,13936.0,22
CPT,66605,REMOVAL OF IRIS,,,2317.68,16799.0,22
CPT,66625,REMOVAL OF IRIS,,,2317.68,6766.0,22
CPT,66630,REMOVAL OF IRIS,,,2317.68,6766.0,22
CPT,66635,REMOVAL OF IRIS,,,2317.68,9469.0,22
CPT,66680,REPAIR IRIS & CILIARY BODY,,,2317.68,9469.0,22
CPT,66682,"HC SUTURE OF IRIS, CILIARY BODY, W/ RETRV OF SUTURE THRU SMALL INCISION",8181.0,4499.55,2317.68,9469.0,106
CPT,66683,IMPLANTATION IRIS PROSTHESIS,,,5761.0,17182.86,22
CPT,66700,HC DESTRUCTION CILIARY BODY,5966.0,3281.3,1789.8,6766.0,53
CPT,66710,HC CILIARY TRANSSLERAL THERAPY,6222.0,3422.1,1866.6,9469.0,159
CPT,66711,ECP CILIARY BODY DESTRUCTION,,,2317.68,9469.0,22
CPT,66720,DESTRUCTION CILIARY BODY,,,2370.75,9469.0,22
CPT,66740,HC DESTRUCTION CILIARY BODY CYCLO,7464.0,4105.2,2239.2,9469.0,106
CPT,66761,HC IRIDOTOMY-IRRIDECTOMY LASER SURG PER SESSION,2510.0,1380.5,557.49,4955.0,159
CPT,66762,HC IRIDOPLASTY BY PHOTOCOAGULATION,1571.0,864.05,471.3,4955.0,106
CPT,66770,REMOVAL OF INNER EYE LESION,,,557.49,4955.0,22
CPT,66820,INCISION SECONDARY CATARACT,,,835.0,5761.0,22
CPT,66821,HC DISCISSION 2NDARY MEMBRANOUS CATARACT LASER YAG,1571.0,864.05,471.3,4955.0,106
CPT,66825,HC REPOSITIONING IO LENS PROSTHESIS REQ INC SPX,7191.0,3955.05,2157.3,9469.0,53
CPT,66830,REMOVAL OF LENS LESION,,,2317.68,9469.0,22
CPT,66840,REMOVAL OF LENS MATERIAL,,,2317.68,9469.0,22
CPT,66850,REMOVAL OF LENS MATERIAL,,,2317.68,9469.0,22
CPT,66852,REMOVAL OF LENS MATERIAL,,,4088.03,16799.0,22
CPT,66920,EXTRACTION OF LENS,,,2317.68,9469.0,22
CPT,66930,EXTRACTION OF LENS,,,4088.03,13936.0,22
CPT,66940,EXTRACTION OF LENS,,,2317.68,6766.0,22
CPT,66982,XCAPSL CTRC RMVL CPLX WO ECP,,,2317.68,9469.0,22
CPT,66983,CATARACT SURG W/IOL 1 STAGE,,,2317.68,9469.0,22
CPT,66984,XCAPSL CTRC RMVL W/O ECP,,,2317.68,9469.0,22
CPT,66985,INSERT LENS PROSTHESIS,,,2317.68,9469.0,22
CPT,66986,EXCHANGE LENS PROSTHESIS,,,2317.68,9469.0,22
CPT,66987,XCAPSL CTRC RMVL CPLX W/ECP,,,4088.03,16799.0,22
CPT,66988,XCAPSL CTRC RMVL W/ECP,,,4088.03,16799.0,22
CPT,66989,XCPSL CTRC RMVL CPLX INSJ 1+,,,5243.3,16799.0,22
CPT,66990,OPHTHALMIC ENDOSCOPE ADD-ON,,,80.57,3533.0,21
CPT,66991,XCAPSL CTRC RMVL INSJ 1+,,,5243.3,16799.0,22
CPT,66999,UNLISTED PX ANT SEGMENT EYE,,,2317.68,29323.0,22
CPT,67005,PARTIAL REMOVAL OF EYE FLUID,,,2317.68,9469.0,22
CPT,67010,PARTIAL REMOVAL OF EYE FLUID,,,2317.68,9469.0,22
CPT,67015,HC RELEASE OF EYE FLUID,9133.0,5023.15,2317.68,9469.0,106
CPT,67025,"HC INJ VITREOUS SUBSTITUTE, PARS PLANA/LIMBAL APPROACH, W/ W/O ASPIR",9203.0,5061.65,2317.68,9469.0,106
CPT,67027,IMPLANT EYE DRUG SYSTEM,,,9733.0,24394.0,22
CPT,67028,HC INJ EYE DRUG,1146.0,630.3,337.06,4258.0,159
CPT,67030,INCISE INNER EYE STRANDS,,,2317.68,9469.0,22
CPT,67031,HC LASR SEVER VITREOUS STRND ADHES SHET MEMBR OPAC,1742.0,958.1,522.6,4955.0,53
CPT,67036,REMOVAL OF INNER EYE FLUID,,,4088.03,16799.0,22
CPT,67039,LASER TREATMENT OF RETINA,,,4088.03,16799.0,22
CPT,67040,LASER TREATMENT OF RETINA,,,4088.03,16799.0,22
CPT,67041,VIT FOR MACULAR PUCKER,,,4088.03,16799.0,22
CPT,67042,VIT FOR MACULAR HOLE,,,4088.03,16799.0,22
CPT,67043,VIT FOR MEMBRANE DISSECT,,,4088.03,16799.0,22
CPT,67101,REPAIR DETACHED RETINA CRTX,,,2317.68,9469.0,22
CPT,67105,"HC REPAIR RETINAL DETACHMENT, INCL DRAIN SUBRETINAL FLUID, PHOTOCOAGULATION",4059.0,2232.45,557.49,4955.0,159
CPT,67107,REPAIR DETACHED RETINA,,,4088.03,16799.0,22
CPT,67108,REPAIR DETACHED RETINA,,,4088.03,16799.0,22
CPT,67110,HC REPR RETINAL DETACHMENT W VITRECT INJ AIR GAS,4912.0,2701.6,1473.6,9469.0,106
CPT,67113,REPAIR RETINAL DETACH CPLX,,,5243.3,16799.0,22
CPT,67115,RELEASE ENCIRCLING MATERIAL,,,4088.03,13936.0,22
CPT,67120,REMOVE EYE IMPLANT MATERIAL,,,2317.68,9469.0,22
CPT,67121,REMOVE EYE IMPLANT MATERIAL,,,2317.68,14658.0,22
CPT,67141,"HC PROPHYLAXIS OF RETINAL DETACHMENT W/O DRAINAGE, CRYOTHERAPY, DIATHERMY",1464.0,805.2,303.77,4258.0,106
CPT,67145,"HC PROPHYLAXIS OF RETINAL DETACHMENT W/O DRAINAGE, PHOTOCOAGULATION",2646.0,1455.3,557.49,4955.0,106
CPT,67208,TREATMENT OF RETINAL LESION,,,303.77,4258.0,22
CPT,67210,"HC DESTRUCT LOCAL LESION RETINA, 1 OR MORE SESSIONS, PHOTOCOAGULATION",2566.0,1411.3,557.49,4955.0,106
CPT,67218,TREATMENT OF RETINAL LESION,,,3832.09,14658.0,22
CPT,67220,"HC DESTRUCT CHOROID LESION PHOTOCOAG LASER, 1 OR MORE SESSIONS",1571.0,864.05,471.3,4955.0,106
CPT,67220,HC TTT LASER,1571.0,864.05,471.3,4955.0,106
CPT,67221,HC OCULAR PHOTODYNAMIC THER,1843.0,1013.65,552.9,4955.0,53
CPT,67225,"HC DESTR LOCALZ LESION CHOROID, PHOTODYN THER, 2ND EYE, SGL SESSION (AD)",1429.0,785.95,26.78,3533.0,106
CPT,67227,DSTRJ EXTENSIVE RETINOPATHY,,,3832.09,14658.0,22
CPT,67228,"HC TREATMENT EXTENSIVE OR PROGRESSIVE RETINOPATHY, PHOTOCOAGULATION",2859.0,1572.45,557.49,4955.0,106
CPT,67229,TR RETINAL LES PRETERM INF,,,557.49,4955.0,22
CPT,67250,REINFORCE EYE WALL,,,2370.75,9469.0,22
CPT,67255,REINFORCE/GRAFT EYE WALL,,,4088.03,9469.0,22
CPT,67299,UNLISTED PX POSTERIOR SEGMNT,,,2317.68,29323.0,22
CPT,67311,REVISE EYE MUSCLE,,,2370.75,9469.0,22
CPT,67312,REVISE TWO EYE MUSCLES,,,3832.09,14658.0,22
CPT,67314,REVISE EYE MUSCLE,,,2370.75,9469.0,22
CPT,67316,REVISE TWO EYE MUSCLES,,,2370.75,9469.0,22
CPT,67318,REVISE EYE MUSCLE(S),,,2370.75,9469.0,22
CPT,67320,REVISE EYE MUSCLE(S) ADD-ON,,,158.94,3533.0,21
CPT,67331,EYE SURGERY FOLLOW-UP ADD-ON,,,115.01,3533.0,21
CPT,67332,REREVISE EYE MUSCLES ADD-ON,,,185.55,3533.0,21
CPT,67334,REVISE EYE MUSCLE W/SUTURE,,,113.54,3533.0,21
CPT,67335,EYE SUTURE DURING SURGERY,,,170.61,3533.0,21
CPT,67340,REVISE EYE MUSCLE ADD-ON,,,265.89,3533.0,21
CPT,67343,RELEASE EYE TISSUE,,,2370.75,9469.0,22
CPT,67345,HC CHEMODENERVATION EXTRAOCULAR MUSCLE,949.0,521.95,284.7,4258.0,106
CPT,67346,BIOPSY EYE MUSCLE,,,3832.09,14658.0,22
CPT,67399,UNLISTED PX EXTRAOCULAR MUSC,,,303.77,29323.0,22
CPT,67400,"HC ORBITOTOMY W/O BONE FLAP, FOR EXPLORATION, W/ OR W/O BX",11430.0,6286.5,3429.0,14658.0,53
CPT,67405,HC ORBITOTOMY W/O BONE FLAP EXPL W/ DRAINAGE ONLY,6092.0,3350.6,1827.6,9469.0,106
CPT,67412,EXPLORE/TREAT EYE SOCKET,,,2370.75,9469.0,22
CPT,67413,EXPLORE/TREAT EYE SOCKET,,,2370.75,9469.0,22
CPT,67414,EXPLR/DECOMPRESS EYE SOCKET,,,3832.09,14658.0,22
CPT,67415,ASPIRATION ORBITAL CONTENTS,,,2370.75,9469.0,22
CPT,67420,EXPLORE/TREAT EYE SOCKET,,,3832.09,14658.0,22
CPT,67430,EXPLORE/TREAT EYE SOCKET,,,3832.09,14658.0,22
CPT,67440,EXPLORE/DRAIN EYE SOCKET,,,3832.09,14658.0,22
CPT,67445,EXPLR/DECOMPRESS EYE SOCKET,,,3832.09,14658.0,22
CPT,67450,EXPLORE/BIOPSY EYE SOCKET,,,3832.09,14658.0,22
CPT,67500,HC RETROBULBAR INJ MEDICATION SEP PROC,1103.0,606.65,303.77,4258.0,106
CPT,67505,INJECT/TREAT EYE SOCKET,,,303.77,4258.0,22
CPT,67515,HC INJ MEDICATION OTHER SUBSTANCE TENON'S CAPSULE,949.0,521.95,284.7,4258.0,106
CPT,67516,HC SUPRACHOROIDAL SPACE INJ OF PHARMACOLOGIC AGENT (SEPARATE PROCEDURE),915.0,503.25,274.5,4258.0,106
CPT,67550,INSERT EYE SOCKET IMPLANT,,,3832.09,14658.0,22
CPT,67560,HC REM REVISE ORBITAL IMPLANT,7252.0,3988.6,2175.6,14658.0,106
CPT,67570,DECOMPRESS OPTIC NERVE,,,3832.09,14658.0,22
CPT,67599,UNLISTED PROCEDURE ORBIT,,,303.77,29323.0,22
CPT,67700,HC DRAINAGE OF EYELID ABSCESS,949.0,521.95,284.7,4258.0,159
CPT,67710,HC INCISION OF EYELID,1842.0,1013.1,552.6,6766.0,106
CPT,67715,HC INCISION OF EYELID FOLD,7392.0,4065.6,2217.6,9469.0,53
CPT,67800,HC EXC CHALAZION SINGLE,784.0,431.2,235.2,4258.0,106
CPT,67801,HC EXC CHALAZION MULT SAME LID,2735.0,1504.25,820.5,6766.0,106
CPT,67805,HC EXC CHALAZION MULT DIFF LIDS,949.0,521.95,284.7,4258.0,106
CPT,67808,REMOVE EYELID LESION(S),,,2370.75,9469.0,22
CPT,67810,HC INC BX EYELID SKIN INCL LID MARGIN,958.0,526.9,287.4,4258.0,159
CPT,67820,HC EPILATION MANUAL FORCEPS,183.0,100.65,54.9,4258.0,106
CPT,67825,HC REVISE EYELASHES,949.0,521.95,284.7,4258.0,106
CPT,67830,REVISE EYELASHES,,,984.23,6766.0,22
CPT,67835,REVISE EYELASHES,,,2370.75,9469.0,22
CPT,67840,HC EXC EYELID LESN WO CLOSURE OR W SIMPLE DIR CLOS,2735.0,1504.25,820.5,6766.0,106
CPT,67850,HC DESTRUCTION OF LESION OF LID MARGIN (UP TO 1 CM),2735.0,1504.25,820.5,6766.0,106
CPT,67875,HC CLOSURE OF EYELID BY SUTURE,3338.0,1835.9,984.23,6766.0,106
CPT,67880,HC REVISION OF EYELID,6160.0,3388.0,1848.0,9469.0,106
CPT,67882,REVISION OF EYELID,,,2370.75,9469.0,22
CPT,67900,REPAIR BROW DEFECT,,,2370.75,9469.0,22
CPT,67901,"HC REPR BLEPHAROPTOSIS, FRONTALIS MUSCLE TECHNQ W SUTURE/OTHER MATERIAL",6925.0,3808.75,2077.5,9469.0,53
CPT,67902,REPAIR EYELID DEFECT,,,3832.09,14658.0,22
CPT,67903,REPAIR EYELID DEFECT,,,2370.75,9469.0,22
CPT,67904,"HC REPAIR OF BLEPHAROPTOSIS, LEVATOR RESECTION OR ADVANCEMENT, EXT APPROACH",7590.0,4174.5,2277.0,9469.0,53
CPT,67906,REPAIR EYELID DEFECT,,,3832.09,14658.0,22
CPT,67908,REPAIR EYELID DEFECT,,,2370.75,9469.0,22
CPT,67909,HC REDUCTION OF OVERCORRECTION OF PTOSIS,5978.0,3287.9,1793.4,9469.0,53
CPT,67911,HC CORRECTION LID RETRACTION,6492.0,3570.6,1947.6,9469.0,106
CPT,67912,CORRECTION EYELID W/IMPLANT,,,2370.75,9469.0,22
CPT,67914,HC REPR ECTROPION BY SUTURE,7162.0,3939.1,2148.6,9469.0,106
CPT,67915,"HC REPAIR ECTROPION, THERMOCAUTERIZATION",5320.0,2926.0,1596.0,9469.0,106
CPT,67916,REPAIR EYELID DEFECT,,,2370.75,9469.0,22
CPT,67917,REPAIR EYELID DEFECT,,,2370.75,9469.0,22
CPT,67921,HC REPR ENTROPION BY SUTURE,6380.0,3509.0,1914.0,9469.0,106
CPT,67922,REPAIR EYELID DEFECT,,,2370.75,9469.0,22
CPT,67923,REPAIR EYELID DEFECT,,,2370.75,9469.0,22
CPT,67924,REPAIR EYELID DEFECT,,,2370.75,9469.0,22
CPT,67930,HC REPR EYELID WND PARTIAL THICKNESS,3582.0,1970.1,1074.6,9469.0,106
CPT,67935,HC REPR EYELID WND FULL THICKNESS,3970.0,2183.5,1191.0,9469.0,159
CPT,67938,"HC REMOVAL EMBEDDED FOREIGN BODY, EYELID",1179.0,648.45,303.77,4258.0,159
CPT,67950,HC CANTHOPLASTY REVISION OF EYELID,5640.0,3102.0,1692.0,9469.0,106
CPT,67961,HC EXCISION & REPAIR OF EYELID UP TO ONE FOURTH OF LID MARGIN,5957.0,3276.35,1787.1,9469.0,106
CPT,67966,"HC EXCISION AND REPAIR OF EYELID, OVER 1/4 OF LID MARGIN",6421.0,3531.55,1926.3,9469.0,106
CPT,67971,RECONSTRUCTION OF EYELID,,,2370.75,9469.0,22
CPT,67973,RECONSTRUCTION OF EYELID,,,2370.75,9469.0,22
CPT,67974,RECONSTRUCTION OF EYELID,,,3832.09,14658.0,22
CPT,67975,HC RECONSTRUCT EYELID FULL THICKNESS TRNSF TARSOCONJUNCTIVAL FLAP 2ND STAGE,6511.0,3581.05,1953.3,9469.0,106
CPT,67999,UNLISTED PROCEDURE EYELIDS,,,303.77,29323.0,22
CPT,68020,"HC INCISION CONJUNCTIVA, DRAINAGE OF CYST",2755.0,1515.25,826.5,6766.0,159
CPT,68040,TREATMENT OF EYELID LESIONS,,,303.77,4258.0,22
CPT,68100,HC EYELID LINING BX,3185.0,1751.75,955.5,5761.0,106
CPT,68110,HC REM EYELID LINING LESION,4500.0,2475.0,1350.0,9469.0,106
CPT,68115,"HC EXCISION LESION, CONJUNCTIVA, OVER 1 CM",5549.0,3051.95,1664.7,9469.0,53
CPT,68130,EXC LES CONJUNCTIVA ADJ SCL,,,2370.75,9469.0,22
CPT,68135,HC DESTROY CONJUNCTIVAL LESION,3442.0,1893.1,1032.6,9469.0,106
CPT,68200,HC TREAT EYELID BY INJ,627.0,344.85,188.1,4258.0,106
CPT,68320,"HC CONJUNCTIVOPLASTY, WITH CONJUNCTIVAL GRAFT OR EXTENSIVE REARRANGEMT",5071.0,2789.05,1521.3,9469.0,53
CPT,68325,REVISE/GRAFT EYELID LINING,,,3832.09,14658.0,22
CPT,68326,REVISE/GRAFT EYELID LINING,,,3832.09,14658.0,22
CPT,68328,REVISE/GRAFT EYELID LINING,,,2370.75,9469.0,22
CPT,68330,REVISE EYELID LINING,,,2317.68,9469.0,22
CPT,68335,REVISE/GRAFT EYELID LINING,,,3832.09,14658.0,22
CPT,68340,"HC REPAIR/DIVISION OF SYMBLEPHARON, W/WO INSERT OF CONFORMER/CONTACT LENS",6492.0,3570.6,1947.6,9469.0,106
CPT,68360,REVISE EYELID LINING,,,3832.09,14658.0,22
CPT,68362,REVISE EYELID LINING,,,2370.75,9469.0,22
CPT,68371,HARVEST EYE TISSUE ALOGRAFT,,,2370.75,9469.0,22
CPT,68399,UNLISTED PX CONJUNCTIVA,,,303.77,29323.0,22
CPT,68400,I&D LACRIMAL GLAND,,,984.23,6766.0,22
CPT,68420,"HC INCISION, DRAIN LACRIMAL SAC",5640.0,3102.0,1692.0,5761.0,159
CPT,68440,HC SNIP INC LACRIMAL PUNCTUM,981.0,539.55,294.3,4258.0,106
CPT,68500,REMOVAL OF TEAR GLAND,,,3832.09,14658.0,22
CPT,68505,PARTIAL REMOVAL TEAR GLAND,,,3832.09,14658.0,22
CPT,68510,BIOPSY OF TEAR GLAND,,,2370.75,9469.0,22
CPT,68520,REMOVAL OF TEAR SAC,,,3832.09,14658.0,22
CPT,68525,HC BX LACRIMAL SAC,4571.0,2514.05,1371.3,9469.0,106
CPT,68530,HC REM FOREIGN BODY DACRYOLITH LACRIMAL PASSAGES,949.0,521.95,284.7,4258.0,106
CPT,68540,REMOVE TEAR GLAND LESION,,,2370.75,9469.0,22
CPT,68550,REMOVE TEAR GLAND LESION,,,3832.09,14658.0,22
CPT,68700,HC PLASTIC REPAIR OF CANALICULI,5327.0,2929.85,1598.1,9469.0,53
CPT,68705,"HC CORRECTION OF EVERTED PUNCTUM, CAUTERY",909.0,499.95,272.7,4258.0,106
CPT,68720,CREATE TEAR SAC DRAIN,,,3832.09,14658.0,22
CPT,68745,CREATE TEAR DUCT DRAIN,,,3832.09,14658.0,22
CPT,68750,HC CONJUNCTIVORHINOSTOMY W INSERT TUBE OR STENT,7833.0,4308.15,2349.9,14658.0,53
CPT,68760,HC PUNCTAL OCCLUSION,1205.0,662.75,303.77,4258.0,106
CPT,68761,HC PUNCTAL PLUGS TEMP-PLUG X,786.0,432.3,235.8,4258.0,106
CPT,68770,CLOSE TEAR SYSTEM FISTULA,,,2370.75,5761.0,22
CPT,68801,"HC DILATION LACRIMAL PUNCTUM, W/WO IRRIGATION",728.0,400.4,218.4,4258.0,106
CPT,68810,HC PROBE NASOLACRIMAL DUCT W/WO IRRIGATION,1154.0,634.7,303.77,4258.0,106
CPT,68811,PROBE NASOLACRIMAL DUCT,,,2370.75,9469.0,22
CPT,68815,HC PROBE NASOLACRIMAL DUCT W TUBE STENT,5419.0,2980.45,1625.7,9469.0,106
CPT,68816,PROBE NL DUCT W/BALLOON,,,2370.75,9469.0,22
CPT,68840,HC EXPLORE IRRIGATE TEAR DUCTS,786.0,432.3,235.8,4258.0,106
CPT,68841,INSJ RX ELUT IMPLT LAC CANAL,,,2370.75,9469.0,22
CPT,68850,HC INJECTION CONTRAST MEDIUM FOR DACRYOCYSTOGRAPY,1129.0,620.95,53.45,3533.0,53
CPT,68850,INJECTION FOR TEAR SAC X-RAY,,,93.54,93.54,1
CPT,68899,UNLISTED PX LACRIMAL SYSTEM,,,303.77,29323.0,22
CPT,69000,"HC DRAINAGE EXTERNAL EAR, ABSCESS OR HEMATOMA, SIMPLE",1649.0,906.95,494.7,4955.0,106
CPT,69005,HC DRN EXTERNAL EAR ABSCESS HEMATOMA COMPLEX,3942.0,2168.1,1182.6,6766.0,53
CPT,69020,"HC DRAINAGE EXTERNAL AUDITORY CANAL, ABSCESS",1283.0,705.65,384.9,4955.0,106
CPT,69090,EAR PIERCING,,,2453.0,4602.0,6
CPT,69100,HC BX EXTERNAL EAR,801.0,440.54999999999995,178.2,4258.0,212
CPT,69105,HC BX EXTERNAL AUDITORY CANAL,2538.0,1395.9,761.4,6766.0,212
CPT,69110,HC EXC EXTERNAL EAR PARTIAL SIMPLE RPR,9332.0,5132.6,2799.6,8363.0,106
CPT,69120,REMOVAL OF EXTERNAL EAR,,,5480.0,13936.0,22
CPT,69140,REMOVE EAR CANAL LESION(S),,,5480.0,13936.0,22
CPT,69145,"HC EXCISION SOFT TISSUE LESION, EXTERNAL AUDITORY CANAL",9332.0,5132.6,2799.6,8363.0,106
CPT,69150,EXTENSIVE EAR CANAL SURGERY,,,5480.0,13936.0,22
CPT,69155,EXTENSIVE EAR/NECK SURGERY,,,1475.6,13936.0,22
CPT,69200,"HC REMOVAL FOREIGN BODY FROM EXTERNAL AUDITORY CANAL, W/O GENERAL ANESTH",379.0,208.45,113.7,4258.0,159
CPT,69205,CLEAR OUTER EAR CANAL,,,1646.49,6766.0,22
CPT,69209,"HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE, UNILATERAL",195.0,107.25,58.5,4258.0,212
CPT,69210,"HC REMOVAL IMPACTED CERUMEN REQUIRING INSTRUMENTATION, UNILATERAL",316.5,174.075,60.36,4258.0,318
CPT,69220,HC DEBRIDE MASTOIDECTOMY CAVITY SIMPLE,579.0,318.45,173.7,4258.0,106
CPT,69222,HC DEBRIDE MASTOIDECTOMY CAVITY COMPLEX,1338.0,735.9,401.4,4258.0,53
CPT,69300,REVISE EXTERNAL EAR,,,3295.61,9469.0,22
CPT,69310,REBUILD OUTER EAR CANAL,,,6011.49,16799.0,22
CPT,69320,REBUILD OUTER EAR CANAL,,,6011.49,16799.0,22
CPT,69399,UNLISTED PX EXTERNAL EAR,,,235.98,29323.0,22
CPT,69420,HC MYRINGOTOMY INCL ASPIR EUSTACHIAN TUBE INFLATN,594.0,326.7,178.2,4258.0,53
CPT,69421,INCISION OF EARDRUM,,,3295.61,6766.0,22
CPT,69424,REMOVE VENTILATING TUBE,,,3295.61,14658.0,22
CPT,69433,HC TYMPANOSTOMY LOCAL TOPICAL ANES,1338.0,735.9,401.4,4258.0,53
CPT,69436,CREATE EARDRUM OPENING,,,1505.28,6766.0,22
CPT,69440,EXPLORATION OF MIDDLE EAR,,,3295.61,9469.0,22
CPT,69450,EARDRUM REVISION,,,3295.61,16799.0,22
CPT,69501,MASTOIDECTOMY,,,6011.49,16799.0,22
CPT,69502,MASTOIDECTOMY,,,5480.0,13936.0,22
CPT,69505,REMOVE MASTOID STRUCTURES,,,6011.49,16799.0,22
CPT,69511,EXTENSIVE MASTOID SURGERY,,,6011.49,16799.0,22
CPT,69530,EXTENSIVE MASTOID SURGERY,,,6011.49,16799.0,22
CPT,69535,REMOVE PART OF TEMPORAL BONE,,,2419.53,13936.0,22
CPT,69540,EXCISION AURAL POLYP,,,1505.28,6766.0,22
CPT,69550,EXC AURL GLOMUS TUM TRNSCANL,,,6011.49,16799.0,22
CPT,69552,EXC AURL GLOMUS TUM TRNSMSTD,,,6011.49,16799.0,22
CPT,69554,EXC AURL GLOMUS TUM EXTENDED,,,2296.95,13936.0,22
CPT,69601,REVJ MSTDC RSLTG COMPL MSTDC,,,6011.49,16799.0,22
CPT,69602,REV MSTDC RSLT MOD RAD MSTDC,,,6011.49,16799.0,22
CPT,69603,REVJ MSTDC RSLTG RAD MSTDC,,,6011.49,16799.0,22
CPT,69604,REVJ MSTDC RSLTG TYMPANPLSTY,,,6011.49,16799.0,22
CPT,69610,TYMPANIC MEMBRANE REPAIR,,,1505.28,9469.0,22
CPT,69620,HC MYRINGOPLASTY,7828.0,4305.4,2348.4,9469.0,53
CPT,69631,REPAIR EARDRUM STRUCTURES,,,6011.49,16799.0,22
CPT,69632,REBUILD EARDRUM STRUCTURES,,,6011.49,16799.0,22
CPT,69633,REBUILD EARDRUM STRUCTURES,,,6011.49,16799.0,22
CPT,69635,REPAIR EARDRUM STRUCTURES,,,6011.49,16799.0,22
CPT,69636,REBUILD EARDRUM STRUCTURES,,,6011.49,16799.0,22
CPT,69637,REBUILD EARDRUM STRUCTURES,,,6011.49,16799.0,22
CPT,69641,REVISE MIDDLE EAR & MASTOID,,,6011.49,16799.0,22
CPT,69642,REVISE MIDDLE EAR & MASTOID,,,6011.49,16799.0,22
CPT,69643,REVISE MIDDLE EAR & MASTOID,,,6011.49,16799.0,22
CPT,69644,REVISE MIDDLE EAR & MASTOID,,,6011.49,16799.0,22
CPT,69645,REVISE MIDDLE EAR & MASTOID,,,6011.49,16799.0,22
CPT,69646,REVISE MIDDLE EAR & MASTOID,,,6011.49,16799.0,22
CPT,69650,STAPES MOBILIZATION,,,3295.61,9469.0,22
CPT,69660,REVISE MIDDLE EAR BONE,,,6011.49,16799.0,22
CPT,69661,REVISE MIDDLE EAR BONE,,,6011.49,16799.0,22
CPT,69662,REVISE MIDDLE EAR BONE,,,6011.49,16799.0,22
CPT,69666,REPAIR MIDDLE EAR STRUCTURES,,,3295.61,9469.0,22
CPT,69667,REPAIR MIDDLE EAR STRUCTURES,,,3295.61,9469.0,22
CPT,69670,REMOVE MASTOID AIR CELLS,,,6011.49,16799.0,22
CPT,69676,REMOVE MIDDLE EAR NERVE,,,3295.61,9469.0,22
CPT,69700,CLOSE MASTOID FISTULA,,,1505.28,6766.0,22
CPT,69705,NPS SURG DILAT EUST TUBE UNI,,,6011.49,16799.0,22
CPT,69706,NPS SURG DILAT EUST TUBE BI,,,6011.49,16799.0,22
CPT,69710,IMPLANT/REPLACE HEARING AID,,,9733.0,16799.0,7
CPT,69711,REMOVE/REPAIR HEARING AID,,,3295.61,16799.0,22
CPT,69714,IMPL OI IMPLT SKULL PERQ ESP,,,12463.0,21512.0,22
CPT,69716,IMPL OI IMPLT SK TC ESP<100,,,10315.0,19884.0,22
CPT,69717,RPLCMT OI IMPLT SKL PRQ ESP,,,7259.46,18485.0,22
CPT,69719,RPLCM OI IMPLT SK TC ESP<100,,,10315.0,19884.0,22
CPT,69720,RELEASE FACIAL NERVE,,,6011.49,16799.0,22
CPT,69725,RELEASE FACIAL NERVE,,,6011.49,16799.0,22
CPT,69726,RMV NTR OI IMPLT SKL PRQ ESP,,,3297.17,14658.0,22
CPT,69727,RMV NTR OI IMP SK TC ESP<100,,,3297.17,14658.0,22
CPT,69728,RMV NTR OI IMP SK TC>=100,,,3297.17,14658.0,22
CPT,69729,IMPL OI IMPLT SK TC ESP>=100,,,10315.0,19884.0,22
CPT,69730,RPLC OI IMPLT SK TC ESP>=100,,,10315.0,19884.0,22
CPT,69740,REPAIR FACIAL NERVE,,,6011.49,16799.0,22
CPT,69745,REPAIR FACIAL NERVE,,,6011.49,16799.0,22
CPT,69799,UNLISTED PX MIDDLE EAR,,,235.98,29323.0,22
CPT,69801,"HC LABYRINTHOTOMY, W PERFUSION VESTIBULOA DRUG(S), TRANSCANAL",3708.0,2039.4,1112.4,6766.0,53
CPT,69805,EXPLORE INNER EAR,,,6011.49,16799.0,22
CPT,69806,EXPLORE INNER EAR,,,6011.49,16799.0,22
CPT,69905,REMOVE INNER EAR,,,6011.49,16799.0,22
CPT,69910,REMOVE INNER EAR & MASTOID,,,6011.49,16799.0,22
CPT,69915,INCISE INNER EAR NERVE,,,3295.61,16799.0,22
CPT,69930,IMPLANT COCHLEAR DEVICE,,,19979.0,34485.0,22
CPT,69949,UNLISTED PX INNER EAR,,,235.98,4258.0,22
CPT,69950,INCISE INNER EAR NERVE,,,1578.78,13936.0,22
CPT,69955,RELEASE FACIAL NERVE,,,6011.49,16799.0,22
CPT,69960,RELEASE INNER EAR CANAL,,,6011.49,16799.0,22
CPT,69970,REMOVE INNER EAR LESION,,,6011.49,16799.0,22
CPT,69979,UNLISTED PX TEMPORAL BONE,,,235.98,4258.0,22
CPT,69990,MICROSURGERY ADD-ON,,,179.43,3533.0,21
CPT,70010,CONTRAST X-RAY OF BRAIN,,,362.92,635.1,16
CPT,70015,CONTRAST X-RAY OF BRAIN,,,802.86,1405.0,16
CPT,70030,"HC X-RAY EXAM, EYE, FOR DETECTION OF FOREIGN BODY",615.5,338.525,89.48,704.98,530
CPT,70100,"HC X-RAY EXAM, MANDIBLE, PARTIAL, LESS THAN 4 VIEWS",716.0,393.8,89.48,619.34,477
CPT,70110,"HC X-RAY EXAM, MANDIBLE, COMPLETE, MINIMUM 4 VIEWS",746.5,410.575,108.06,795.8,530
CPT,70120,X-RAY EXAM OF MASTOIDS,,,108.06,189.11,16
CPT,70130,"HC X-RAY EXAM, MASTOIDS, COMPLETE, MINIMUM 3 VIEWS PER SIDE",208.0,114.4,62.4,617.0,53
CPT,70134,X-RAY EXAM OF MIDDLE EAR,,,557.18,975.07,16
CPT,70140,"HC X-RAY EXAM, FACIAL BONES, LESS THAN 3 VIEWS",696.0,382.8,89.48,617.0,477
CPT,70150,"HC X-RAY EXAM, FACIAL BONES, COMPLETE, MINIMUM 3 VIEWS",931.5,512.325,108.06,836.46,477
CPT,70160,"HC X-RAY EXAM, NASAL BONES, COMPLETE, MINIMUM 3 VIEWS",653.5,359.42499999999995,89.48,617.0,530
CPT,70170,"HC DACRYOCYSTOGRAPHY, NASOLACRIMAL DUCT, RADIOLOGICAL SUPERVISION & INTERP",674.0,370.7,202.2,617.0,53
CPT,70190,X-RAY EXAM OF EYE SOCKETS,,,89.48,156.58,16
CPT,70200,"HC X-RAY EXAM, ORBITS, COMPLETE, MINIMUM 4 VIEWS",537.0,295.35,108.06,617.0,318
CPT,70210,"HC X-RAY EXAM, SINUSES, PARANASAL, LESS THAN 3 VIEWS",454.0,249.7,89.48,617.0,477
CPT,70220,"HC X-RAY EXAM, SINUSES, PARANASAL, COMPLETE, MINIMUM 3 VIEWS",631.0,347.04999999999995,89.48,617.0,477
CPT,70240,X-RAY EXAM PITUITARY SADDLE,,,89.48,156.58,16
CPT,70250,"HC X-RAY EXAM, SKULL, LESS THAN 4 VIEWS",418.0,229.9,108.06,617.0,530
CPT,70260,"HC X-RAY EXAM, SKULL, COMPLETE, MINIMUM 4 VIEWS",1295.0,712.25,108.06,1133.15,477
CPT,70300,X-RAY EXAM OF TEETH,,,89.48,156.58,16
CPT,70310,X-RAY EXAM OF TEETH,,,245.64,429.86,16
CPT,70320,FULL MOUTH X-RAY OF TEETH,,,245.64,429.86,16
CPT,70328,X-RAY EXAM OF JAW JOINT,,,89.48,156.58,16
CPT,70330,"HC BILAT, X-RAY EXAM, TEMPOROMANDIBULAR JOINT, OPEN AND CLOSED MOUTH",727.0,399.85,89.48,628.86,477
CPT,70332,X-RAY EXAM OF JAW JOINT,,,245.64,429.86,16
CPT,70336,HC MAGNETIC IMAGE JAW JOINT,5168.5,2842.675,245.64,4606.13,424
CPT,70350,X-RAY HEAD FOR ORTHODONTIA,,,89.48,156.58,16
CPT,70355,HC PANORAMIC X-RAY OF JAWS,459.0,252.45,89.48,617.0,106
CPT,70360,"HC X-RAY EXAM, NECK, SOFT TISSUE",510.5,280.775,89.48,617.0,477
CPT,70370,THROAT X-RAY & FLUOROSCOPY,,,89.48,156.58,16
CPT,70371,SPEECH EVALUATION COMPLEX,,,245.64,429.86,16
CPT,70380,X-RAY EXAM OF SALIVARY GLAND,,,89.48,156.58,16
CPT,70390,X-RAY EXAM OF SALIVARY DUCT,,,245.64,429.86,16
CPT,70450,CT HEAD/BRAIN W/O DYE,,,189.11,189.11,1
CPT,70450,"HC CT, HEAD OR BRAIN, WITHOUT CONTRAST",2131.0,1172.0500000000002,108.06,2091.57,424
CPT,70460,CT HEAD/BRAIN W/DYE,,,316.58,316.58,1
CPT,70460,"HC CT, HEAD OR BRAIN, WITH CONTRAST",3174.0,1745.6999999999998,180.9,3229.91,371
CPT,70470,CT HEAD/BRAIN W/O & W/DYE,,,316.58,316.58,1
CPT,70470,"HC CT, HEAD/BRAIN, W/O CONTRAST, F/B CONTRAST AND FURTHER SECTIONS",3883.5,2135.925,180.9,3799.95,371
CPT,70480,CT ORBIT/EAR/FOSSA W/O DYE,,,189.11,189.11,1
CPT,70480,"HC CT, ORBIT, SELLA/POSTERIOR FOSSA/OUTER, MIDDLE/INNER EAR, W/O CONTRAST",3317.0,1824.35,108.06,2961.76,424
CPT,70481,CT ORBIT/EAR/FOSSA W/DYE,,,316.58,316.58,1
CPT,70481,"HC CT, ORBIT, SELLA/POSTERIOR FOSSA/OUTER, MIDDLE/INNER EAR, W/ CONTRAST",3531.0,1942.0500000000002,180.9,3146.87,371
CPT,70482,CT ORBIT/EAR/FOSSA W/O&W/DYE,,,316.58,316.58,1
CPT,70482,"HC CT, ORBIT, SELLA OR POST FOSSA/OUT, MID/INNER EAR, W/O CONTR, F/B CONTR",3745.0,2059.75,180.9,3331.98,371
CPT,70486,CT MAXILLOFACIAL W/O DYE,,,189.11,189.11,1
CPT,70486,"HC CBCT DX, MAXILLOFACIAL AREA, WITHOUT CONTRAST",202.0,111.1,60.6,1621.0,53
CPT,70486,"HC CT, MAXILLOFACIAL AREA, WITHOUT CONTRAST",2690.5,1479.775,108.06,2437.57,318
CPT,70486,HC DENTASCAN (LTD STUDY),345.0,189.75,103.5,1621.0,159
CPT,70487,CT MAXILLOFACIAL W/DYE,,,316.58,316.58,1
CPT,70487,"HC CT, MAXILLOFACIAL AREA, WITH CONTRAST",3149.5,1732.225,180.9,2854.5,371
CPT,70488,CT MAXILLOFACIAL W/O & W/DYE,,,316.58,316.58,1
CPT,70488,"HC CT, MAXILLOFACIAL AREA, WITHOUT CONTRAST, F/B CONTR AND FURTHER SECTIONS",4146.0,2280.3,180.9,3586.29,212
CPT,70490,CT SOFT TISSUE NECK W/O DYE,,,189.11,189.11,1
CPT,70490,"HC CT, SOFT TISSUE NECK, WITHOUT CONTRAST",3163.5,1739.925,108.06,2895.16,371
CPT,70491,CT SOFT TISSUE NECK W/DYE,,,316.58,316.58,1
CPT,70491,"HC CT, SOFT TISSUE NECK, WITH CONTRAST",3568.0,1962.3999999999999,180.9,3264.51,371
CPT,70492,CT SFT TSUE NCK W/O & W/DYE,,,316.58,316.58,1
CPT,70492,"HC CT, SOFT TISSUE NECK, W/O CONTRAST F/B CONTRAST AND FURTHER SECTIONS",4242.5,2333.375,180.9,3845.79,371
CPT,70496,CT ANGIOGRAPHY HEAD,,,316.58,316.58,1
CPT,70496,"HC CTA, HEAD, W/ CONTRAST, INCL NONCONTRAST IMAGES, AND IMG POSTPROC",4238.0,2330.9,180.9,3849.25,371
CPT,70498,"HC CTA, NECK, W/ CONTRAST, INCL NONCONTRAST IMAGES, AND IMG POSTPROC",3901.0,2145.55,180.9,3535.26,371
CPT,70540,"HC MRI, ORBIT, FACE, AND/OR NECK, WITHOUT CONTRAST",5299.5,2914.725,245.64,4635.54,424
CPT,70542,"HC MRI, ORBIT, FACE, AND/OR NECK, WITH CONTRAST",5893.0,3241.15,362.92,5097.45,424
CPT,70543,"HC MRI, ORBIT, FACE, AND/OR NECK, W/O CONTRAST, F/B CONTRAST-FURTHER SEQ",6634.5,3648.975,362.92,6062.79,424
CPT,70544,"HC MRA, HEAD, WITHOUT CONTRAST",4593.0,2526.15,245.64,4399.39,424
CPT,70545,"HC MRA, HEAD, WITH CONTRAST",5029.5,2766.225,362.92,4925.31,424
CPT,70546,"HC MRA, HEAD, WITHOUT CONTRAST, FOLLOWED BY CONTRAST AND FURTHER SEQUENCES",6598.0,3628.9,362.92,6623.31,424
CPT,70547,"HC MRA, NECK, WITHOUT CONTRAST",5153.0,2834.15,245.64,4457.35,371
CPT,70548,"HC MRA, NECK, WITH CONTRAST",5662.0,3114.1,362.92,4897.63,424
CPT,70549,"HC MRA, NECK, WITHOUT CONTRAST, FOLLOWED BY CONTRAST AND FURTHER SEQUENCES",5943.0,3268.65,362.92,5140.7,424
CPT,70551,"HC MRI, BRAIN (INCLUDING BRAIN STEM), WITHOUT CONTRAST",4866.5,2676.575,245.64,4358.74,424
CPT,70552,"HC MRI, BRAIN (INCLUDING BRAIN STEM), WITH CONTRAST",5256.0,2890.8,362.92,4546.44,424
CPT,70553,"HC MRI, BRAIN (INCL BRAIN STEM), W/O CONTRAST, F/B CONTRAST AND FURTHER SEQ",7284.0,4006.2,362.92,6425.22,424
CPT,70554,HC FMRI BRAIN BY TECH,6660.0,3663.0,245.64,5760.9,53
CPT,70555,HC FMRI BRAIN BY PHYS PSYCH,9733.0,5353.15,245.64,8419.05,53
CPT,70557,"HC MRI, BRAIN, DURING INTRACRANIAL PROC, W/O CONTRAST",5185.0,2851.75,557.18,4485.03,53
CPT,70558,"HC MRI, BRAIN, DURING INTRACRANIAL PROC, W/ CONTRAST",5489.0,3018.95,180.9,4747.99,53
CPT,70559,"HC MRI, BRAIN, DURING INTRACRANIAL PROC, W/O CONTRAST, F/B CONTRAST",6930.0,3811.5,180.9,5994.45,53
CPT,71045,"HC X-RAY EXAM, CHEST, SINGLE VIEW",321.5,176.825,89.48,617.0,530
CPT,71046,"HC X-RAY EXAM, CHEST, 2 VIEWS",356.5,196.075,89.48,617.0,530
CPT,71047,"HC X-RAY EXAM, CHEST, 3 VIEWS",606.0,333.3,89.48,617.0,477
CPT,71048,"HC X-RAY EXAM, CHEST, 4 OR MORE VIEWS",697.0,383.35,108.06,617.0,477
CPT,71100,"HC X-RAY EXAM, RIBS, UNILATERAL, 2 VIEWS",616.0,338.8,89.48,617.0,530
CPT,71101,"HC X-RAY EXAM, RIBS, UNILAT, INCL POSTEROANTERIOR CHEST, MIN 3 VIEWS",1157.0,636.3499999999999,108.06,1006.0,530
CPT,71110,"HC X-RAY EXAM, RIBS, BILATERAL, 3 VIEWS",1020.0,561.0,108.06,882.3,530
CPT,71111,"HC X-RAY EXAM, RIBS, BILAT, INCL POSTEROANTERIOR CHEST, MIN 4 VIEWS",1151.0,633.05,108.06,1038.87,477
CPT,71120,"HC X-RAY EXAM, STERNUM, MINIMUM 2 VIEWS",677.0,372.35,89.48,617.0,530
CPT,71130,"HC X-RAY EXAM, STERNOCLAVICULAR JOINT OR JOINTS, MINIMUM 3 VIEWS",731.0,402.04999999999995,89.48,656.54,530
CPT,71250,"HC CT, THORAX, DX, W/O CONTRAST",3042.0,1673.1,108.06,2806.06,424
CPT,71260,"HC CT, THORAX, DX, W/ CONTRAST",3722.0,2047.1,180.9,3312.95,371
CPT,71270,"HC CT, THORAX, DX, W/O CONTRAST, FOLLOW BY CONTRAST & FURTHER SECTIONS",3911.0,2151.05,180.9,3383.02,371
CPT,71271,"HC CT, THORAX, LOW DOSE FOR LUNG CANCER SCREENING, W/O CONTRAST MATERIAL(S)",966.0,531.3,108.06,1621.0,265
CPT,71275,"HC CTA, CHEST (NONCOR), W/ CONTR, INCL NON-CONTR IMG, AND IMG POSTPROCESS",4062.5,2234.375,180.9,3604.46,424
CPT,71550,"HC MRI, CHEST, WITHOUT CONTRAST",4382.0,2410.1,245.64,4004.95,424
CPT,71551,"HC MRI, CHEST, WITH CONTRAST",5497.0,3023.35,802.86,4754.91,106
CPT,71552,"HC MRI, CHEST, WITHOUT CONTRAST, FOLLOWED BY CONTRAST AND FURTHER SEQUENCES",6007.5,3304.125,362.92,5256.61,424
CPT,71555,"HC MRA, CHEST, WITH CONTRAST",6354.0,3494.7,313.67,5496.21,106
CPT,71555,"HC MRA, CHEST, WITHOUT CONTRAST",5569.0,3062.95,313.67,4817.19,106
CPT,71555,"HC MRA, CHEST, WITHOUT CONTRAST, FOLLOWED BY CONTRAST",7385.5,4062.0249999999996,313.67,6750.46,212
CPT,72020,"HC X-RAY EXAM, SPINE, SINGLE VIEW, SPECIFY LEVEL",280.5,154.27499999999998,80.1,617.0,530
CPT,72040,"HC X-RAY EXAM, SPINE, CERVICAL, 2 OR 3 VIEWS",712.0,391.6,89.48,629.72,530
CPT,72050,"HC X-RAY EXAM, SPINE, CERVICAL, 4 OR 5 VIEWS",1132.5,622.875,108.06,997.35,530
CPT,72052,"HC X-RAY EXAM, SPINE, CERVICAL, 6 OR MORE VIEWS",1091.0,600.05,108.06,1020.7,530
CPT,72070,"HC X-RAY EXAM, SPINE, THORACIC, 2 VIEWS",795.5,437.525,108.06,706.71,530
CPT,72072,"HC X-RAY EXAM, SPINE, THORACIC, 3 VIEWS",984.5,541.4749999999999,108.06,880.57,530
CPT,72074,"HC X-RAY EXAM, SPINE, THORACIC, MINIMUM 4 VIEWS",993.5,546.425,108.06,960.15,530
CPT,72080,"HC X-RAY EXAM, SPINE, THORACOLUMBAR JUNCTION, MINIMUM 2 VIEWS",550.0,302.5,89.48,617.0,530
CPT,72081,"HC X-RAY EXAM SPINE ENTIRE THOR LUMB, INCL SKULL CERV SACRAL SPINE, 1 VW",779.0,428.45,89.48,673.84,424
CPT,72082,"HC X-RAY EXAM SPINE ENTIRE THOR LUMB, INCL SKULL CERV SACRAL SPINE, 2/3 VW",827.0,454.85,108.06,736.98,477
CPT,72083,"HC X-RAY EXAM SPINE ENTIRE THOR LUMB, INCL SKULL CERV SACRAL SPINE, 4/5 VW",863.5,474.92499999999995,108.06,776.77,477
CPT,72084,"HC X-RAY EXAM SPINE ENTIRE THOR LUMB, INCL SKULL CERV SACRAL SPINE, MIN 6VW",733.5,403.42499999999995,108.06,664.32,424
CPT,72100,"HC X-RAY EXAM, SPINE, LUMBOSACRAL, 2 OR 3 VIEWS",794.5,436.975,108.06,703.25,530
CPT,72110,"HC X-RAY EXAM, SPINE, LUMBOSACRAL, MINIMUM 4 VIEWS",1053.0,579.1500000000001,108.06,966.21,530
CPT,72114,"HC X-RAY EXAM, SPINE, LUMBOSACRAL, COMPLETE, INCL BENDING VIEWS, MIN 6 VWS",820.0,451.0,108.06,887.49,477
CPT,72120,"HC X-RAY EXAM, SPINE, LUMBOSACRAL, BENDING VIEWS ONLY, 2 OR 3 VIEWS",811.0,446.05,108.06,701.52,371
CPT,72125,"HC CT, CERVICAL SPINE, WITHOUT CONTRAST",2831.0,1557.05,108.06,2595.0,371
CPT,72126,"HC CT, CERVICAL SPINE, WITH CONTRAST",3137.0,1725.35,362.92,2713.51,371
CPT,72127,"HC CT, CERVICAL SPINE, W/O CONTRAST, FOLLOW BY CONTRAST AND FURTHER SECT",5429.0,2985.95,180.9,4696.09,106
CPT,72128,"HC CT, THORACIC SPINE, WITHOUT CONTRAST",2392.0,1315.6,108.06,2490.34,371
CPT,72129,"HC CT, THORACIC SPINE, WITH CONTRAST",3143.0,1728.65,180.9,2718.7,371
CPT,72130,"HC CT, THORACIC SPINE, WITHOUT CONTRAST, F/B CONTRAST AND FURTHER SECTIONS",4253.0,2339.15,180.9,3678.85,106
CPT,72131,"HC CT, LUMBAR SPINE, WITHOUT CONTRAST",2944.0,1619.1999999999998,108.06,2665.93,371
CPT,72132,"HC CT, LUMBAR SPINE, WITH CONTRAST",3317.0,1824.35,362.92,2869.21,371
CPT,72133,"HC CT, LUMBAR SPINE, WITHOUT CONTRAST, F/B CONTRAST AND FURTHER SECTIONS",5472.0,3009.6,180.9,4733.28,371
CPT,72141,"HC MRI, SPINAL CANAL AND CONTENTS, CERVICAL, WITHOUT CONTRAST",5230.5,2876.775,245.64,4719.44,424
CPT,72142,"HC MRI, SPINAL CANAL AND CONTENTS, CERVICAL, WITH CONTRAST",5707.0,3138.85,362.92,4936.56,424
CPT,72146,"HC MRI, SPINAL CANAL AND CONTENTS, THORACIC, WITHOUT CONTRAST",4851.0,2668.05,245.64,4196.12,424
CPT,72147,"HC MRI, SPINAL CANAL AND CONTENTS, THORACIC, WITH CONTRAST",6545.0,3599.75,362.92,5661.43,424
CPT,72148,"HC MRI, SPINAL CANAL AND CONTENTS, LUMBAR, WITHOUT CONTRAST",4972.5,2734.875,245.64,4350.95,424
CPT,72149,"HC MRI, SPINAL CANAL AND CONTENTS, LUMBAR, WITH CONTRAST",5275.5,2901.5249999999996,362.92,4609.59,424
CPT,72156,"HC MRI, SPINAL CANAL-CONTENTS, CERV, W/O CONTRAST, F/B CONTRAST-FURTHER SEQ",6871.0,3779.05,362.92,5943.42,424
CPT,72157,"HC MRI, SPINAL CANAL-CONTENTS, THOR, W/O CONTRAST, F/B CONTRAST-FURTHER SEQ",6375.0,3506.25,362.92,5872.49,424
CPT,72158,"HC MRI, SPINAL CANAL-CONTENTS, LUMB, W/O CONTRAST, F/B CONTRAST-FURTHER SEQ",6477.0,3562.35,362.92,5602.61,424
CPT,72159,MR ANGIO SPINE W/O&W/DYE,,,321.39,331.03,15
CPT,72170,"HC X-RAY EXAM, PELVIS, 1 OR 2 VIEWS",569.5,313.225,108.06,617.0,530
CPT,72190,"HC X-RAY EXAM, PELVIS, COMPLETE, MINIMUM 3 VIEWS",563.5,309.925,108.06,617.0,530
CPT,72191,"HC CTA, PELVIS, W/ CONTRAST, INCL NONCONTRAST IMAGES, AND IMG POSTPROC",4497.0,2473.3500000000004,180.9,4075.02,371
CPT,72192,"HC CT, PELVIS, WITHOUT CONTRAST",2313.5,1272.4250000000002,108.06,2096.76,371
CPT,72193,"HC CT, PELVIS, WITH CONTRAST",3194.5,1756.975,180.9,2895.16,371
CPT,72194,"HC CT, PELVIS, WITHOUT CONTRAST, FOLLOWED BY CONTRAST AND FURTHER SECTIONS",3859.0,2122.45,180.9,3338.04,371
CPT,72195,"HC MRI, PELVIS, WITHOUT CONTRAST",4617.5,2539.625,245.64,4218.61,424
CPT,72195,"HC MRI, PELVIS, WITHOUT CONTRAST (LTD STUDY FIBROIDS)",570.0,313.5,171.0,2524.0,371
CPT,72196,"HC MRI, PELVIS, WITH CONTRAST",5476.0,3011.8,362.92,4736.74,212
CPT,72197,"HC MRI, PELVIS, W/O CONTRAST, F/B CONTRAST AND FURTHER SEQUENCES",6251.5,3438.325,362.92,6097.39,424
CPT,72198,"HC MRA, PELVIS, WITHOUT CONTRAST",3761.0,2068.55,318.51,3253.27,53
CPT,72198,"HC MRA, PELVIS, WITHOUT CONTRAST FOLLOWED BY CONTRAST",4320.0,2376.0,318.51,3736.8,424
CPT,72200,X-RAY EXAM SI JOINTS,,,108.06,189.11,16
CPT,72202,"HC X-RAY EXAM, SACROILIAC JOINTS, 3 OR MORE VIEWS",760.5,418.275,108.06,688.54,530
CPT,72220,"HC X-RAY EXAM, SACRUM AND COCCYX, MINIMUM 2 VIEWS",895.5,492.525,89.48,800.13,530
CPT,72240,MYELOGRAPHY NECK SPINE,,,802.86,1405.0,16
CPT,72255,MYELOGRAPHY THORACIC SPINE,,,802.86,1405.0,16
CPT,72265,MYELOGRAPHY L-S SPINE,,,802.86,1405.0,16
CPT,72270,MYELOGPHY 2/> SPINE REGIONS,,,802.86,1405.0,16
CPT,72285,DISCOGRAPHY CERV/THOR SPINE,,,1984.4,3472.71,16
CPT,72295,X-RAY OF LOWER SPINE DISK,,,1984.4,3472.71,16
CPT,73000,"HC X-RAY EXAM, CLAVICLE, COMPLETE",433.5,238.425,89.48,617.0,530
CPT,73010,"HC X-RAY EXAM, SCAPULA, COMPLETE",539.0,296.45,108.06,617.0,530
CPT,73020,"HC X-RAY EXAM, SHOULDER, 1 VIEW",236.0,129.8,68.1,617.0,530
CPT,73030,"HC X-RAY EXAM, SHOULDER, COMPLETE, MINIMUM 2 VIEWS",648.5,356.67499999999995,89.48,617.0,530
CPT,73040,HC SHOULDER ARTHROGRAM,1557.0,856.35,359.0,1346.81,106
CPT,73050,"HC X-RAY EXAM, ACROMIOCLAVICULAR JTS, BILAT, W/ OR W/O WEIGHTED DISTRACTION",489.5,269.225,89.48,617.0,530
CPT,73060,"HC X-RAY EXAM, HUMERUS, MINIMUM 2 VIEWS",528.5,290.675,89.48,617.0,530
CPT,73070,"HC X-RAY EXAM, ELBOW, 2 VIEWS",342.0,188.1,89.48,617.0,530
CPT,73080,"HC X-RAY EXAM, ELBOW, COMPLETE, MINIMUM 3 VIEWS",581.0,319.55,89.48,617.0,530
CPT,73085,CONTRAST X-RAY OF ELBOW,,,362.92,635.1,16
CPT,73090,"HC X-RAY EXAM, FOREARM, 2 VIEWS",483.5,265.925,89.48,617.0,530
CPT,73092,"HC X-RAY EXAM, UPPER EXTREMITY, INFANT, MINIMUM 2 VIEWS",523.0,287.65,108.06,617.0,371
CPT,73100,"HC X-RAY EXAM, WRIST, 2 VIEWS",493.0,271.15,89.48,617.0,530
CPT,73110,"HC X-RAY EXAM, WRIST, COMPLETE, MINIMUM 3 VIEWS",532.0,292.6,89.48,617.0,530
CPT,73115,CONTRAST X-RAY OF WRIST,,,362.92,635.1,16
CPT,73120,"HC X-RAY EXAM, HAND, 2 VIEWS",703.0,386.65,108.06,632.32,530
CPT,73130,"HC X-RAY EXAM, HAND, MINIMUM 3 VIEWS",784.5,431.475,89.48,703.25,530
CPT,73140,"HC X-RAY EXAM, FINGER(S), MINIMUM 2 VIEWS",444.5,244.47500000000002,89.48,617.0,530
CPT,73200,"HC CT, UPPER EXTREMITY, WITHOUT CONTRAST",2605.5,1433.025,108.06,2407.3,424
CPT,73201,"HC CT, UPPER EXTREMITY, WITH CONTRAST",3478.0,1912.9,362.92,3139.09,371
CPT,73202,"HC CT, UPPER EXTREM, W/O CONTRAST, F/B CONTRAST AND FURTHER SECTIONS",3708.0,2039.4,180.9,3207.42,212
CPT,73206,"HC CTA, UPPER EXTREM, W/ CONTR, INCL NON-CONTR IMG, AND IMG POSTPROCESS",3959.0,2177.45,180.9,3794.76,318
CPT,73218,"HC MRI, UPPER EXTREMITY, OTHER THAN JOINT, WITHOUT CONTRAST",4714.0,2592.7,245.64,4077.61,424
CPT,73219,"HC MRI, UPPER EXTREMITY, OTHER THAN JOINT, WITH CONTRAST",5510.0,3030.5,362.92,4766.15,159
CPT,73220,"HC MRI, UPPER EXTREM, OTH THN JOINT, W/O CONTRAST, F/B CONTRAST-FURTHER SEQ",5880.0,3234.0,362.92,5576.66,424
CPT,73221,"HC MRI, ANY JOINT OF UPPER EXTREMITY, WITHOUT CONTRAST",4715.0,2593.25,245.64,4078.48,424
CPT,73222,"HC MRI, ANY JOINT OF UPPER EXTREMITY, WITH CONTRAST",5132.5,2822.875,802.86,4677.92,424
CPT,73223,"HC MRI, ANY JOINT UPPER EXTREMITY, W/O CONTRAST, F/B CONTRAST-FURTHER SEQ",5963.0,3279.6499999999996,362.92,5723.71,424
CPT,73225,"HC MRA, UPPER EXTREMITY, WITH CONTRAST",4352.0,2393.6,306.75,3764.48,212
CPT,73225,"HC MRA, UPPER EXTREMITY, WITHOUT CONTRAST",3023.0,1662.65,306.75,2614.9,159
CPT,73225,"HC MRA, UPPER EXTREMITY, WITHOUT CONTRAST FOLLOWED BY CONTRAST",3166.0,1741.3,306.75,2738.59,371
CPT,73501,"HC X-RAY EXAM, HIP, UNILATERAL, WITH PELVIS WHEN PERFORMED, 1 VIEW",360.0,198.0,89.48,617.0,530
CPT,73502,"HC X-RAY EXAM, HIP, UNILATERAL, WITH PELVIS WHEN PERFORMED, 2-3 VIEWS",559.0,307.45000000000005,89.48,617.0,530
CPT,73503,"HC X-RAY EXAM, HIP, UNILAT, W/ PELVIS, MINIMUM 4 VIEWS",623.0,342.65,108.06,617.0,530
CPT,73521,"HC X-RAY EXAM, HIPS, BILATERAL, WITH PELVIS WHEN PERFORMED, 2 VIEWS",1140.5,627.2750000000001,108.06,992.16,530
CPT,73522,"HC X-RAY EXAM, HIPS, BILATERAL, WITH PELVIS WHEN PERFORMED, 3-4 VIEWS",1095.5,602.5250000000001,108.06,1140.94,530
CPT,73523,HC RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS,499.0,274.45,108.06,617.0,530
CPT,73525,HC HIP ARTHROGRAM,1427.0,784.85,359.0,1234.36,159
CPT,73551,"HC X-RAY EXAM, FEMUR, 1 VIEW",466.0,256.3,89.48,617.0,530
CPT,73552,"HC X-RAY EXAM, FEMUR, MINIMUM 2 VIEWS",548.0,301.4,89.48,617.0,530
CPT,73560,"HC X-RAY EXAM, KNEE, 1 OR 2 VIEWS",461.5,253.825,89.48,617.0,530
CPT,73562,"HC X-RAY EXAM, KNEE, 3 VIEWS",805.0,442.75,89.48,722.28,530
CPT,73564,"HC X-RAY EXAM, KNEE, COMPLETE, 4 OR MORE VIEWS",805.0,442.75,108.06,768.12,530
CPT,73565,"HC X-RAY EXAM, KNEE, BOTH KNEES, STANDING, ANTEROPOSTERIOR",646.0,355.29999999999995,89.48,617.0,530
CPT,73580,CONTRAST X-RAY OF KNEE JOINT,,,362.92,635.1,16
CPT,73590,"HC X-RAY EXAM, TIBIA AND FIBULA, 2 VIEWS",526.5,289.575,89.48,617.0,530
CPT,73592,"HC X-RAY EXAM, LOWER EXTREMITY, INFANT, MINIMUM 2 VIEWS",537.0,295.35,89.48,617.0,371
CPT,73600,"HC X-RAY EXAM, ANKLE, 2 VIEWS",466.5,256.575,89.48,617.0,530
CPT,73610,"HC X-RAY EXAM, ANKLE, COMPLETE, MINIMUM 3 VIEWS",554.0,304.70000000000005,89.48,617.0,530
CPT,73615,HC ANKLE ARTHROGRAM,1259.0,692.45,359.0,1089.04,53
CPT,73620,"HC X-RAY EXAM, FOOT, 2 VIEWS",620.5,341.275,89.48,617.0,530
CPT,73630,"HC X-RAY EXAM, FOOT, COMPLETE, MINIMUM 3 VIEWS",730.0,401.5,89.48,655.67,530
CPT,73650,"HC X-RAY EXAM, CALCANEUS, MINIMUM 2 VIEWS",483.0,265.65,89.48,617.0,530
CPT,73660,"HC X-RAY EXAM, TOE(S), MINIMUM 2 VIEWS",500.0,275.0,89.48,617.0,530
CPT,73700,"HC CT, LOWER EXTREMITY, WITHOUT CONTRAST",2762.0,1519.1,108.06,2532.72,424
CPT,73701,"HC CT, LOWER EXTREMITY, WITH CONTRAST",3171.0,1744.05,180.9,2872.67,371
CPT,73702,"HC CT, LOWER EXTREM, W/O CONTRAST, F/B CONTRAST AND FURTHER SECTIONS",3638.0,2000.9,180.9,3146.87,371
CPT,73706,"HC CTA, LOW EXTREM, W/ CONTRAST, INCL NONCONTRAST IMAGES, AND IMG POSTPROC",2782.0,1530.1,180.9,2591.54,371
CPT,73718,"HC MRI, LOWER EXTREMITY OTHER THAN JOINT, WITHOUT CONTRAST",4809.5,2645.225,245.64,4199.58,424
CPT,73719,"HC MRI, LOWER EXTREMITY OTHER THAN JOINT, WITH CONTRAST",5837.0,3210.35,362.92,5049.01,424
CPT,73720,"HC MRI, LOWER EXTREM OTH THN JOINT, W/O CONTRAST, F/B CONTRAST-FURTHER SEQ",5792.0,3185.6000000000004,362.92,5225.47,424
CPT,73721,"HC MRI, ANY JOINT OF LOWER EXTREMITY, WITHOUT CONTRAST",5241.5,2882.825,245.64,4829.3,424
CPT,73722,"HC MRI, ANY JOINT OF LOWER EXTREMITY, WITH CONTRAST",5526.0,3039.3,802.86,4962.51,424
CPT,73723,"HC MRI, ANY JOINT LOWER EXTREMITY, W/O CONTRAST, F/B CONTRAST-FURTHER SEQ",6261.0,3443.55,362.92,5982.34,424
CPT,73725,"HC MRA, LOWER EXTREMITY, WITH CONTRAST",4566.0,2511.3,316.99,3949.59,212
CPT,73725,"HC MRA, LOWER EXTREMITY, WITHOUT CONTRAST",2774.0,1525.7,316.99,2524.0,53
CPT,73725,"HC MRA, LOWER EXTREMITY, WITHOUT CONTRAST, FOLLOWED BY CONTRAST",4822.0,2652.1,316.99,4171.03,424
CPT,74018,"HC X-RAY EXAM, ABDOMEN, 1 VIEW",475.5,261.525,89.48,617.0,530
CPT,74019,"HC X-RAY EXAM, ABDOMEN, 2 VIEWS",592.0,325.6,108.06,617.0,530
CPT,74021,"HC X-RAY EXAM, ABDOMEN, 3 OR MORE VIEWS",918.0,504.9,108.06,794.07,477
CPT,74022,"HC RAD EXAM, COMPL ACUTE ABD SERIES, INCL 2/MORE VWS ABD, AND SGL VW CHEST",1140.0,627.0,108.06,1101.15,477
CPT,74150,"HC CT, ABDOMEN, WITHOUT CONTRAST",3018.5,1660.175,108.06,2735.13,424
CPT,74160,"HC CT, ABDOMEN, WITH CONTRAST",3698.0,2033.8999999999999,180.9,3351.01,371
CPT,74170,"HC CT, ABDOMEN, WITHOUT CONTRAST, FOLLOWED BY CONTRAST AND FURTHER SECTIONS",4396.5,2418.075,180.9,3983.33,371
CPT,74174,"HC CTA, ABD AND PELVIS, W/ CONTRAST, INCL NONCONTRAST IMG, AND IMG POSTPROC",6232.0,3427.6,362.92,5734.95,265
CPT,74175,"HC CTA, ABDOMEN, W/ CONTRAST, INCL NONCONTRAST IMAGES, AND IMG POSTPROC",4487.5,2468.125,180.9,4177.95,265
CPT,74176,"HC CT, ABDOMEN AND PELVIS, WITHOUT CONTRAST",4898.5,2694.175,245.64,4657.16,371
CPT,74177,"HC CT, ABDOMEN AND PELVIS, WITH CONTRAST",5933.5,3263.425,362.92,5801.56,371
CPT,74178,"HC CT, ABD AND PELVIS, W/O CONTRAST IN ONE/BOTH BODY REGIONS, F/B CONTRAST",8941.0,4917.55,362.92,8093.81,371
CPT,74181,"HC MRI, ABDOMEN, WITHOUT CONTRAST",4702.0,2586.1,245.64,4067.23,424
CPT,74181,"HC MRI, ABDOMEN, WITHOUT CONTRAST, LTD FOR IRON CONTENT",3091.0,1700.05,245.64,2673.72,53
CPT,74182,"HC MRI, ABDOMEN, WITH CONTRAST",5874.0,3230.7,362.92,5081.01,159
CPT,74183,"HC MRI, ABDOMEN, W/O CONTRAST, F/B CONTRAST-FURTHER SEQ",6026.0,3314.3,362.92,5212.49,424
CPT,74185,"HC MRA, ABDOMEN, WITH CONTRAST",4694.0,2581.7,316.96,4060.31,424
CPT,74185,"HC MRA, ABDOMEN, WITHOUT CONTRAST",3108.0,1709.4,316.96,2688.42,424
CPT,74185,"HC MRA, ABDOMEN, WITHOUT CONTRAST, FOLLOWED BY CONTRAST",6102.0,3356.1,316.96,6179.56,424
CPT,74190,HC PERITONEOGRAM,1280.0,704.0,359.0,1107.2,53
CPT,74210,"HC RAD EXAM, PHARYNX AND/OR CERVICAL ESOPHAGUS, INCL SCOUT NECK, CONTRAST",601.0,330.55,180.3,617.0,106
CPT,74220,"HC RAD EXAM, ESOPHAGUS, INCL SCOUT CHEST, SGL-CONTRAST",915.0,503.25,180.9,791.48,106
CPT,74221,HC RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY,1142.0,628.1,180.9,987.83,53
CPT,74230,"HC RAD EXAM, SWALLOW FUNCT, W CINERAD/VIDEORAD, INCL SCOUT NECK, CONTRAST",911.0,501.05,180.9,788.02,106
CPT,74240,"HC RAD EXAM, UPPER GI TRACT, INCL SCOUT ABD, SGL-CONTRAST",1045.0,574.75,180.9,903.93,106
CPT,74246,"HC RAD EXAM, UPPER GI TRACT, INCL SCOUT ABD, DBL-CONTRAST, INCL GLUCAGON",1153.0,634.15,180.9,997.35,106
CPT,74248,HC RADIOLOGIC SMALL INTESTINE FOLLOW-THROUGH STUDY (ADD ON),1047.0,575.85,75.49,905.66,53
CPT,74250,"HC RAD EXAM, SM INTEST, INCL MULT SERIAL IMG & SCOUT ABD, SGL-CONTR",860.0,473.0,180.9,743.9,106
CPT,74251,X-RAY XM SM INT 2CNTRST STD,,,180.9,316.58,16
CPT,74261,"HC CT, COLONOGRAPHY, DIAGNOSTIC, INCL IMAGE POSTPROCESSING, W/O CONTRAST",2376.0,1306.8,108.06,2055.24,53
CPT,74262,"HC CT, COLONOGRAPHY, DX, INCL IMG POSTPRCS, W/ CONTRST INCL NON-CONTRST IMG",3506.0,1928.3,180.9,3032.69,53
CPT,74263,HC CT COLONOGRAPHY SCREEN,2393.0,1316.15,245.64,2069.95,53
CPT,74270,"HC RAD EXAM, COLON, INCL SCOUT ABD, SGL-CONTRAST",1114.0,612.7,180.9,963.61,106
CPT,74280,"HC RAD EXAM, COLON, INCL SCOUT ABD, DBL-CONTRAST, INCL GLUCAGON",1799.0,989.45,180.9,1556.14,106
CPT,74283,"HC THERA ENEMA, CONTR/AIR, FOR REDUCT INTUSSUSCEPTION/OTH INTRALUM OBSTRUCT",956.0,525.8,180.9,826.94,106
CPT,74290,CONTRAST X-RAY GALLBLADDER,,,180.9,316.58,16
CPT,74300,HC X-RAY BILE DUCTS PANCREAS,776.0,426.8,232.8,671.24,76
CPT,74328,HC X-RAY BILE DUCT ENDOSCOPY,638.0,350.9,191.4,617.0,76
CPT,74329,HC X-RAY PANCREAS ENDOSCOPY,883.0,485.65,264.9,763.8,76
CPT,74330,HC COMBO ENDOSCOPIC CATH BIL & PANCR DUCT SYS RS&I,1727.0,949.85,359.0,1493.86,76
CPT,74340,"HC INTRODUCTION LONG GI TUBE, INCL MULTIPLE FLUORO AND IMAGES, RS-I",669.0,367.95,200.7,617.0,114
CPT,74360,HC X-RAY GUIDE GI DILATION,664.0,365.2,199.2,617.0,76
CPT,74400,UROGRAPHY IV +-KUB TOMOG,,,180.9,316.58,16
CPT,74410,UROGRAPHY NFS DRIP&/BOLUS,,,180.9,316.58,16
CPT,74415,UROGRAPHY NFS DRIP&/BLS W/NF,,,180.9,316.58,16
CPT,74420,HC UROGRAM RETROGRADE W OR WO KUB,2286.0,1257.3,359.0,1977.39,106
CPT,74425,"HC UROGRAPHY, ANTEGRADE",1130.0,621.5,339.0,977.45,159
CPT,74430,"HC CYSTOGRAPHY, MINIMUM 3 VIEWS",1287.0,707.85,359.0,1113.26,159
CPT,74440,X-RAY MALE GENITAL TRACT,,,245.64,429.86,16
CPT,74445,X-RAY EXAM OF PENIS,,,108.06,189.11,16
CPT,74450,HC URETHROCYSTOGRAM RETROGRADE RS & I,1099.0,604.45,245.64,950.64,159
CPT,74455,HC URETHROCYSTOGRAM VOIDING RS & I,957.0,526.35,245.64,827.81,106
CPT,74470,"HC X-RAY EXAM, RENAL CYST STUDY, TRANSLUMBAR, CONTRAST VISUALIZATION",1553.0,854.15,359.0,1343.35,53
CPT,74485,DILATION URTR/URT RS&I,,,2081.7,3642.97,16
CPT,74712,"HC MRI FETAL, INCL PLACENTAL AND MATERNAL PELVIC IMAG, SINGLE/1ST GESTATION",909.0,499.95,245.64,2524.0,53
CPT,74713,MRI FETAL EA ADDL GESTATION,,,187.63,193.26,15
CPT,74740,"HC HYSTEROSALPINGOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION",1485.0,816.75,245.64,1370.16,212
CPT,74775,X-RAY EXAM OF PERINEUM,,,245.64,429.86,16
CPT,75557,HC CARDIAC MRI FOR MORPHOLOGY AND FUNCTION WITHOUT CONTRAST,4581.0,2519.55,245.64,3962.57,371
CPT,75559,CARDIAC MRI W/STRESS IMG,,,557.18,573.9,15
CPT,75561,"HC CARDIAC MRI FOR MORPH AND FUNCT W/O CONTRST, F/B CONTRST & FURTHER SEQ",5520.0,3036.0,362.92,5264.39,371
CPT,75563,"HC CARD MRI FOR MORPH AND FUNCT W/O CONTR F/B CONTR FURTH SEQ, W/STRESS IMG",7007.0,3853.85,802.86,6061.06,53
CPT,75565,CARD MRI VELOC FLOW MAPPING,,,42.24,43.51,15
CPT,75571,"HC CT, HEART, W/O CONTRAST, W/ QUANT EVAL CORONARY CALCIUM RESEARCH",90.0,49.5,46.0,92.16,40
CPT,75571,"HC CT, HEART, W/O CONTRAST, W/ QUANT EVAL CORONRY CALCIUM",281.0,154.55,84.3,1621.0,53
CPT,75571,"HC EHP ONLY, CT, HEART, W/O CONTRAST, W/ QUANT EVAL CORONARY CALCIUM",65.0,35.75,19.5,1621.0,53
CPT,75571,"HC SP ONLY, CT, HEART, W/O CONTRAST, W/ QUANT EVAL CORONARY CALCIUM",50.0,27.5,15.0,1621.0,106
CPT,75572,"HC CT, HEART, W/ CONTRAST, FOR EVAL OF CARDIAC STRUCTURE AND MORPHOLOGY",2658.0,1461.9,362.92,2299.17,106
CPT,75573,"HC CT, HEART, W/ CONTRAST, EVAL CARD STRUCT & MORPH CONGENIT HEART DISEASE",3773.0,2075.15,362.92,3263.65,53
CPT,75574,"HC CTA, HEART, CORONARY ART AND BYPASS GRFTS, W/ CONTRAST, INCL 3D IMG POST",4436.0,2439.8,362.92,3837.14,106
CPT,75580,HC NONINVASIVE EST CORONARY FFR FROM AUGMENT SOFTWARE ANALYS COR CT ANGIOGR,3031.0,1667.05,909.3,2621.82,106
CPT,75600,CONTRAST EXAM THORACIC AORTA,,,3198.49,5597.36,16
CPT,75605,"HC AORTOGRAPHY, THORACIC, BY SERIALOGRAPHY",9240.0,5082.0,359.0,9613.23,53
CPT,75625,"HC AORTOGRAPHY, ABDOMINAL, BY SERIALOGRAPHY, RADIOLOGICAL SUPV AND INTERP",11084.0,6096.2,359.0,9587.66,53
CPT,75625,"HC ARTOGRAPHY, ABDOMINAL, BY SERIALOGRAPHY",11084.0,6096.2,359.0,9587.66,106
CPT,75630,HC ABD BILAT ILIOFEMORAL LWR EXTRM AORTGRAM W CATH,6446.0,3545.3,359.0,5597.36,53
CPT,75635,"HC CTA, ABD AORTA AND BILAT ILIOFEMORAL LOW EXTREM RUNOFF, W/ CONTRAST",4401.5,2420.825,180.9,3909.8,371
CPT,75705,"HC ANGIO, SPINAL, SELECTIVE",8625.0,4743.75,359.0,9613.23,53
CPT,75705,HC IN ART SPINAL SELECTIVE ANGIO,8700.0,4785.0,359.0,9613.23,53
CPT,75710,"HC ANGIOGRAPY, EXTREMITY, UNILAT",5925.0,3258.75,359.0,5597.36,212
CPT,75710,HC IN ART UPPER OR LOWER EXT ANGIO UNILAT,5925.0,3258.75,359.0,5597.36,53
CPT,75716,HC ANGIO EXTREM BILAT,8592.0,4725.6,359.0,7432.08,106
CPT,75716,HC IN ART UPPER OR LOWER EXT ANGIO BILAT,8592.0,4725.6,359.0,7432.08,53
CPT,75726,"HC ANGIO, VISCERAL, SELECTIVE OR SUPRASELECTIVE (W/ OR W/O FLUSH AORTOGRAM)",7176.0,3946.8,359.0,9613.23,53
CPT,75726,HC IN ART ABD VISCERAL SELECT ANGIO,7176.0,3946.8,359.0,9613.23,53
CPT,75731,"HC UNILAT, ANGIO, ADRENAL, SELECTIVE",10386.0,5712.3,359.0,8983.89,53
CPT,75733,ARTERY X-RAYS ADRENALS,,,3198.49,5597.36,16
CPT,75736,HC ANGIO PELVIS,7975.0,4386.25,359.0,9613.23,53
CPT,75736,HC IN PELVIS SELECTIVE,7975.0,4386.25,359.0,9613.23,53
CPT,75741,HC ANGIO PULMONARY UNILAT,7964.0,4380.2,359.0,6888.86,53
CPT,75743,"HC BILAT, ANGIO, PULMONARY, SELECTIVE",7188.0,3953.4,359.0,6217.62,53
CPT,75746,"HC ANGIO, PULMONARY, NONSELECTIVE CATH OR VENOUS INJ",5598.0,3078.9,359.0,5597.36,53
CPT,75756,"HC ANGIO, INTERNAL MAMMARY",5181.0,2849.55,359.0,5597.36,53
CPT,75774,"HC ANGIO, SELECTIVE, EA ADDL VESSEL STUDIED AFTER BASIC EXAM (ADD ON)",3635.0,1999.25,88.63,3144.28,53
CPT,75774,HC IN SELECTIVE ADDL VESSEL,3635.0,1999.25,88.63,3144.28,53
CPT,75801,"HC UNILAT, LYMPHANGIO, EXTREMITY ONLY",2121.0,1166.55,359.0,1834.67,53
CPT,75803,LYMPH VESSEL X-RAY ARMS/LEGS,,,1578.61,2762.56,16
CPT,75805,"HC UNILAT, LYMPHANGIO, PELVIC/ABDOMINAL",3856.0,2120.8,359.0,5597.36,53
CPT,75807,"HC BILAT, LYMPHANGIO, PELVIC/ABDOMINAL",4375.0,2406.25,359.0,5597.36,106
CPT,75809,NONVASCULAR SHUNT X-RAY,,,108.06,189.11,16
CPT,75810,HC SPLENOPORTOGRAPHY,4347.0,2390.85,359.0,5597.36,53
CPT,75820,HC VENOGRAM EXTREM UNILAT,2888.0,1588.4,359.0,2762.56,106
CPT,75822,HC VENOGRAM EXTREM BILAT,2867.0,1576.85,359.0,2762.56,53
CPT,75825,HC VENOGRAM INFERIOR VENA CAVA,5888.0,3238.4,359.0,5597.36,53
CPT,75827,HC VENOGRAM SUPERIOR VENA CAVA,4776.0,2626.8,359.0,4131.24,53
CPT,75831,HC VENOGRAM RENAL SELECTIVE UNILAT,6709.0,3689.95,359.0,5803.29,53
CPT,75833,HC VENOGRAM RENAL SELECTIVE BILAT,6709.0,3689.95,359.0,5803.29,53
CPT,75840,"HC UNILAT, VENOGRAPHY, ADRENAL, SELECTIVE",8972.0,4934.6,359.0,7760.78,53
CPT,75842,APC,,,5493.27,5658.07,15
CPT,75842,Other Radiology,,,9613.23,9613.23,1
CPT,75860,HC IN VEN JUGULAR SINUS,6041.0,3322.55,359.0,5597.36,53
CPT,75860,"HC VENOGRAPHY, VENOUS SINUS OR JUGULAR, CATHETER",6041.0,3322.55,359.0,5597.36,53
CPT,75870,HC IN VEN SUPERIOR SAGGITAL,3856.0,2120.8,359.0,5597.36,53
CPT,75872,HC IN VEN EPIDURAL,4437.0,2440.35,359.0,3838.01,53
CPT,75872,"HC VENOGRAPHY, EPIDURAL",4437.0,2440.35,359.0,3838.01,53
CPT,75880,VEIN X-RAY EYE SOCKET,,,628.28,1099.48,16
CPT,75885,HC PERC TRANSHEPATIC PORTOGRAPHY W/ HEMODYNAMIC EVAL,7117.0,3914.35,359.0,6156.21,53
CPT,75887,HC PERC TRANSHEPATIC PORTOGRAPHY W/O HEMODYNAMIC EVAL,4498.0,2473.9,359.0,5597.36,53
CPT,75889,"HC HEPATIC VENOGRAPHY, WEDGED OR FREE, W/ HEMODYNAMIC EVAL",6621.0,3641.55,359.0,5727.17,53
CPT,75891,"HC HEPATIC VENOGRAPHY, WEDGED OR FREE, W/O HEMODYNAMIC EVAL",7158.0,3936.9,359.0,6191.67,53
CPT,75893,HC IN VEN SAMPLING THRU CATH UNILAT,9884.0,5436.2,359.0,9613.23,53
CPT,75893,"HC VENOUS SAMPLING THROUGH CATH, W/ OR W/O ANGIO",9884.0,5436.2,359.0,9613.23,53
CPT,75894,HC IN EMB TRANS CATHETER,9730.0,5351.5,359.0,8416.45,38
CPT,75894,HC TRANSCATH THER EMBOLIZATION RAD S&I,9730.0,5351.5,359.0,8416.45,38
CPT,75894,"HC TRANSCATHETER THERAPY, EMBOLIZATION, ANY METHOD LTD",9730.0,5351.5,359.0,8416.45,38
CPT,75898,HC FOLLOWUP ANGIOGRAPHY THRU EXIST CATH,4039.0,2221.45,359.0,5597.36,53
CPT,75898,HC IN FOLLOW UP ANGIO EXISTING CATH,4039.0,2221.45,359.0,5597.36,53
CPT,75901,HC MECH REM PERICATH OBSTR MATERIAL FROM CVD RS&I,1423.0,782.65,205.83,1230.9,53
CPT,75902,REMOVE CVA LUMEN OBSTRUCT,,,78.98,138.21,16
CPT,75956,HC ENDOVASC TAA REPR W LT SUBCLAVIAN COVERAGE RS&I,1676.0,921.8,359.0,1449.74,38
CPT,75957,HC ENDOVASC TAA REPR WO LT SUBCLAVIAN COVERGE RS&I,7040.0,3872.0,359.0,6089.6,38
CPT,75958,HC ENDOVASC TAA REPR W PLC PROX EXT PRSTH RAD S&I,3223.0,1772.65,359.0,2787.9,38
CPT,75959,HC ENDOVASC TAA REPR W PLC DISTAL EXT PROSTH RS&I,3223.0,1772.65,359.0,2787.9,38
CPT,75970,"HC TRANSCATHETER BIOPSY, RAD S&I",4540.0,2497.0,359.0,3927.1,38
CPT,75984,HC CHANGE PERC TUBE OR DRAINAGE CATH WITH CONTRAST MONITORING,1296.0,712.8,87.54,1121.04,265
CPT,75989,HC RAD GUID PERCUTAN DRN W PLC CATH RAD S&I,2591.0,1425.05,102.81,2241.22,212
CPT,76000,"HC BRIEF, FLUOROSCOPY (SEP PROC), UP TO 1 HR PHYSICIAN/OTH QHP TIME",100.0,55.0,30.0,617.0,106
CPT,76000,"HC FLUOROSCOPY (SEP PROC), UP TO 1 HR PHYSICIAN/OTH QHP TIME",949.0,521.95,245.64,877.98,371
CPT,76010,"HC X-RAY EXAM FROM NOSE TO RECTUM FOR FOREIGN BODY, SINGLE VIEW, CHILD",323.0,177.65,89.48,617.0,106
CPT,76014,HC MR SAFETY IMPLANT & FOREIGN BODY ASSESS W WRITTEN REP; INITIAL 15 MINS,68.0,37.4,20.4,2524.0,477
CPT,76015,HC MR SAFETY IMPLANT & FOREIGN BODY ASSESS W WRITTEN REP; EA ADDL 30 MINS,68.0,37.4,20.4,2524.0,477
CPT,76016,"HC MR SAFETY DETERMINATION, WITH WRITTEN REPORT",245.0,134.75,73.5,2524.0,477
CPT,76017,"HC MR SAFETY MED PHY EX CUST, PLANNING & PERF MONITORING, W WRITTEN REPORT",672.0,369.6,201.6,2524.0,424
CPT,76018,HC MR SAFETY IMPLANT ELECTRONICS PREPARATION WITH WRITTEN REPORT,255.0,140.25,76.5,2524.0,477
CPT,76019,"HC MR SAFETY IMPLANT POSITIONING & IMMOBILIZATION, WITH WRITTEN REPORT",165.0,90.75,49.5,2524.0,424
CPT,76080,"HC X-RAY EXAM, ABSCESS, FISTULA OR SINUS TRACT STUDY",1149.0,631.95,344.7,993.89,212
CPT,76098,HC X-RAY EXAM BREAST SPECIMEN,1093.0,601.15,327.9,975.07,212
CPT,76098,HC X-RAY EXAM BREAST SPECIMEN OR,1093.0,601.15,327.9,975.07,53
CPT,76100,X-RAY EXAM OF BODY SECTION,,,108.06,189.11,16
CPT,76120,CINE/VIDEO X-RAYS,,,108.06,189.11,16
CPT,76145,MED PHYSIC DOS EVAL RAD EXPS,,,539.2,943.59,16
CPT,76376,3D RENDER W/INTRP POSTPROCES,,,41.49,41.49,1
CPT,76376,"HC CT 3D RENDER W/INTERP-RPT IMAG POSTPROC CONCURR SUPERV, W/O INDEP WRKSTN",1160.0,638.0,23.71,1621.0,318
CPT,76376,"HC IN 3D RENDER W/INTERP-RPT IMAG POSTPROC CONCURR SUPERV, W/O INDEP WRKSTN",1045.0,574.75,23.71,1621.0,53
CPT,76376,"HC US 3D RENDER W/INTERP-RPT IMAG POSTPROC CONCURR SUPERV, W/O INDEP WRKSTN",1124.0,618.2,23.71,972.26,106
CPT,76377,3D RENDER W/INTRP POSTPROCES,,,128.73,128.73,1
CPT,76377,"HC CT 3D RENDER W/INTERP-RPT IMAG POSTPROC CONCURR SUPERV, ON INDEP WRKSTN",1217.0,669.35,73.56,1621.0,477
CPT,76377,"HC IN 3D RENDER W/INTERP-RPT IMAG POSTPROC CONCURR SUPERV, ON INDEP WRKSTN",1217.0,669.35,73.56,1621.0,53
CPT,76377,"HC MR 3D RENDER W/INTERP-RPT IMAG POSTPROC CONCURR SUPERV, ON INDEP WRKSTN",1212.0,666.6,73.56,2524.0,477
CPT,76377,"HC US 3D RENDER W/INTERP-RPT IMAG POSTPROC CONCURR SUPERV, ON INDEP WRKSTN",1308.0,719.4,73.56,1131.42,106
CPT,76380,HC CAT SCAN LIMITED OR FOLLOW-UP STUDY,1466.0,806.3,89.48,1621.0,53
CPT,76380,HC IN CT LIMITED FOLLOW UP STUDY,1466.0,806.3,89.48,1621.0,53
CPT,76380,HC SCOUT (R/O METAL MISC) LTD,107.0,58.85,32.1,1621.0,265
CPT,76390,HC MR SPECTROSCOPY,3140.0,1727.0,89.48,2716.1,53
CPT,76391,"HC MAGNETIC RESONANCE (EG, VIBRATION) ELASTOGRAPHY",802.0,441.1,240.6,2524.0,53
CPT,76496,UNLISTED FLUOROSCOPIC PX,,,89.48,156.58,16
CPT,76497,HC UNLISTED WHOLE BODY CT WO CONTRAST,953.0,524.15,89.48,1621.0,106
CPT,76498,HC MR RCBV SEQUENCE,883.0,485.65,89.48,2524.0,159
CPT,76498,HC MRI SIM PLANNING WITHOUT INTERP,5755.0,3165.25,89.48,5201.25,106
CPT,76498,"HC MRáSPRINGBOKáMUSCLE COMPOSITION, UNLISTED MR PROC",904.0,497.2,89.48,2524.0,53
CPT,76498,"HC WHOLE BODY SURVEY, UNLISTED MR PROCEDURE",4896.0,2692.8,89.48,4235.04,53
CPT,76499,HC NUCLEAR MEDICINE DXA BODY COMPOSITION,882.0,485.1,89.48,762.93,53
CPT,76499,"HC UNLIST DIAGNOSTIC RAD PROC, VISCERAL VENOGRAM",3746.0,2060.3,89.48,3240.29,53
CPT,76506,ECHO EXAM OF HEAD,,,108.06,111.3,15
CPT,76510,OPH US DX B-SCAN&QUAN A-SCAN,,,130.99,134.92,15
CPT,76511,OPH US DX QUAN A-SCAN ONLY,,,108.06,111.3,15
CPT,76512,HC OPHTH US B-SCAN W OR WO NON-QUANT A-SCAN,1001.0,550.55,108.06,865.87,159
CPT,76513,"HC OPHTH US, DX, ANT SEGM, IMMERS B-SCAN/HI RES BIOMICROSCP, UNILAT/BILAT",597.0,328.35,108.06,668.0,159
CPT,76514,HC ECHO EXAM OF EYE THICKNESS,209.0,114.95,24.89,668.0,106
CPT,76516,"HC OPHTH BIOMETRY BY US ECHOGRAPHY, A-SCAN",423.0,232.65,108.06,668.0,106
CPT,76519,HC AXIAL LENGTH US W INTRAOCULAR LENS,452.0,248.6,108.06,668.0,106
CPT,76529,ECHO EXAM OF EYE,,,89.48,92.16,15
CPT,76536,"HC US, SOFT TISSUES HEAD AND NECK, REAL TIME WITH IMAGE DOCUMENTATION",1545.5,850.025,108.06,1406.49,371
CPT,76604,"HC LTD, US, CHEST (INCLUDES MEDIASTINUM), REAL TIME W/ IMAG DOCUMENT",1158.0,636.9,108.06,1001.67,53
CPT,76604,"HC US, CHEST (INCLUDES MEDIASTINUM)",1158.0,636.9,108.06,1001.67,212
CPT,76641,HC ULTRASOUND BREAST COMPLETE,1237.5,680.625,108.06,1198.03,424
CPT,76642,"HC US POC, BREAST, UNILAT, REAL TIME W/ IMAGE DOC, INCL AXILLA, LTD",878.0,482.9,89.48,789.75,159
CPT,76642,"HC US, BREAST, UNILAT, REAL TIME W/ IMAGE DOC, INCL AXILLA, LTD",798.0,438.9,89.48,729.2,318
CPT,76700,"HC US, ABDOMINAL, REAL TIME WITH IMAGE DOCUMENTATION, COMPLETE",2053.0,1129.15,108.06,1775.85,318
CPT,76705,"HC LTD, US, ABDOMINAL",1360.0,748.0,108.06,1176.4,159
CPT,76705,"HC LTD, US, ABDOMINAL, REAL TIME W/ IMAG DOCUMENT",1339.5,736.725,108.06,1176.4,424
CPT,76706,"HC US ABDOMINAL AORTA, REAL TIME W/ IMAG DOC, SCREEN FOR AAA",858.0,471.9,108.06,1009.46,371
CPT,76770,"HC US, RETROPERITONEAL, REAL TIME WITH IMAGE DOCUMENTATION, COMPLETE",1427.0,784.85,108.06,1249.06,424
CPT,76775,"HC LTD, US, RETROPERITONEAL",1536.0,844.8,108.06,1328.64,53
CPT,76775,"HC LTD, US, RETROPERITONEAL, REAL TIME W/ IMAG DOCUMENT",1504.0,827.2,108.06,1328.64,212
CPT,76776,"HC US, TRANSPLANTED KIDNEY, REAL TIME AND DUPLEX DOPPLER WITH IMAGE DOC",1563.0,859.65,108.06,1352.0,159
CPT,76800,US EXAM SPINAL CANAL,,,108.06,111.3,15
CPT,76801,HC OB US < 14 WKS SINGLE FETUS,980.0,539.0,108.06,847.7,53
CPT,76801,"HC OB US, UTERUS, FETAL AND MATERNAL EVAL, LESS TH 14 WKS, SGL/1ST GEST",864.5,475.475,108.06,847.7,212
CPT,76802,HC OB US < 14 WKS ADDL FETUS,953.0,524.15,55.96,824.35,106
CPT,76802,"HC US, PREG UTERUS, FIRST TRIMESTER, TRANSABD APPROACH, EA ADDL GEST (ADD)",953.0,524.15,55.96,824.35,53
CPT,76805,"HC OB US, UTERUS, FETAL AND MATERNAL EVAL, MORE TH/EQL 14 WKS, SGL/1ST GEST",1554.0,854.7,108.06,1344.21,106
CPT,76805,"HC US, PREG UTERUS, AFTER FIRST TRIMESTER, TRANSABD APPROACH, SGL/1ST GEST",1554.0,854.7,108.06,1344.21,53
CPT,76810,"HC OB US, UTERUS, FETAL AND MATERNAL EVAL, MORE TH/EQL 14 WKS, EA ADDITL",874.0,480.7,80.93,756.01,212
CPT,76811,"HC OB US, UTERUS, FETAL-MATRNL EVAL PLUS DETAIL FETL ANAT EXAM,SGL/1ST GEST",1211.0,666.05,245.64,1047.52,53
CPT,76812,HC OB US DETAILED ADDL FETUS,664.0,365.2,176.78,668.0,53
CPT,76813,HC OB US NUCHAL MEASUREMENT FIRST GEST,979.0,538.45,108.06,846.84,53
CPT,76814,HC OB US NUCHAL MEASUREMENT EA ADDL GEST,281.0,154.55,68.87,668.0,53
CPT,76815,HC OB US LTD FETUS(S),614.0,337.7,108.06,668.0,106
CPT,76815,"HC OB US, UTERUS, LIMITED, 1 OR MORE FETUSES",614.0,337.7,108.06,668.0,159
CPT,76816,HC OB US FOLLOW-UP PER FETUS EA ADDL GEST,1152.0,633.6,108.06,996.48,53
CPT,76816,"HC OB US, UTERUS, FOLLOW-UP, TRANSABDOMINAL APPROACH, PER FETUS",1213.0,667.15,108.06,1049.25,265
CPT,76817,"HC OB US, UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, TRANSVAGINAL",881.5,484.825,108.06,798.4,477
CPT,76818,HC FETAL BIOPHYSICAL PROFILE W NST,1513.0,832.15,108.06,1308.75,53
CPT,76818,HC FETAL BIOPHYSICAL PROFILE W NST EA ADDL GEST,1513.0,832.15,108.06,1308.75,53
CPT,76818,"HC FETAL BIOPHYSICAL PROFILE, W/ NON-STRESS TESTING",1513.0,832.15,108.06,1308.75,53
CPT,76819,HC FETAL BIOPHYSICAL PROFILE WO NST,1145.0,629.75,108.06,990.43,53
CPT,76819,HC FETAL BIOPHYSICAL PROFILE WO NST EA ADDL GEST,1145.0,629.75,108.06,990.43,53
CPT,76819,"HC FETAL BIOPHYSICAL PROFILE, W/O NON-STRESS TESTING",1145.0,629.75,108.06,990.43,53
CPT,76820,HC DOPPLER VELOCIMETRY FETAL UMBILICAL ART,542.0,298.1,108.06,668.0,53
CPT,76820,HC DOPPLER VELOCMTRY FETAL UMBILIC ART EA ADL GEST,542.0,298.1,108.06,668.0,53
CPT,76821,HC DOPLR VELOCMTRY FETL MID CEREBR ART EA ADL GEST,528.0,290.4,108.06,668.0,53
CPT,76821,HC DOPPLER VELOCIMETRY FETAL MIDDLE CEREBRAL ART,528.0,290.4,108.06,668.0,53
CPT,76825,HC ECHO FETAL CARDIOVASC 2D,1741.0,957.55,348.0,1505.97,53
CPT,76825,HC ECHO FETAL CARDIOVASC 2D EA ADDL GEST,1741.0,957.55,348.0,1505.97,53
CPT,76826,HC ECHO FETAL CARDIOVASC 2D REPEAT,1594.0,876.7,245.64,1378.81,53
CPT,76826,HC ECHO FETAL CARDIOVASC 2D REPEAT EA ADDL GEST,1594.0,876.7,245.64,1378.81,53
CPT,76827,HC DOPPLER ECHOCARDIOGRAPHY FETAL SPECT COMPLETE,692.0,380.6,108.06,668.0,53
CPT,76828,HC DOPPLER ECHOCARDGRPHY FETAL SPECT COMPL REPEAT,545.0,299.75,108.06,668.0,53
CPT,76830,"HC NON-OB US, TRANSVAGINAL",1269.0,697.95,108.06,1114.99,371
CPT,76830,"HC US, TRANSVAGINAL",1289.0,708.95,108.06,1114.99,106
CPT,76831,HC SALINE INFUSION SONOHYSTEROGRAPHY (SIS),992.0,545.6,245.64,858.08,212
CPT,76856,"HC NON-OB US, PELVIC, REAL TIME WITH IMAGE DOCUMENTATION, COMPLETE",1723.0,947.65,108.06,1621.88,424
CPT,76857,"HC LTD OR FOLLOW-UP, US, PELVIC (NON-OB)",967.0,531.85,108.06,836.46,106
CPT,76857,"HC NON-OB US, PELVIC, REAL TIME WITH IMAGE DOC, LIMITED OR FOLLOW-UP",816.5,449.07500000000005,108.06,836.46,265
CPT,76870,"HC US, SCROTUM AND CONTENTS",1417.0,779.35,108.06,1378.81,371
CPT,76872,HC US TRANSRECTAL,1318.0,724.9000000000001,108.06,1140.94,212
CPT,76873,HC ECHOGRAP TRANS R PROS STUDY,711.0,391.05,108.06,668.0,106
CPT,76881,"HC US, COMPLETE JOINT, REAL-TIME W/ IMAGE DOC",1465.0,805.75,108.06,1267.23,159
CPT,76882,"HC US, LTD, JOINT/FOCAL EVAL OTHER NONVASC EXTREM STRUCT, REAL-TIME",911.5,501.325,108.06,833.0,371
CPT,76883,US NRV&ACC STRUX 1XTR COMPRE,,,108.06,111.3,15
CPT,76885,US EXAM INFANT HIPS DYNAMIC,,,89.48,92.16,15
CPT,76886,US EXAM INFANT HIPS STATIC,,,89.48,92.16,15
CPT,76936,HC US GUID COMPRESSION REPAIR OF ART PSEUDOANEURYSM/ARTERIOVENOUS FISTULAE,1697.0,933.35,316.44,1467.91,53
CPT,76937,HC IN US GUIDE VASC ACCESS DEVICE,1066.0,586.3,35.41,922.09,53
CPT,76937,"HC US GUID FOR VASC ACCESS, DOC SELECT VSL PATENCY, VISUAL NDL ENTRY (ADD)",1020.0,561.0,35.41,882.3,53
CPT,76937,HC US GUIDED VASCULAR ACCESS (ADD ON),1066.0,586.3,35.41,922.09,159
CPT,76940,"HC ULTRASOUND GUIDANCE FOR, AND MONITORING OF, PARENCHYMAL TISSUE ABLATION",1255.0,690.25,348.0,1085.58,38
CPT,76940,"HC US GUIDANCE FOR, AND MONITORING OF, PARENCHYMAL TISSUE ABLATION",1255.0,690.25,348.0,1085.58,38
CPT,76941,HC ECHO GUIDE FOR TRANSFUSION,438.0,240.9,131.4,668.0,38
CPT,76941,HC ECHO GUIDE FOR TRANSFUSION EA ADDL GEST,438.0,240.9,131.4,668.0,38
CPT,76942,"HC US GUID NEEDLE PLACE (BX, ASPIR, INJ, LOCALZ DEV), IMG SUPRV-INTERP",1388.5,763.675,54.91,1273.28,689
CPT,76942,"HC US POC, GUID NEEDLE PLACE (BX, ASPIR, INJ, LOCALZ DEV), IMG SUPRV-INTERP",1614.0,887.7,54.91,1518.94,318
CPT,76945,HC ECHO GUIDE VILLUS SAMPLING,496.0,272.8,148.8,668.0,38
CPT,76945,HC ECHO GUIDE VILLUS SAMPLING EA ADDL GEST,496.0,272.8,148.8,668.0,38
CPT,76946,HC US GUIDE FOR AMNIOCENTESIS,873.0,480.15,31.08,755.15,159
CPT,76946,HC US GUIDE FOR AMNIOCENTESIS EA ADDL GEST,873.0,480.15,31.08,755.15,53
CPT,76948,HC ECHO GUIDE OVA ASPIR,689.0,378.95,74.51,668.0,106
CPT,76965,HC GUIDANCE FOR INTERSTITIAL RADIOELEMENT APPLICATION,1465.0,805.75,89.38,1267.23,53
CPT,76975,GI ENDOSCOPIC ULTRASOUND,,,245.64,253.0,15
CPT,76977,US BONE DENSITY MEASURE,,,108.06,111.3,15
CPT,76978,"HC US, TARG DYN MICRBUBBLE SONOGR CONTR CHARACTR, INIT LES",523.0,287.65,156.9,668.0,53
CPT,76979,"HC US, TARG DYN MICRBUBBLE SONOGR CONTR CHARACTR, EA ADL LES W SEP INJ (AD)",664.0,365.2,114.71,668.0,53
CPT,76981,"HC US, ELASTOGRAPHY, PARENCHYMA",576.0,316.8,108.06,668.0,53
CPT,76982,"HC US, ELASTOGRAPHY, FIRST TARGET LESION",465.0,255.75,108.06,668.0,53
CPT,76983,"HC US, ELASTOGRAPHY, EA ADDL TARGET LESION (AD)",363.0,199.65,55.15,668.0,53
CPT,76998,HC US GUIDE INTRAOP,1340.0,737.0,348.0,1159.1,114
CPT,76999,HC EVALUATION OF DIALYSIS CIRCUIT OR EXTREMITY FOR VASCULAR FLOW,670.0,368.5,89.48,668.0,53
CPT,76999,"HC TRANSVAGINAL ASPIRATION,UNLISTED US PROC",1088.0,598.4,89.48,941.12,53
CPT,77001,"HC FLUORO GUID FOR CVAD PLACE, REPLACE (CATH ONLY OR COMPL), OR REMOVAL",836.0,459.8,89.6,723.14,159
CPT,77002,"HC FLUORO GUIDE NEEDLE PLACEMENT (BX, ASPIR, INJ, LOCALZ) (ADD ON CODE)",1221.0,671.55,105.5,1107.2,636
CPT,77003,HC FLUORO GUIDE LOCALZ NEEDLE/CATH SPINE/PARASPINOUS INJ (ADD ON CODE),1160.0,638.0,95.37,1073.47,265
CPT,77003,HC IN FLUORO GUIDE LOCALZ NEEDLE/CATH SPINE/PARASPINOUS INJ (ADD ON CODE),1079.0,593.45,95.37,933.34,53
CPT,77011,HC CT SCAN FOR LOCALIZATION,3209.0,1764.95,202.51,2775.79,53
CPT,77012,HC CT GUIDANCE FOR NEEDLE PLACEMENT,2634.0,1448.7,117.28,2278.41,159
CPT,77013,"HC CT GUIDANCE FOR, AND MONITORING OF, PARENCHYMAL TISSUE ABLATION",3251.0,1788.05,930.0,2812.12,38
CPT,77014,HC CT GUIDANCE FOR SIMULATION,3024.5,1663.475,110.99,2791.36,318
CPT,77014,HC CT GUIDANCE FOR SIMULATION - PROTON,2637.0,1450.35,110.99,2281.01,53
CPT,77014,HC IGRT CT SCAN FOR THERAPY GUIDE,2430.0,1336.5,110.99,2101.95,53
CPT,77021,HC MRI GUIDANCE FOR NEEDLE PLACEMENT,4372.0,2404.6,386.48,3781.78,53
CPT,77022,"HC MRI GUIDANCE FOR, AND MONITORING OF, PARENCHYMAL TISSUE ABLATION",3431.0,1887.05,1029.3,2967.82,38
CPT,77046,"HC UNILAT, MRI, BREAST, W/O CONTRAST MATERIAL",5103.0,2806.65,245.64,4414.1,159
CPT,77047,"HC BILAT, MRI, BREAST, W/O CONTRAST MATERIAL",5370.5,2953.775,245.64,6098.25,318
CPT,77048,"HC UNILAT, MRI, BREAST, W/O AND W/ CONTRAST MATERIAL(S), INCL CAD",5859.0,3222.45,316.25,5068.04,318
CPT,77049,"HC ABBREV, BILAT, MRI, BREAST, W/O AND W/ CONTRAST MATERIAL(S)",415.0,228.25,124.5,2524.0,106
CPT,77049,"HC BILAT, MRI, BREAST, W/O AND W/ CONTRAST MATERIAL(S), INCL CAD",6345.0,3489.75,322.21,6137.18,318
CPT,77053,HC X-RAY OF MAMMARY DUCT,1117.0,614.35,245.64,966.21,106
CPT,77054,HC X-RAY OF MAMMARY DUCTS,1770.0,973.5,245.64,1531.05,106
CPT,77061,"HC UNILATERAL, DIGITAL BREAST DX TOMOSYNTHESIS",106.0,58.3,31.8,211.0,152
CPT,77062,"HC BILATERAL, DIGITAL BREAST DX TOMOSYNTHESIS",190.0,104.5,57.0,211.0,152
CPT,77063,"HC BILATERAL, DIGITAL BREAST SCREENING TOMOSYNTHESIS",190.0,104.5,48.83,211.0,212
CPT,77065,"HC UNILAT, DX MAMMOGRAPHY, INCLUDING CAD",465.0,255.75,116.61,402.23,318
CPT,77066,"HC BILAT, DX MAMMOGRAPHY, INCLUDING CAD",724.0,398.2,123.0,626.26,318
CPT,77067,"HC BILAT, SCREEN MAMMOGRAPHY, INCLUDING CAD",683.0,375.65,119.22,590.8,318
CPT,77071,HC JOINT X-RAY W MANUAL STRESS APPL,284.0,156.2,85.2,617.0,106
CPT,77072,HC BONE AGE STUDIES,692.0,380.6,108.06,617.0,424
CPT,77073,"HC BONE LENGTH STUDIES (ORTHOROENTGENOGRAM, SCANOGRAM)",529.0,290.95,108.06,617.0,424
CPT,77074,"HC X-RAY EXAM, OSSEOUS SURVEY, LIMITED",1001.0,550.55,108.06,865.87,106
CPT,77075,"HC X-RAY EXAM, OSSEOUS SURVEY, COMPLETE",1949.0,1071.95,108.06,1685.89,477
CPT,77076,RADEX OSSEOUS SURVEY INFANT,,,108.06,189.11,16
CPT,77077,JOINT SURVEY SINGLE VIEW,,,108.06,189.11,16
CPT,77078,CT BONE DENSITY AXIAL,,,89.48,92.16,15
CPT,77080,"HC DXA, BONE DENSITY STUDY, 1 OR MORE SITES, AXIAL SKELETON",755.0,415.25,108.06,669.51,106
CPT,77081,"HC DXA, BONE DENSITY STUDY, 1 OR MORE SITES, APPENDICULAR SKELETON",388.5,213.675,89.48,617.0,106
CPT,77084,MRI BONE MARROW BLOOD SUPPLY,,,245.64,253.0,15
CPT,77085,HC DXA BONE DENSITY STUDY AXIAL INCL VERTEBRAL FX ASSESSMENT,859.0,472.45,108.06,743.04,53
CPT,77086,HC VERTEBRAL FRACTURE ASSESSMENT VIA DXA,400.0,220.0,89.48,617.0,53
CPT,77089,TBS DXA CAL W/I&R FX RISK,,,36.82,64.43,16
CPT,77090,TBS TECHL PREP&TRANSMIS DATA,,,89.48,156.58,16
CPT,77091,HC TBS TECHL CALCULATION ONLY,233.75,128.565,65.25,617.0,106
CPT,77092,TBS I&R FX RSK QHP,,,9.05,15.84,16
CPT,77261,THER RADIOLOGY TX PLNG SMPL,,,66.22,68.21,15
CPT,77262,THER RADIOLOGY TX PLNG INTRM,,,101.68,104.73,15
CPT,77263,THER RADIOLOGY TX PLNG CPLX,,,157.38,162.1,15
CPT,77280,HC TX RADIATION SIMULATION AIDED FIELD SET SIMPLE,2299.0,1264.45,134.92,4266.0,212
CPT,77280,HC TX RADIATION SIMULATION AIDED FIELD SET SIMPLE - PROTON,1999.0,1099.45,134.92,4266.0,53
CPT,77285,HC TX RADIATION SIMULATION AID FIELD SET INTERMED,4945.0,2719.75,372.0,4277.43,159
CPT,77290,HC TX RADIATION SIMLTN AID FIELD SET COMPLEX_TBI,5176.0,2846.8,372.0,4477.24,53
CPT,77290,HC TX RADIATION SIMULATION AID FIELD SET COMPLEX,5176.0,2846.8,372.0,4477.24,212
CPT,77290,HC TX RADIATION SIMULATION AID FIELD SET COMPLEX - PROTON,4501.0,2475.55,372.0,4266.0,53
CPT,77290,HC TX RADTN SIMLTN AID FIELD SET COMPLEX_NECK,5175.0,2846.25,372.0,4476.38,53
CPT,77293,HC RESPIRATORY MOTION MANAGEMENT SIMULATION,2371.0,1304.05,374.7,4266.0,212
CPT,77293,HC RESPIRATORY MOTION MANAGEMENT SIMULATION - PROTON,2062.0,1134.1,374.7,4266.0,53
CPT,77295,HC 3D RADIOTHERAPY PLAN INCL DOSE-VOL HISTOGRAMS,9085.0,4996.75,1390.43,8256.43,318
CPT,77295,HC 3D RADIOTHERAPY PLAN INCL DOSE-VOL HISTOGRAMS - PROTON,7500.0,4125.0,1390.43,6487.5,53
CPT,77299,UNLISTED PX THER RAD TX PLNG,,,134.92,138.97,15
CPT,77300,HC BASIC RADIATION DOSIMETRY CALCULATN CENTRL AXIS,1006.0,553.3,134.92,4266.0,212
CPT,77300,HC BASIC RADIATION DOSIMETRY CALCULATN CENTRL AXIS - PROTON,875.0,481.25,134.92,4266.0,53
CPT,77300,HC RADIATION THERAPY DOSE PLAN,737.0,405.35,134.92,4266.0,53
CPT,77301,HC RADIOTHERAPY DOSE PLAN IMRT,14950.0,8222.5,1390.43,12931.75,212
CPT,77301,HC RADIOTHERAPY DOSE PLAN IMRT - PROTON,13000.0,7150.0,1390.43,11245.0,53
CPT,77306,HC TELETHERAPY ISODOSE PLAN SIMPLE,4118.0,2264.9,372.0,4266.0,159
CPT,77307,HC TELETHERAPY ISODOSE PLAN COMPLEX,4782.0,2630.1,372.0,4266.0,212
CPT,77316,HC BRACHYTHERAPY ISODOSE PLAN SIMPLE,3692.0,2030.6,372.0,4266.0,53
CPT,77317,HC BRACHYTHERAPY ISODOSE PLAN INTERMEDIATE,4257.0,2341.35,372.0,4266.0,53
CPT,77318,HC BRACHYTHERAPY ISODOSE PLAN COMPLEX,4732.0,2602.6,372.0,4266.0,53
CPT,77321,HC SPECIAL TELETX PORT PLAN,2471.0,1359.05,372.0,4266.0,212
CPT,77331,HC SPECIAL RADIATION DOSIMETRY,909.0,499.95,134.92,4266.0,212
CPT,77331,HC SPECIAL RADIATION DOSIMETRY - PROTON,790.0,434.5,134.92,4266.0,53
CPT,77332,HC RADIATION TREATMENT DEVICE SIMPLE,679.0,373.45,134.92,4266.0,212
CPT,77332,HC RADIATION TREATMENT DEVICE SIMPLE - PROTON,590.0,324.5,134.92,4266.0,53
CPT,77333,HC RADIATION TREATMENT DEVICE INTERMEDIATE,762.0,419.1,134.92,4266.0,212
CPT,77333,HC RADIATION TREATMENT DEVICE INTERMEDIATE - PROTON,663.0,364.65,134.92,4266.0,53
CPT,77334,HC RADIATION TREATMENT DEVICE COMPLEX,2329.5,1281.225,372.0,4266.0,265
CPT,77334,HC RADIATION TREATMENT DEVICE COMPLEX - PROTON,2073.0,1140.15,372.0,4266.0,53
CPT,77334,HC RADIATION TRTMNT DEVICE COMPLEX_CUSTOM SHIELD,2384.0,1311.2,372.0,4266.0,212
CPT,77336,HC CONTINUING RADIATION PHYSICS CONSULT,2989.0,1643.95,134.92,4266.0,265
CPT,77336,HC CONTINUING RADIATION PHYSICS CONSULT - PROTON,2798.0,1538.9,134.92,4266.0,53
CPT,77338,HC DESIGN MLC DEVICE FOR IMRT,2734.0,1503.7,372.0,4266.0,212
CPT,77338,HC DESIGN MLC DEVICE FOR IMRT - PROTON,2377.5,1307.63,372.0,4266.0,53
CPT,77370,HC SPECIAL RADIATION PHYSICS CONSULT,1480.0,814.0,134.92,4266.0,265
CPT,77370,HC SPECIAL RADIATION PHYSICS CONSULT - PROTON,1287.0,707.85,134.92,4266.0,53
CPT,77371,HC SRS MULTISOURCE,97750.0,53762.5,7768.33,85455.0,53
CPT,77372,SRS LINEAR BASED,,,7768.33,85455.0,19
CPT,77373,HC SBRT DELIVERY,11821.0,6501.55,1784.36,10225.17,212
CPT,77373,HC SBRT DELIVERY - PROTON,10279.0,5653.45,1784.36,8891.34,53
CPT,77373,"HC STEREOTACTIC BODY RADIATION THERAPY, TREAT DELIVERY, PER FRACTION 1-5",26064.0,14335.2,1784.36,22545.36,53
CPT,77385,HC IMRT SIMPLE,6710.0,3690.5,587.84,5804.15,212
CPT,77386,HC IMRT COMPLEX,7472.0,4109.6,587.84,6463.28,212
CPT,77387,"HC GUID LOCALZ TARGET VOL FOR DELIV RADIATION TX, INCL INTRAFRACT TRACK",808.0,444.4,242.4,4266.0,152
CPT,77399,UNLISTED PX MED RADJ PHYSICS,,,134.92,138.97,15
CPT,77401,HC RADIATION TX DELIVERY SUPERFICIAL-ORTHO VOLTAGE PER DAY,650.0,357.5,111.27,4266.0,53
CPT,77402,"HC RADIATION TREATMENT DELIVERY, GREATER THAN 1 MEV, SIMPLE",1305.0,717.75,111.27,4266.0,212
CPT,77407,"HC RADIATION TREATMENT DELIVERY, GREATER THAN 1 MEV, INTERMEDIATE",1679.0,923.45,267.24,4266.0,212
CPT,77412,"HC RADIATION TREATMENT DELIVERY, GREATER THAN 1 MEV, COMPLEX",3102.0,1706.1,267.24,4266.0,212
CPT,77417,HC THERAPEUTIC RADIOLOGY PORT IMAGE(S),735.0,404.25,14.76,4266.0,212
CPT,77423,NEUTRON BEAM TX COMPLEX,,,587.84,605.48,15
CPT,77424,IO RAD TX DELIVERY BY X-RAY,,,7768.33,8001.38,15
CPT,77425,IO RAD TX DELIVER BY ELCTRNS,,,7768.33,8001.38,15
CPT,77427,RADIATION TX MANAGEMENT X5,,,179.07,184.44,15
CPT,77431,RADIATION THERAPY MANAGEMENT,,,100.81,103.84,15
CPT,77432,STEREOTACTIC RADIATION TRMT,,,396.97,408.88,15
CPT,77435,SBRT MANAGEMENT,,,600.28,618.29,15
CPT,77469,IO RADIATION TX MANAGEMENT,,,299.48,308.46,15
CPT,77470,HC SPECIAL RADIATION TREATMENT,3705.5,2038.025,587.84,4266.0,265
CPT,77470,HC SPECIAL RADIATION TREATMENT - PROTON,3691.0,2030.05,587.84,4266.0,53
CPT,77520,PROTON TRMT SIMPLE W/O COMP,,,587.84,605.48,15
CPT,77522,PROTON TRMT SIMPLE W/COMP,,,1296.17,1335.06,15
CPT,77523,HC PROTON TX DELIVERY INTERMEDIATE,3240.5,1782.28,972.15,4266.0,53
CPT,77525,HC PROTON TX DELIVERY COMPLEX,3240.5,1782.28,972.15,4266.0,53
CPT,77600,HYPERTHERMIA EXT GEN SUPFC,,,267.24,275.26,15
CPT,77605,HYPERTHERMIA EXT GEN DEEP,,,705.05,726.2,15
CPT,77610,HYPERTHERMIA NTRSTL PRB 5/<,,,587.84,605.48,15
CPT,77615,HYPERTHERMIA NTRSTL PRB>5,,,587.84,605.48,15
CPT,77620,HYPERTHERMIA GEN INTRCV PRB,,,587.84,605.48,15
CPT,77750,INFUSE RADIOACTIVE MATERIALS,,,267.24,275.26,15
CPT,77761,APPLY INTRCAV RADIAT SIMPLE,,,587.84,605.48,15
CPT,77762,APPLY INTRCAV RADIAT INTERM,,,587.84,605.48,15
CPT,77763,APPLY INTRCAV RADIAT COMPL,,,705.05,726.2,15
CPT,77767,HDR RDNCL SKN SURF BRACHYTX,,,267.24,275.26,15
CPT,77768,HDR RDNCL SKN SURF BRACHYTX,,,267.24,275.26,15
CPT,77770,"HC HDR RADIONUCLIDE INTERSTITIAL OR INTRACAVITARY BRACHYTHERAPY, 1 CHANNEL",6248.0,3436.4,705.05,5404.52,53
CPT,77771,"HC HDR RADIONUCLIDE INTERSTITIAL/INTRACAVITARY BRACHYTHERAPY, 2-12 CHANNELS",7380.0,4059.0,705.05,6383.7,53
CPT,77772,"HC HDR RADIONUCLIDE INTERSTITIAL/INTRACAVITARY BRACHYTHERAPY, OVER 12 CHAN",9290.0,5109.5,705.05,8035.85,53
CPT,77778,"HC INTERSTITIAL RAD SOURCE APPL, COMPLX, INCL SUPRV, HANDL, LOAD RAD SOURCE",9235.0,5079.25,705.05,7988.28,53
CPT,77789,APPLY SURF LDR RADIONUCLIDE,,,111.27,114.61,15
CPT,77790,HC RADIATION HANDLING,872.0,479.6,17.24,4266.0,159
CPT,77799,UNLISTED PX CLIN BRACHYTX,,,111.27,114.61,15
CPT,78012,HC THYROID UPTAKE SGL OR MULT QUANT MEASUREMENT(S),1311.0,721.05,393.3,2528.0,53
CPT,78013,HC THYROID IMAGE I-123,1016.0,558.8,304.8,2528.0,53
CPT,78013,HC THYROID IMAGE TC99M,1016.0,558.8,304.8,2528.0,53
CPT,78014,HC THYROID IMAGE SGL UPTAKE QUANT MEASURE,2269.0,1247.95,408.34,2528.0,53
CPT,78015,THYROID MET IMAGING,,,408.34,420.59,15
CPT,78016,THYROID MET IMAGING/STUDIES,,,408.34,420.59,15
CPT,78018,HC THYROID MET IMAG BODY,2833.0,1558.15,546.99,2528.0,53
CPT,78020,THYROID MET UPTAKE,,,73.39,75.59,15
CPT,78070,"HC PARATHYROID PLANAR IMAGING, INCLUDING SUBTRACTION, WHEN PERFORMED",1882.0,1035.1,408.34,2528.0,53
CPT,78071,HC PARATHYROID PLANAR IMAGING INCL SUBTRACTION W/ TOMOGRAPHIC (SPECT),2632.0,1447.6,408.34,2528.0,53
CPT,78072,HC PARATHYROID PLANAR IMAGE (SPECT) & CT,2869.0,1577.95,546.99,2528.0,53
CPT,78075,HC ADRENAL NUCLEAR IMAG,5557.0,3056.35,1326.63,4806.81,53
CPT,78099,UNLISTED ENDOCRINE PX DX NUC,,,408.34,420.59,15
CPT,78102,BONE MARROW IMAGING LTD,,,408.34,420.59,15
CPT,78103,"HC BONE MARROW IMAGING, MULTIPLE AREAS",1035.0,569.25,310.5,2528.0,53
CPT,78104,"HC BONE MARROW IMAGING, WHOLE BODY",1248.0,686.4,374.4,2528.0,53
CPT,78110,PLASMA VOLUME SINGLE,,,1326.63,1366.43,15
CPT,78111,"HC PLASMA VOLUME, RADIOPHARMACEUTICAL VOLUME-DILUTION TECH, MULT SAMPLINGS",3496.0,1922.8,1048.8,3024.04,53
CPT,78120,RED CELL MASS SINGLE,,,408.34,420.59,15
CPT,78121,HC RED CELL MASS MULTIPLE,1326.0,729.3,397.8,2528.0,53
CPT,78122,HC WHOLE BLOOD VOLUME DETERMINATION,1781.0,979.55,534.3,2528.0,53
CPT,78130,RED CELL SURVIVAL STUDY,,,408.34,420.59,15
CPT,78140,RED CELL SEQUESTRATION,,,408.34,420.59,15
CPT,78185,SPLEEN IMAGING,,,408.34,420.59,15
CPT,78191,PLATELET SURVIVAL STUDY,,,408.34,420.59,15
CPT,78195,HC LYMPH SYSTEM IMAG,2732.0,1502.6,546.99,2528.0,53
CPT,78199,UNLSTD HEMATOP RET/ENDO LYMP,,,408.34,420.59,15
CPT,78201,"HC LIVER IMAGING, STATIC ONLY",2181.0,1199.55,546.99,2528.0,53
CPT,78202,HC LIVER IMAG WITH FLOW,2849.0,1566.95,546.99,2528.0,53
CPT,78215,"HC LIVER AND SPLEEN IMAGING, STATIC ONLY",1442.0,793.1,408.34,2528.0,53
CPT,78216,LVR&SPLEEN IMG W/VASC FLOW,,,408.34,420.59,15
CPT,78226,"HC HEPATOBILIARY SYSTEM IMAGING, INCLUDING GALLBLADDER WHEN PRESENT",2316.0,1273.8,408.34,2528.0,53
CPT,78227,"HC HEPATOBILIARY SYS IMG INCL GALLBLADDER, W/ PHARM INTERV, INCL QUANT MEAS",2840.0,1562.0,546.99,2528.0,53
CPT,78230,SALIVARY GLAND IMAGING,,,408.34,420.59,15
CPT,78231,SALIVARY GLND IMG SERIAL IMG,,,408.34,420.59,15
CPT,78232,HC SALIVARY GLAND FUNCTION STUDY,1016.0,558.8,304.8,2528.0,53
CPT,78258,ESOPHAGEAL MOTILITY,,,408.34,420.59,15
CPT,78261,GASTRIC MUCOSA IMAGING,,,408.34,420.59,15
CPT,78262,GASTROESOPHAGEAL REFLUX STD,,,408.34,420.59,15
CPT,78264,HC GASTRIC EMPTYING IMAGING STUDY,2289.0,1258.95,408.34,2528.0,53
CPT,78265,"HC GASTRIC EMPTYING IMAGING STUDY, W SMALL BOWEL TRANSIT",1564.0,860.2,408.34,2528.0,53
CPT,78266,GSTR EMPT IMG SM BWL&COLON,,,546.99,563.4,15
CPT,78267,UREA BREATH TST C-14 ACQUISJ,,,11.06,55.3,17
CPT,78268,UREA BREATH TEST C-14 ALYS,,,94.41,472.05,17
CPT,78278,HC ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING,2704.0,1487.2,408.34,2528.0,53
CPT,78282,GI PROTEIN LOSS,,,408.34,420.59,15
CPT,78290,HC MECKELS DIVERT EXAM,1398.0,768.9,408.34,2528.0,53
CPT,78291,HC PERITONEAL-VENOUS SHUNT PATENCY TEST,1311.0,721.05,393.3,2528.0,53
CPT,78299,UNLISTED GI PX DX NUC MED,,,408.34,420.59,15
CPT,78300,"HC BONE AND/OR JOINT IMAGING, LIMITED AREA",1387.0,762.85,408.34,2528.0,53
CPT,78305,"HC BONE AND/OR JOINT IMAGING, MULTIPLE AREAS",1470.0,808.5,408.34,2528.0,53
CPT,78306,"HC BONE AND/OR JOINT IMAGING, WHOLE BODY",2512.0,1381.6,408.34,2528.0,53
CPT,78315,"HC BONE AND/OR JOINT IMAGING, 3 PHASE STUDY",2155.0,1185.25,408.34,2528.0,53
CPT,78350,BONE MINERAL SINGLE PHOTON,,,29.62,30.51,15
CPT,78351,BONE MINERAL DUAL PHOTON,,,13.63,14.04,15
CPT,78399,UNLISTED MUSCSKEL PX DX NUC,,,408.34,420.59,15
CPT,78414,NON-IMAGING HEART FUNCTION,,,546.99,563.4,15
CPT,78428,HC CARDIAC SHUNT IMAG,6386.0,3512.3,408.34,5523.89,53
CPT,78429,MYOCRD IMG PET 1 STD W/CT,,,1482.22,1526.69,15
CPT,78430,"HC MYOCARDIAL IMAGING, PET PERFUSION SINGLE STUDY REST/STRESS CONCURRENT CT",5087.0,2797.85,1453.0,4400.26,53
CPT,78431,"HC MYOCARDIAL IMAGING, PET PERFUSION MULT STUDIES REST/STRESS CONCURRENT CT",5950.0,3272.5,1453.0,5146.75,53
CPT,78432,MYOCRD IMG PET 2RTRACER,,,1880.48,1936.89,15
CPT,78433,"HC MYOCARDIAL IMAGING, PET COMBINED PERFUSION W/ METAB EVAL STDY CONCRNT CT",6227.0,3424.85,1453.0,5386.36,53
CPT,78434,"HC ABSOLUTE QUANT MYOCARD BLOOD FLOW (AQMBF), PET, REST & PHARM STRESS (AD)",2976.0,1636.8,892.8,2574.24,38
CPT,78445,VASCULAR FLOW IMAGING,,,408.34,420.59,15
CPT,78451,"HC MYOCARDIAL PERFUS IMG, TOMOGRAPH (SPECT), SGL STUDY AT REST/STRESS",4389.0,2413.95,1316.7,3796.49,53
CPT,78452,"HC MYOCARDIAL PERFUS IMG, TOMOGRAPH (SPECT), MULT STUDIES AT REST &/STRESS",5693.0,3131.15,1326.63,4924.45,53
CPT,78453,"HC MYOCARDIAL PERFUSION IMAG, PLANAR, SINGLE STUDY, AT REST OR STRESS",4025.0,2213.75,1207.5,3481.63,53
CPT,78454,"HC MYOCARDIAL PERFUSION IMAG, PLANAR, MULT STUDIES, AT REST AND/OR STRESS",3704.0,2037.2,1111.2,3203.96,53
CPT,78456,ACUTE VENOUS THROMBUS IMAGE,,,1326.63,1366.43,15
CPT,78457,VENOUS THROMBOSIS IMAGING,,,546.99,563.4,15
CPT,78458,VEN THROMBOSIS IMAGES BILAT,,,408.34,420.59,15
CPT,78459,"HC MYOCARD IMG, PET, METABOLIC EVAL STUDY, SGL STUDY",11215.0,6168.25,1326.63,9700.98,53
CPT,78466,HEART INFARCT IMAGE,,,408.34,420.59,15
CPT,78468,HEART INFARCT IMAGE (EF),,,546.99,563.4,15
CPT,78469,"HC MYOCARDIAL IMAG, INFARCT AVID, PLANAR, TOMOGRAPHIC SPECT W/ W/O QUANT",3165.0,1740.75,546.99,2737.73,53
CPT,78472,"HC CARDIAC BLOOD POOL IMG GATED EQUILIBRIUM PLANAR, SGL STDY AT REST/STRESS",1788.0,983.4,408.34,2528.0,53
CPT,78473,GATED HEART MULTIPLE,,,408.34,420.59,15
CPT,78481,HEART FIRST PASS SINGLE,,,546.99,563.4,15
CPT,78483,HEART FIRST PASS MULTIPLE,,,546.99,563.4,15
CPT,78491,"HC MYOCARD IMG, PET, PERFUS, SGL STUDY, AT REST/STRESS",8371.0,4604.05,1482.22,8322.0,53
CPT,78492,MYOCRD IMG PET MLT RST&STRS,,,1482.22,1526.69,15
CPT,78494,HEART IMAGE SPECT,,,408.34,420.59,15
CPT,78496,HEART FIRST PASS ADD-ON,,,38.68,39.84,15
CPT,78499,UNLISTED CV PX DX NUC MED,,,408.34,420.59,15
CPT,78579,HC PULMONARY VENTILATION IMAGING,1056.0,580.8,316.8,2528.0,53
CPT,78580,HC PULMONARY PERFUSION IMAGING,2495.0,1372.25,408.34,2528.0,53
CPT,78582,HC PULMONARY VENTILATION AND PERFUSION IMAGING,2550.0,1402.5,546.99,2528.0,53
CPT,78597,"HC QUANTITATIVE DIFFERENTIAL PULMONARY PERFUSION, INCL IMAG WHEN PERFORMED",1912.0,1051.6,408.34,2528.0,53
CPT,78598,HC QUANTATIVE DIFFERENTIAL PULMONARY PERFUSION AND VENTILATION INCL IMAGING,2370.0,1303.5,546.99,2528.0,53
CPT,78599,UNLISTED RESP PX DX NUC MED,,,408.34,420.59,15
CPT,78600,BRAIN IMAGE < 4 VIEWS,,,408.34,420.59,15
CPT,78601,"HC BRAIN IMAGING, LESS THAN 4 STATIC VIEWS, W/ VASCULAR FLOW",2235.0,1229.25,408.34,2528.0,53
CPT,78605,BRAIN IMAGE 4+ VIEWS,,,546.99,563.4,15
CPT,78606,BRAIN IMAGE W/FLOW 4 + VIEWS,,,546.99,563.4,15
CPT,78608,HC BRAIN IMAGING PET METABOLIC EVALUATION,4643.0,2553.65,1392.9,8322.0,53
CPT,78609,HC BRAIN IMAGING PET PERFUSION EVALUATION,8440.0,4642.0,67.1,8322.0,53
CPT,78610,BRAIN FLOW IMAGING ONLY,,,546.99,563.4,15
CPT,78630,HC CSF FLOW WO MATERIAL CISTERNOGRAPHY,1950.0,1072.5,546.99,2528.0,106
CPT,78635,CSF VENTRICULOGRAPHY,,,546.99,563.4,15
CPT,78645,HC CSF SHUNT EVALUATION,2576.0,1416.8,546.99,2528.0,53
CPT,78650,HC CSF LEAKAGE IMAG,4561.0,2508.55,1326.63,3945.27,53
CPT,78660,HC RADIOPHARMACEUTICAL DACRYOCYSTOGRAPHY,1016.0,558.8,304.8,2528.0,53
CPT,78699,UNLISTED NRVS SYS PX DX NUC,,,408.34,420.59,15
CPT,78700,KIDNEY IMAGING MORPHOL,,,408.34,420.59,15
CPT,78701,"HC KIDNEY IMAGING MORPHOLOGY, WITH VASCULAR FLOW",2029.0,1115.95,408.34,2528.0,53
CPT,78707,"HC KIDNEY IMG MORPH, W/ VASCULAR FLOW AND FUNCT, SGL STDY W/O PHARM INTERV",2464.0,1355.2,546.99,2528.0,53
CPT,78708,"HC KIDNEY IMG MORPH, W/ VASCULAR FLOW AND FUNCT, SGL STDY, W/ PHARM INTERV",2679.0,1473.45,546.99,2528.0,53
CPT,78709,K FLOW/FUNCT IMAGE MULTIPLE,,,546.99,563.4,15
CPT,78725,HC KIDNEY FUNCTION STUDY,2704.0,1487.2,408.34,2528.0,53
CPT,78730,URINARY BLADDER RETENTION,,,61.3,63.14,15
CPT,78740,URETERAL REFLUX STUDY,,,408.34,420.59,15
CPT,78761,TESTICULAR IMAGING W/FLOW,,,408.34,420.59,15
CPT,78799,UNLISTED GU PX DX NUC MED,,,408.34,420.59,15
CPT,78800,"HC RAD PHARM LOCZ TUM, PLANAR, SGL AREA, SGL DAY IMG",1677.0,922.35,408.34,2528.0,53
CPT,78801,"HC RAD PHARM LOCZ TUM, PLANAR, 2/ MORE AREAS, 1/+ DAYS/SGL AREA OVR 2/+DAYS",2303.0,1266.65,408.34,2528.0,53
CPT,78802,"HC RADPHARM LOCZ TUM, PLANAR, WHOLE BODY, SGL DAY IMG",3497.0,1923.35,1049.1,3024.91,53
CPT,78803,"HC RADPHARM LOCZ TUM, SPECT, SGL AREA/ACQUISITION, SGL DAY IMG",3497.0,1923.35,1049.1,3024.91,53
CPT,78804,"HC RADPHARM LOCZ TUM, PLANAR, WHOLE BODY, 2/MORE DAYS IMG",5741.0,3157.55,1326.63,4965.97,53
CPT,78808,"HC INJ PX FOR RADIOPHARM LOCALZ BY NON-IMG PROBE STUDY, IV",657.0,361.35,197.1,2528.0,53
CPT,78811,PET IMAGE LTD AREA,,,1326.63,1366.43,15
CPT,78812,PET IMAGE SKULL-THIGH,,,1482.22,1526.69,15
CPT,78813,PET IMAGE FULL BODY,,,1482.22,1526.69,15
CPT,78814,HC PET IMAGE W CT LIMITED,6945.0,3819.75,1482.22,8322.0,53
CPT,78815,HC PET IMAGE W CT SKULL-THIGH,9785.0,5381.75,1482.22,8464.03,53
CPT,78816,HC PET IMAGE W CT FULL BODY,10815.0,5948.25,1482.22,9354.98,53
CPT,78830,"HC RADPHARM LOCZ TUM, SPECT CONCUR CT, SGL AREA/ACQUISITION, SGL DAY IMG",3981.0,2189.55,1194.3,3443.57,53
CPT,78831,"HC RP LOCZ TUM, SPECT, MIN 2 AR/SEP ACQ, SGL DAY IMG/AR-ACQ OVR 2/+ DAYS",4759.0,2617.45,1326.63,4116.54,53
CPT,78832,"HC RP LOCZ TUM, SPECT CT, MIN 2 AR/SEP ACQ, SGL DAY IMG/AR-ACQ OVR 2/+ DAYS",5218.0,2869.9,1453.0,4513.57,53
CPT,78835,HC RADIOPHARMACEUTICAL QUANTIFICATION MEASUREMENT SINGLE AREA (ADD ON),660.0,363.0,82.08,2528.0,53
CPT,78999,UNLISTED MISC PX DX NUC MED,,,408.34,420.59,15
CPT,79005,HC NUCLEAR RX ORAL ADMIN,1195.0,657.25,227.76,2528.0,53
CPT,79101,HC NUCLEAR RX IV ADMIN,1230.0,676.5,227.76,2528.0,265
CPT,79200,NUCLEAR RX INTRACAV ADMIN,,,227.76,234.59,15
CPT,79300,NUCLR RX INTERSTIT COLLOID,,,227.76,234.59,15
CPT,79403,HC HEMATOPOIETIC NUCLEAR TX,6459.0,3552.45,227.76,5587.04,53
CPT,79440,NUCLEAR RX INTRA-ARTICULAR,,,227.76,234.59,15
CPT,79445,"HC RADIOPHARMACEUTICAL THERAPY, BY INTRA-ARTERIAL PARTICULATE ADMIN",2239.0,1231.45,227.76,2528.0,53
CPT,79999,RP THERAPY UNLISTED PX,,,227.76,234.59,15
CPT,80047,HC METABOLIC PANEL IONIZED CA,202.0,111.1,13.35,174.73,53
CPT,80048,HC METABOLIC PANEL TOTAL CA,169.0,92.95,8.23,146.19,53
CPT,80050,GENERAL HEALTH PANEL,,,39.52,193.16,8
CPT,80051,HC ELECTROLYTE PANEL,289.0,158.95,6.81,249.99,53
CPT,80051,"HC POC, WHOLE BLOOD, ELECTROLYTE PANEL",160.0,88.0,6.81,138.4,159
CPT,80053,HC COMPREHEN METABOLIC PANEL,246.0,135.3,10.26,212.79,106
CPT,80055,HC OBSTETRIC PANEL,471.0,259.05,46.47,407.42,53
CPT,80061,HC LIPID PANEL,209.0,114.95,13.01,180.79,53
CPT,80061,HC LIPID PANEL (NMR),141.0,77.55,13.01,121.97,53
CPT,80069,HC RENAL FUNCTION PANEL,177.0,97.35,8.44,153.11,53
CPT,80074,HC ACUTE HEPATITIS PANEL,606.0,333.3,46.3,524.19,53
CPT,80076,HC HEPATIC FUNCTION PANEL,229.0,125.95,7.94,212.79,106
CPT,80081,HC OBSTETRIC PANEL (INCLUDES HIV TESTING),196.0,107.8,58.8,374.3,53
CPT,80143,HC DRUG ASSAY ACETAMINOPHEN,89.0,48.95,18.12,93.2,53
CPT,80145,"HC ANSER ADA SERUM, ADALIMUMAB",2746.0,1510.3,37.49,2375.29,53
CPT,80150,HC AMIKACIN PEAK ASSAY,132.0,72.6,14.66,114.18,53
CPT,80150,HC AMIKACIN RANDOM ASSAY,133.0,73.15,14.66,115.05,53
CPT,80150,HC AMIKACIN TROUGH ASSAY,132.0,72.6,14.66,114.18,53
CPT,80151,HC AMIODARONE,63.0,34.65,18.12,93.2,53
CPT,80155,"HC CAFFEINE, DRUG ASSAY",107.0,58.85,32.1,192.85,53
CPT,80155,HC DRUG SCREEN QUANT CAFFEINE,80.0,44.0,24.0,192.85,106
CPT,80156,HC ASSAY CARBAMAZEPINE TOTAL,202.0,111.1,14.16,174.73,53
CPT,80156,"HC CARBAMAZEPINE, TOTAL ASSAY",76.0,41.8,14.16,72.85,53
CPT,80157,HC ASSAY CARBAMAZEPINE FREE,70.0,38.5,12.88,66.25,53
CPT,80158,HC CYCLOSPORINE & METABOLITE + PARENT ASSAY,456.0,250.8,17.54,394.44,53
CPT,80158,HC CYCLOSPORINE PARENT ASSAY,300.0,165.0,17.54,259.5,53
CPT,80159,HC DRUG SCREEN QUANT CLOZAPINE,62.0,34.1,18.6,100.75,53
CPT,80161,"HC CARBAMAZEPINE, -10, 11-EPOXIDE",94.0,51.7,18.12,93.2,53
CPT,80162,HC DIGOXIN TOTAL ASSAY,165.0,90.75,12.92,142.73,106
CPT,80163,ASSAY OF DIGOXIN FREE,,,12.92,66.4,23
CPT,80164,"HC DRUG ASSAY, VALPROIC ACID (DIPROPYLACETIC ACID), TOTAL",190.0,104.5,13.17,164.35,53
CPT,80165,"HC VALPROIC ACID (DIPROPYLACETIC ACID), FREE, DRUG SCREEN",61.0,33.55,13.17,67.7,106
CPT,80167,HC FELBAMATE,201.0,110.55,18.12,173.87,53
CPT,80168,HC ETHOSUXIMIDE ASSAY,45.0,24.75,13.5,81.7,53
CPT,80169,HC DRUG SCREEN QUANT EVEROLIMUS,388.5,213.675,13.35,373.68,106
CPT,80170,HC GENTAMICIN ASSAY,115.0,63.25,15.92,99.48,53
CPT,80170,"HC GENTAMICIN ASSAY, PEAK",115.0,63.25,15.92,99.48,53
CPT,80170,"HC GENTAMICIN ASSAY, RANDOM",115.0,63.25,15.92,99.48,53
CPT,80171,HC GABEPENTIN WHOLE BLOOD-SERUM-PLASMA ASSAY,72.0,39.6,21.06,108.35,53
CPT,80173,HC HALOPERIDOL ASSAY,62.0,34.1,15.35,78.9,53
CPT,80175,HC DRUG SCREEN QUANT LAMOTRIGINE (LAMICTAL),142.0,78.1,12.88,122.83,53
CPT,80176,HC LIDOCAINE ASSAY,79.0,43.45,14.28,73.45,53
CPT,80177,HC DRUG SCREEN QUANT LEVETIRACETAM,159.0,87.45,12.88,137.54,106
CPT,80178,HC LITHIUM ASSAY,93.0,51.15,6.43,80.45,53
CPT,80179,HC DRUG ASSAY SALICYLATE,47.0,25.85,14.1,93.2,53
CPT,80180,HC DRUG SCREEN QUANT MYCOPHENOLIC ACID,175.0,96.25,17.54,151.38,53
CPT,80181,HC FLECAINIDE,88.0,48.4,18.12,93.2,53
CPT,80183,"HC TRILEPTAL, OXCARBAZEPINE DRUG SCREEN, QUANT",66.0,36.3,12.88,66.25,53
CPT,80184,HC PHENOBARBITAL ASSAY,142.0,78.1,14.87,122.83,106
CPT,80185,HC PHENYTOIN ASSAY TOTAL,175.0,96.25,12.88,151.38,53
CPT,80186,"HC PHENYTOIN, FREE, DRUG SCREEN",102.0,56.1,13.37,88.23,106
CPT,80187,HC POSACONAZOLE,148.0,81.4,26.35,135.55,53
CPT,80188,HC PRIMIDONE ASSAY,72.0,39.6,16.13,82.95,53
CPT,80189,HC DRUG ASSAY ITRACONZAOLE,93.0,51.15,26.35,135.55,53
CPT,80190,ASSAY OF PROCAINAMIDE,,,58.32,300.0,23
CPT,80192,HC PROCAINAMIDE ASSAY,252.0,138.6,16.28,217.98,53
CPT,80193,HC LEFLUNOMIDE,188.0,103.4,37.49,192.85,106
CPT,80194,HC QUINIDINE ASSAY,89.0,48.95,14.19,76.99,53
CPT,80195,HC SIROLIMUS ASSAY,217.0,119.35,13.35,187.71,53
CPT,80197,HC TACROLIMUS ASSAY,180.0,99.0,13.35,155.7,53
CPT,80198,HC THEOPHYLLINE ASSAY,137.0,75.35,13.74,118.51,53
CPT,80199,"HC GABITRIL, TIAGABINE DRUG SCREEN, QUANT",175.0,96.25,26.35,151.38,53
CPT,80200,HC TOBRAMYCIN ASSAY,136.0,74.8,15.68,117.64,53
CPT,80200,"HC TOBRAMYCIN ASSAY, PEAK",136.0,74.8,15.68,117.64,53
CPT,80200,"HC TOBRAMYCIN ASSAY, RANDOM",136.0,74.8,15.68,117.64,53
CPT,80201,HC TOPIRAMATE (TOPAMAX) ASSAY,140.0,77.0,11.58,121.1,106
CPT,80202,HC VANCOMYCIN ASSAY,170.0,93.5,13.17,147.05,53
CPT,80202,"HC VANCOMYCIN ASSAY, PEAK",170.0,93.5,13.17,147.05,53
CPT,80202,"HC VANCOMYCIN ASSAY, RANDOM",170.0,93.5,13.17,147.05,53
CPT,80202,HC VANCOMYCIN CSF ASSAY,220.0,121.0,13.17,190.3,53
CPT,80203,HC DRUG SCREEN QUANT ZONISAMIDE,278.0,152.9,12.88,240.47,106
CPT,80204,HC DRUG ASSAY METHOTREXATE,79.0,43.45,23.7,192.85,53
CPT,80210,HC RUFINAMIDE,131.0,72.05,26.35,135.55,53
CPT,80220,DRUG ASY HYDROXYCHLOROQUINE,,,18.12,93.2,23
CPT,80230,"HC ANSER IFX SERUM, INFLIXIMAB",556.0,305.8,37.49,480.94,53
CPT,80235,HC LACOSAMIDE,112.0,61.6,26.35,135.55,53
CPT,80280,"HC ANSER VDZ SERUM, VEDOLIZUMAB",591.0,325.05,37.49,511.22,53
CPT,80285,HC VORICONAZOLE,119.0,65.45,26.35,135.55,53
CPT,80299,"HC 5-FLUCYTOSINE, QUANTITATION THERAPEUTIC DRUG, NES",141.0,77.55,18.12,121.97,53
CPT,80299,"HC ADALIMIMAB CONCENTRATION, QUANTITATION THERAPEUTIC DRUG, NES",214.0,117.7,18.12,185.11,53
CPT,80299,"HC AMPHOTERICINE LEVEL, QUANT THER DRUG, NES",226.0,124.3,18.12,195.49,53
CPT,80299,"HC ANSER UST SERUM, USTEKINUMAB, QUANTITATION THERAPEUTIC DRUG, NES",2793.0,1536.15,18.12,2415.95,53
CPT,80299,"HC APIXABAN (UW), QUANTITATION THERAPEUTIC DRUG ASSAY, NES",383.0,210.65,18.12,331.3,53
CPT,80299,"HC APIXABAN LEVEL, QUANTITATION THERAPEUTIC DRUG, NES",201.0,110.55,18.12,173.87,53
CPT,80299,"HC ATENOLOL, QUANT THER DRUG, NES",116.0,63.8,18.12,100.34,53
CPT,80299,"HC AZITHROMYCIN, QUANTITATION THERAPEUTIC DRUG, NES",171.0,94.05,18.12,147.92,53
CPT,80299,"HC BUSULFAN PARMOKINETICS, QUANTITATION THERAPEUTIC DRUG, NES",382.0,210.1,18.12,330.43,53
CPT,80299,"HC CENOBOMATE, QUANT THER DRUG, NES",227.0,124.85,18.12,196.36,53
CPT,80299,"HC CYCLOBENZAPRINE, QUANT THER DRUG, NES",67.0,36.85,18.12,93.2,53
CPT,80299,"HC CYCLOSERINE, QUANTITATION THERAPEUTIC DRUG, NES",168.0,92.4,18.12,145.32,53
CPT,80299,"HC DEXAMETHASONE, QUANTITATION THERAPEUTIC DRUG, NOS",77.0,42.35,18.12,93.2,53
CPT,80299,"HC DIGITOXIN, QUANTITATION THERAPEUTIC DRUG, NES",152.0,83.6,18.12,131.48,53
CPT,80299,"HC DISOPYRAMIDE (NORPACE), QUANTITATION THERAPEUTIC DRUG, NES, ASSAY",59.0,32.45,17.7,93.2,53
CPT,80299,"HC FLUCONAZOLE QUANTITATION OF THERAPEUTIC DRUG, NES",106.0,58.3,18.12,93.2,53
CPT,80299,"HC FLUCONAZOLE, QUANTITATION THERAPEUTIC DRUG, NES",106.0,58.3,18.12,93.2,53
CPT,80299,"HC IMATINIB, QUANTITATION THERAPEUTIC DRUG, NES",94.0,51.7,18.12,93.2,53
CPT,80299,"HC INFLIXIMAB DRUG LEVEL, QUANTITATION THERAPEUTIC DRUG, NES",248.0,136.4,18.12,214.52,53
CPT,80299,"HC ISAVUCONAZOLE, QUANT THER DRUG, NES",552.0,303.6,18.12,477.48,53
CPT,80299,"HC ISONIAZIDE LEVEL, QUANTITATION THERAPEUTIC DRUG, NES",129.0,70.95,18.12,111.59,53
CPT,80299,"HC LAMIVUDINE, QUANTITATION OF THERAPEUTIC DRUG, NOS",140.0,77.0,18.12,121.1,53
CPT,80299,"HC LAMOTRIGINE (LAMICTAL), QUANTITATION THERAPEUTIC DRUG, NES",75.0,41.25,18.12,93.2,53
CPT,80299,"HC LEFLUNOMIDE, QUANTITATION OF THERAPEUTIC DRUG, NOS",110.0,60.5,18.12,95.15,53
CPT,80299,"HC LINEZOLID II, QUANT THER DRUG, NES",171.0,94.05,18.12,147.92,53
CPT,80299,"HC LINEZOLID, QUANTITATION THERAPEUTIC DRUG, NES",160.0,88.0,18.12,138.4,53
CPT,80299,"HC LOXAPINE, QUANT THER DRUG, NES",93.0,51.15,18.12,93.2,53
CPT,80299,"HC MEXILETINE, QUANTITATION THERAPEUTIC DRUG, NES",87.0,47.85,18.12,93.2,53
CPT,80299,"HC MOXIFLOXACIN, QUANTITATION THERAPEUTIC DRUG, NES",118.0,64.9,18.12,102.07,53
CPT,80299,"HC NATALIZUMAB, QUANT THER DRUG, NES",282.0,155.1,18.12,243.93,53
CPT,80299,"HC PIPERACILLIN LEVEL, QUANTITATION THERAPEUTIC DRUG, NES",178.0,97.9,18.12,153.97,53
CPT,80299,"HC RIFABUTIN, QUANTITATION THERAPEUTIC DRUG, NES",153.5,84.43,18.12,132.78,53
CPT,80299,"HC RISANKIZUMAB, QUANT THER DRUG, NES",563.0,309.65,18.12,487.0,53
CPT,80299,"HC RITUXIMAB, QUANT THER DRUG, NES",354.5,194.98,18.12,306.64,53
CPT,80299,"HC RIVAROXABAB, QUANTITATION OF THERAPEUTIC DRUG, NOS",373.0,205.15,18.12,322.65,53
CPT,80299,"HC SYNTHETIC GLUCOCORTICOID SCREEN, QUANTIFICATION OF THERAPEUTIC DRUG, NES",270.0,148.5,18.12,233.55,53
CPT,80299,"HC TRIKAFTA, QUANTITATION DRUG NOT ELSEWHERE SPECIFIED",553.0,304.15,18.12,478.35,53
CPT,80299,"HC VIGABATRIN, QUANT THER DRUG, NES",112.0,61.6,18.12,96.88,53
CPT,80305,DRUG TEST PRSMV DIR OPT OBS,,,12.25,63.0,23
CPT,80306,DRUG TEST PRSMV INSTRMNT,,,16.66,85.7,23
CPT,80307,"HC ACETAMINOPHEN, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",209.0,114.95,60.4,310.7,53
CPT,80307,"HC AMPHETAMINE UR, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",209.0,114.95,60.4,310.7,106
CPT,80307,"HC AMPHETAMINE, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",241.0,132.55,60.4,310.7,53
CPT,80307,"HC ANABOLIC STEROIDS UR, DRG TST, PRSMV, ANY NUM DRG CL, CHM ANLYZ, PER DOS",241.0,132.55,60.4,310.7,53
CPT,80307,"HC BARBITURATES UR, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",218.0,119.9,60.4,310.7,106
CPT,80307,"HC BARBITURATES, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",236.0,129.8,60.4,310.7,53
CPT,80307,"HC BENZODIAZEPINE URINE, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ",218.0,119.9,60.4,310.7,106
CPT,80307,"HC BENZODIAZEPINE, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",236.0,129.8,60.4,310.7,53
CPT,80307,"HC BUPRENORPHINE UR, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ",198.0,108.9,59.4,310.7,53
CPT,80307,"HC BUTORPHANOL UR, DRG TST, PRESUM, ANY NUM DRG CL, CHEM ANYZ, PER DOS",209.0,114.95,60.4,310.7,53
CPT,80307,"HC CANNABINOID UR, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",209.0,114.95,60.4,310.7,106
CPT,80307,"HC CHLOROPHENIRAMINE URINE, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ",209.0,114.95,60.4,310.7,53
CPT,80307,"HC COCAINE CONFIRM, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",265.0,145.75,60.4,310.7,53
CPT,80307,"HC COCAINE URINE, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",209.0,114.95,60.4,310.7,106
CPT,80307,"HC DIAZEPAM & METABOLITE UR, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ",499.0,274.45,60.4,431.64,53
CPT,80307,"HC DRG SCREEN EXP EA, DRG TST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",449.0,246.95,60.4,388.39,53
CPT,80307,"HC DRUG ABUSE FLUID, DRUG TST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",1022.0,562.1,60.4,884.03,53
CPT,80307,"HC DRUG SCREEN PNL 9, DRG TST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",228.0,125.4,60.4,310.7,53
CPT,80307,"HC DRUG TEST PANEL, URINE, PRESUM, ANY NUM DRG, CHEM ANLYZ, PER DOS",345.0,189.75,60.4,310.7,106
CPT,80307,"HC DRUG TEST PANEL, URINE, PRESUM, ANY NUM DRG, CHEM ANLYZ, PER DOS ARUP",94.0,51.7,28.2,310.7,106
CPT,80307,"HC ECSTACY URINE, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",209.0,114.95,60.4,310.7,53
CPT,80307,"HC ETHANOL URINE, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",209.0,114.95,60.4,310.7,106
CPT,80307,"HC ETHYL GLUCURONIDE URINE, DRUG TST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ",172.0,94.6,51.6,310.7,53
CPT,80307,"HC FENTANYL URINE, DRUG TEST",248.0,136.4,60.4,310.7,53
CPT,80307,"HC FLUNITRAZEPAM(ROHYPNOL) UR, DRUG TST, PRESUMP, ANY NUM DRG CL, CHEM ANLZ",209.0,114.95,60.4,310.7,53
CPT,80307,"HC GAMMA HB ACID UR, DRUG TST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",209.0,114.95,60.4,310.7,53
CPT,80307,"HC KATAMINE URINE, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",209.0,114.95,60.4,310.7,53
CPT,80307,"HC KRATOM URINE, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",574.0,315.7,60.4,496.51,53
CPT,80307,"HC LSD SERUM, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",209.0,114.95,60.4,310.7,53
CPT,80307,"HC MDMA CONFIRM, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",209.0,114.95,60.4,310.7,53
CPT,80307,"HC MECONIUM PANEL, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",179.0,98.45,53.7,310.7,53
CPT,80307,"HC MEPERIDINE UR, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",209.0,114.95,60.4,310.7,53
CPT,80307,"HC MEPHEDRONE URINE, DRUG TST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",521.0,286.55,60.4,450.67,53
CPT,80307,"HC METHADONE, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",209.0,114.95,60.4,310.7,106
CPT,80307,"HC NALOXONE, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",1010.0,555.5,60.4,873.65,53
CPT,80307,"HC OPIATE & OPIODS SERUM, DRG TST, PRESUM, ANY NUM DRG CL, CHEM ANYZ",502.0,276.1,60.4,434.23,53
CPT,80307,"HC OPIATE URINE, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",308.0,169.4,60.4,310.7,106
CPT,80307,"HC OXYCODONE OXYMORPHONE, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ",209.0,114.95,60.4,310.7,53
CPT,80307,"HC OXYCODONE URINE, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",209.0,114.95,60.4,310.7,53
CPT,80307,"HC PCP URINE, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",209.0,114.95,60.4,310.7,53
CPT,80307,"HC PHENCYCLIDINE UR, DRG TST, PRESUM, ANY NUM DRG CL, CHEM ANYZ, PER DOS",71.0,39.05,21.3,310.7,53
CPT,80307,"HC PROPOXYPHENE URINE, DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE",126.0,69.3,37.8,310.7,53
CPT,80307,"HC STRYCHNINE UR, DRG TST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",538.0,295.9,60.4,465.37,53
CPT,80307,"HC SYNTH CANNABINOID, DRG TST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",842.0,463.1,60.4,728.33,53
CPT,80307,"HC SYNTHETIC CANNABINOID UR, DRUG TST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ",241.0,132.55,60.4,310.7,53
CPT,80307,"HC TARGETED DRUG PANEL SCRN, DRG TST, PRESUM, ANY NUM DRG CL, CHEM ANYZ",18.0,9.9,5.4,310.7,53
CPT,80307,"HC TARGETED DRUG PANEL, DRG TST, PRESUM, ANY NUM",8.5,4.68,2.55,310.7,53
CPT,80307,"HC TMS URINE, DRUG TEST PRSMV CHEM ANLYZR PER DOS",187.0,102.85,56.1,310.7,53
CPT,80307,"HC TRICYCLIC, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS",209.0,114.95,60.4,310.7,53
CPT,80307,"HC UNBILICAL CORD PNL, DRG TST, PRESUM, ANY NUM DRG CL, CHEM ANYZ",426.0,234.3,60.4,368.49,53
CPT,80307,"HC URINE DRUG SCREEN, DRUG TEST PRESUMPTIVE CHEMISTRY ANALYZER",577.0,317.35,60.4,499.11,53
CPT,80320,"HC VOLATILE, ALCOHOLS DRUG SCREEN",278.0,152.9,83.4,240.47,38
CPT,80321,"HC ETHYL GLUCURONIDE CONFIRMATION, ALCOHOL BIOMARKERS, 1 OR 2",145.0,79.75,43.5,125.43,38
CPT,80321,"HC PHOSPHATIDYLETHANOL, ALCOHOL BIOMARKERS, 1 OR 2",174.0,95.7,52.2,150.51,38
CPT,80323,"HC ALKALOIDS, NOS, NICOTINE & METABOLITES, URINE, CONF",135.0,74.25,40.5,116.78,76
CPT,80323,"HC ALKALOIDS, NOS, NICOTINE AND METABOLITE QUANT SERUM",163.0,89.65,48.9,141.0,38
CPT,80323,"HC MECONIUM, ALKALOIDS, NOS",131.0,72.05,39.3,114.28,38
CPT,80323,"HC NICOTINE METABOLITE URINE, ALKALOIDS, NOT OTHERWISE SPECIFIED",159.0,87.45,47.7,137.54,38
CPT,80323,"HC PSILOCYBIN, ALKALOIDS, NOS",730.0,401.5,114.28,631.45,38
CPT,80324,HC AMPHETAMINES 1-2 LISDEXAMFETAMINES ASSAY,432.0,237.6,114.28,373.68,38
CPT,80324,HC AMPHETAMINES D/L DIFFERENTIATION,409.0,224.95,114.28,353.79,38
CPT,80324,"HC CONFIRMATION, DRUG SCREEN, AMPHETAMINES, 1 OR 2",163.0,89.65,48.9,141.0,38
CPT,80324,"HC MECONIUM CONFIRMATION, AMPHETAMINE, 1 OR 2",159.0,87.45,47.7,137.54,38
CPT,80324,"HC METHAMPHETAMINE, DRUG SCREEN, AMPHETAMINES, 1 OR 2",163.0,89.65,48.9,141.0,38
CPT,80325,"HC AMPHETAMINES 3 OR 4, UMBILICAL TISSUE, DRUG SCREEN QUANT",131.0,72.05,39.3,113.32,38
CPT,80325,"HC MECONIUM, AMPHETAMINES, 3 OR 4 , DRUG SCREEN",131.0,72.05,39.3,113.32,38
CPT,80325,"HC METHAMPHETAMINE QUANT URINE, AMPHETAMINES, 3 OR 4 , DRUG SCREEN",145.0,79.75,43.5,125.43,38
CPT,80326,"HC CONFIRMATION, AMPHETAMINES, 5 OR MORE",186.0,102.3,55.8,160.89,38
CPT,80326,"HC MECONIUM, AMPHETAMINES, 5/MORE",139.0,76.45,41.7,120.24,38
CPT,80326,"HC TARGETED DRUG PANEL, AMPHEMATIME",8.5,4.68,2.55,7.35,38
CPT,80326,"HC TARGETED DRUG PANEL, AMPHETAMINES, 5/MORE",18.0,9.9,5.4,15.57,38
CPT,80326,"HC UMBILICAL TISSUE, AMPHETAMINES, 5/MORE",134.0,73.7,40.2,115.91,38
CPT,80327,ANABOLIC STEROID 1 OR 2,,,114.28,114.28,2
CPT,80329,HC ANALGESICS NON-OPIOD 1-2 IBUPROFEN URINE ASSAY,145.0,79.75,43.5,125.43,38
CPT,80329,"HC DRUG SCREEN, ANALGESICS, NON-OPIOD, 1 OR 2, ACETAMINOPHEN",145.0,79.75,43.5,125.43,38
CPT,80329,"HC IBUPROFEN, DRUG SCREEN, ANALGESICS, NON-OPIOD, 1-2",163.0,89.65,48.9,141.0,38
CPT,80329,"HC NAPROXEN, DRUG SCREEN, ANALGESICS, NON-OPIOD, 1-2",203.0,111.65,60.9,175.6,38
CPT,80331,"HC NSAID PANEL, ANALGESICS, NON-OPIOID, 6 OR MORE",717.0,394.35,215.1,620.21,38
CPT,80332,HC ANTIDEPRESSANTS SEROTONERGIC CLASS 1-2 ESCITALOPRAM (LEXAPRO) ASSAY,151.0,83.05,45.3,130.62,38
CPT,80332,"HC CITALOPRAM (CELEXA), ANTIDEPRESSANTS, SEROTONERGIC CLASS, 1 OR 2",284.0,156.2,85.2,245.66,38
CPT,80332,"HC DULOXETINE (CYMBALTA), ANTIDEPRESSANTS, SEROTONERGIC CLASS, 1 OR 2",151.0,83.05,45.3,130.62,38
CPT,80332,"HC FLUOXETINE, ANTIDEPRESSANTS, SEROTONERGIC CLASS, 1 OR 2",208.0,114.4,62.4,179.92,38
CPT,80332,"HC FLUVOXAMINE, ANTIDEPRESSANTS, SEROTONERGIC CLASS, 1/2",145.0,79.75,43.5,125.43,38
CPT,80332,"HC SERTRALINE, ANTIDEPRESSANTS, SEROTONERGIC CLASS, 1 OR 2",163.0,89.65,48.9,141.0,38
CPT,80333,"HC URINE, ANTIDEPRESSANTS, SEROTONERGIC CLASS, 3 TO 5",164.0,90.2,49.2,141.86,38
CPT,80335,"HC ANTIDEPRESSANTS, TRICYCLIC AND OTHER CYCLICALS, 1 OR 2, AMITRIPTYLINE",159.0,87.45,47.7,137.54,38
CPT,80335,"HC ANTIDEPRESSANTS, TRICYCLIC AND OTHER CYCLICALS, 1 OR 2, DOXEPIN",159.0,87.45,47.7,137.54,38
CPT,80335,"HC ANTIDEPRESSANTS, TRICYCLIC AND OTHER CYCLICALS, 1 OR 2, IMIPRAMINE",159.0,87.45,47.7,137.54,38
CPT,80335,"HC ANTIDEPRESSANTS, TRICYCLIC AND OTHER CYCLICALS, 1 OR 2, NORTRIPTYLINE",159.0,87.45,47.7,137.54,38
CPT,80335,"HC CLOMIPRAMINE, ANTIDEPRESSANTS, TRICYCLIC AND OTHER CYCLICALS, 1 OR 2",140.0,77.0,42.0,121.1,38
CPT,80335,"HC DESIPRAMINE, ANTIDEPRESSANTS, TRICYCLIC AND OTHER CYCLICALS, 1 OR 2",159.0,87.45,47.7,137.54,38
CPT,80337,"HC URINE, ANTIDEPRESSANTS, TRICYCLICLIC AND OTHER CYCLICALS, 6 OR MORE",164.0,90.2,49.2,141.86,38
CPT,80338,HC ANTIDEPRESSANTS NOS BUPROPION (WELLBUTRIN) ASSAY,150.0,82.5,45.0,129.75,38
CPT,80338,"HC TRAZODONE, ANTIDEPRESSANTS, NOS",159.0,87.45,47.7,137.54,38
CPT,80338,HC VENLAFAXINE (EFFEXOR) QUANT COL CHRMTGRPH MULT ANALYTES (2),160.0,88.0,48.0,138.4,38
CPT,80339,HC ANTIEPILEPTICS NOS 1-3 VIGABATRIN (SABRIL),131.0,72.05,39.3,114.28,38
CPT,80339,"HC ANTIEPILEPTICS, NOS, 1-3, CLOBAZAM",194.0,106.7,58.2,167.81,38
CPT,80339,"HC CLOBAZAM AND DESMETHYCLOBAZAM, ANTIEPILEPTICS, NOS 1-3",302.0,166.1,90.6,261.23,38
CPT,80339,"HC PERAMPANEL, ANTIEPILEPTICS, NOS, 1-3",331.0,182.05,99.3,286.32,38
CPT,80342,"HC ARIPIPRAZOLE, ANTIPSYCHOTICS, NOS, 1-3",164.0,90.2,49.2,141.86,38
CPT,80342,"HC BREXPIPRAZOLE, ANTIPSYCHOTICS NOT OTHERWISE SPECIFIED 1-3",359.0,197.45,107.7,310.54,38
CPT,80342,"HC CHLORPROMAZINE, ANTIPSYCHOTICS, NOS, 1-3",155.0,85.25,46.5,134.08,38
CPT,80342,"HC LURASIDONE, ANTIPSYCHOTICS, NOS, 1-3",314.0,172.7,94.2,271.61,38
CPT,80342,"HC OLANZEPINE (ZYPREXA), ANTIPSYCHOTICS NOS, 1-3",119.0,65.45,35.7,114.28,38
CPT,80342,"HC PALIPERIDONE, ANTIPSYCHOTICS, NOS, 1-3",110.0,60.5,33.0,114.28,38
CPT,80342,"HC PROLIXIN (FLUPHENAZINE), ANTIPSYCHOTICS, NOS, 1-3",163.0,89.65,48.9,141.0,38
CPT,80342,"HC QUETIAPINE (SEROQUEL), ANTIPSYCHOTICS, NOS, 1-3",163.0,89.65,48.9,141.0,38
CPT,80342,"HC RISPERADONE (RISPERAL), ANTIPSYCHOTICS, NOS; 1-3",159.0,87.45,47.7,137.54,38
CPT,80342,"HC THIOTHIXENE (NAVANE), ANTIPSYCHOTICS, NOS, 1-3",163.0,89.65,48.9,141.0,38
CPT,80342,"HC TRILAFON, ANTIPSYCHOTICS, NOS, 1-3",159.0,87.45,47.7,137.54,38
CPT,80345,"HC BARBITURATES UMBILICAL TISSUE, DRUG SCREENING",131.0,72.05,39.3,114.28,38
CPT,80345,"HC BARBITURATES, SERUM, QUANT, DRUG SCREENING",555.0,305.25,114.28,480.08,38
CPT,80345,"HC CONFIRMATION, DRUG SCREEN, BARBITURATES",163.0,89.65,48.9,141.0,38
CPT,80345,"HC DRUG SCREEN, BARBITURATES, URINE CONFIRMATION",149.0,81.95,44.7,128.89,38
CPT,80345,"HC MECONIUM CONFIRMATION, BARBITURATES",286.0,157.3,85.8,247.39,38
CPT,80345,"HC MECONIUM, BARBITURATES",131.0,72.05,39.3,114.28,38
CPT,80345,"HC TARGETED DRUG PANEL, BARBITURATES",8.5,4.68,2.55,114.28,38
CPT,80345,"HC THIOPENTAL AND PENTOBARBITAL, BARBITURATES",163.0,89.65,48.9,141.0,38
CPT,80346,"HC ALPRAZOLAM (XANAX), BENZODIAZEPINES, 1-12",163.0,89.65,48.9,141.0,38
CPT,80346,"HC ALPRAZOLAM QT URINE, BENZODIAZEPINES, 1-12",155.0,85.25,46.5,134.08,38
CPT,80346,HC BENZODIAZEPINES 1-12 URINE CONFIRMATION ASSAY (2),90.0,49.5,27.0,114.28,38
CPT,80346,"HC BENZODIAZEPINES UMBILICAL TISSUE, DRUG SCREENING",131.0,72.05,39.3,114.28,38
CPT,80346,"HC BENZODIAZEPINES, 1-12",145.0,79.75,43.5,125.43,38
CPT,80346,"HC CHLORDIAZEPOXIDE, BENZODIAZEPINES, 1-12",145.0,79.75,43.5,125.43,38
CPT,80346,"HC CLONAZEPAM AND METABOLITE URINE, BENZODIAZEPINES, 1-12",145.0,79.75,43.5,125.43,38
CPT,80346,"HC DRUG SCREEN, BENZODIAZEPINES, 1-12, CLONAZEPAM",159.0,87.45,47.7,137.54,38
CPT,80346,"HC DRUG SCREEN, BENZODIAZEPINES, 1-12, CLORAZEPATE (TRANXENE)",163.0,89.65,48.9,141.0,38
CPT,80346,"HC DRUG SCREEN, BENZODIAZEPINES, 1-12, FLUNITRAZEPAM (ROHYPNOL) SERUM",153.0,84.15,45.9,132.35,38
CPT,80346,"HC DRUG SCREEN, BENZODIAZEPINES, 1-12, LORAZEPAM",160.0,88.0,48.0,138.4,38
CPT,80346,"HC DRUG SCREEN, BENZODIAZEPINES, 1-12, URINE CONFIRMATION",163.0,89.65,48.9,141.0,38
CPT,80346,"HC DRUG SCREEN, BENZODIAZEPINES, 1-12, VALIUM",255.0,140.25,76.5,220.58,38
CPT,80346,"HC MECONIUM CONFIRMATION, BENZODIAZEPINES, 1-12",273.0,150.15,81.9,236.15,38
CPT,80346,"HC MECONIUM, BENZODIAZEPINES, 1-12",131.0,72.05,39.3,114.28,38
CPT,80347,"HC CONFIRMATION, BENZODIAZEPINES, 13 OR MORE",335.0,184.25,100.5,289.78,38
CPT,80347,"HC CONFIRMATION, DRUG SCREEN, BENZODIAZEPINES, 13 OR MORE",163.0,89.65,48.9,141.0,38
CPT,80347,"HC MECONIUM, BENZODIAZEPINES, 13/MORE",139.0,76.45,41.7,120.24,38
CPT,80347,"HC NOVEL PSYCHOA DRUGS,  BENZODIAZEPINES 13 OR MORE",126.0,69.3,37.8,108.99,38
CPT,80347,"HC TARGETED DRUG PANEL, BENZODIAZEPINES",8.5,4.68,2.55,7.35,38
CPT,80347,"HC TARGETED DRUG PANEL, BENZODIAZEPINES, 13/MORE",18.0,9.9,5.4,15.57,38
CPT,80347,"HC UMBILICAL TISSUE, BENZODIAZEPINES, 13/MORE",134.0,73.7,40.2,115.91,38
CPT,80348,"HC BUPRENORPHINE & METABOLITES, URINE, CONFIRMATION",134.0,73.7,40.2,115.91,38
CPT,80348,HC BUPRENORPHINE CONFIRMATION,163.0,89.65,48.9,141.0,38
CPT,80348,"HC BUPRENORPHINE UMBILICAL TISSUE, DRUG SCREENING",131.0,72.05,39.3,113.32,38
CPT,80348,"HC BUPRENORPHINE, SERUM, QUANT, DRUG SCREENING",563.0,309.65,168.9,487.0,38
CPT,80348,"HC DRUG SCREEN, BUPRENORPHINE URINE",186.0,102.3,55.8,160.89,38
CPT,80348,"HC MECONIUM CONFIRMATION, BUPRENORPHINE",167.0,91.85,50.1,144.46,38
CPT,80348,"HC MECONIUM, BUPRENORPHINE",131.0,72.05,39.3,113.32,38
CPT,80348,"HC TARGETED DRUG PANEL, BUPRENORPHINE",8.5,4.68,2.55,7.35,38
CPT,80349,"HC MECONIUM CONFIRMATION, CANNABINOIDS, NATURAL",217.0,119.35,65.1,187.71,38
CPT,80349,"HC THC CONFIRMATION, DRUG SCREEN, CANNABINOIDS, NATURAL",163.0,89.65,48.9,141.0,38
CPT,80349,"HC THC METABOLITE REFLEX, CANNABINOIDS, NATURAL",159.0,87.45,47.7,137.54,38
CPT,80349,"HC THC METABOLITE SERUM, CANNABINOIDS, NATURAL",159.0,87.45,47.7,137.54,38
CPT,80349,"HC THC URINE QUANTITATIVE, CANNABINOIDS, NATURAL",159.0,87.45,47.7,137.54,38
CPT,80350,CANNABINOIDS SYNTHETIC 1-3,,,114.28,114.28,2
CPT,80352,"HC NOVEL PSYCHOA DRUGS, CANNABINOIDS, SYNTHETIC 7 OR MORE",126.0,69.3,37.8,108.99,38
CPT,80353,"HC COCAINE METABOLITE URINE QUANT, COCAINE, DRUG SCREEN",160.0,88.0,48.0,138.4,76
CPT,80353,"HC COCAINE METABOLITE, URINE, CONFIRMATION",134.0,73.7,40.2,115.91,76
CPT,80353,"HC COCAINE UMBILICAL TISSUE, DRUG SCREENING",131.0,72.05,39.3,114.28,38
CPT,80353,"HC CONFIRMATION, DRUG SCREEN, COCAINE",163.0,89.65,48.9,141.0,38
CPT,80353,"HC DRUG SCREEN, COCAINE",252.0,138.6,75.6,217.98,38
CPT,80353,"HC DRUG SCREEN, COCAINE, METABOLITE CONFIRMATION",163.0,89.65,48.9,141.0,38
CPT,80353,"HC DRUG SCREEN, COCAINE, SERUM",175.0,96.25,52.5,151.38,38
CPT,80353,"HC MECONIUM CONFIRMATION, COCAINE",210.0,115.5,63.0,181.65,38
CPT,80353,"HC MECONIUM, COCAINE",131.0,72.05,39.3,114.28,38
CPT,80354,"HC FENTANYL & METABOLITE, URINE, CONFIRMATION",134.0,73.7,40.2,115.91,76
CPT,80354,HC FENTANYL CONFIRMATION,163.0,89.65,48.9,141.0,38
CPT,80354,"HC FENTANYL URINE, DRUG SCREENING",160.0,88.0,48.0,138.4,38
CPT,80354,"HC FENTANYL, DRUG TEST",153.0,84.15,45.9,132.35,38
CPT,80354,"HC FENTANYL, UMBILICAL TISSUE, DRUG SCREENING",131.0,72.05,39.3,114.28,38
CPT,80354,"HC MECONIUM, FENTANYLS",131.0,72.05,39.3,114.28,38
CPT,80354,"HC NOVEL PSYCHOA DRUGS, FENTANYL",126.0,69.3,37.8,114.28,38
CPT,80355,"HC MECONIUM, GABAPENTIN, NON-BLOOD",131.0,72.05,39.3,114.28,38
CPT,80355,"HC TARGETED DRUG PANE, GABAPENTIN",8.5,4.68,2.55,114.28,38
CPT,80355,"HC TARGETED DRUG PANEL, GABAPENTIN, NON-BLOOD",18.0,9.9,5.4,114.28,38
CPT,80355,"HC UMBILICAL TISSUE, GABAPENTIN, NON-BLOOD",131.0,72.05,39.3,114.28,38
CPT,80356,"HC CONFIRMATION, DRUG SCREEN, HEROINE METABOLITE",163.0,89.65,48.9,141.0,38
CPT,80356,"HC DRUG SCREEN, HEROINE METABOLITE",250.0,137.5,75.0,216.25,38
CPT,80356,"HC DRUG SCREEN, HEROINE METABOLITE, 6-MONOACETYLMOPHINE URINE",163.0,89.65,48.9,141.0,38
CPT,80356,"HC HEROIN METABOLITE IN OPIATE UNCONJUGATE, HEROINE METABOLITE",145.0,79.75,43.5,125.43,38
CPT,80356,"HC HEROIN METABOLITE, UMBILICAL TISSUE, DRUG SCREENING",131.0,72.05,39.3,114.28,38
CPT,80356,"HC MECONIUM, HEROIN METABOLITE",131.0,72.05,39.3,114.28,38
CPT,80356,"HC TARGETED DRUG PANEL, HEROIN METABOLITE",8.5,4.68,2.55,114.28,38
CPT,80357,"HC CONFIRMATION URINE, KETAMINE AND NORKETAMINE",349.0,191.95,104.7,301.89,38
CPT,80358,"HC DRUG SCREEN, METHADONE SERUM",159.0,87.45,47.7,137.54,38
CPT,80358,"HC MECONIUM CONFIRMATION, METHADONE",208.0,114.4,62.4,179.92,38
CPT,80358,"HC MECONIUM, METHADONE",131.0,72.05,39.3,114.28,38
CPT,80358,"HC METHADONE & METABOLITE, URINE, CONFIRMATION",134.0,73.7,40.2,115.91,76
CPT,80358,HC METHADONE CONFIRMATION,163.0,89.65,48.9,141.0,38
CPT,80358,HC METHADONE CONFIRMATION REFLEX,451.0,248.05,114.28,390.12,38
CPT,80358,HC METHADONE METABOLITE (EDP) URINE,151.0,83.05,45.3,130.62,38
CPT,80358,"HC METHADONE UMBILICAL TISSUE, DRUG SCREENING",131.0,72.05,39.3,114.28,38
CPT,80358,"HC METHADONE URINE, DRUG SCREENING",159.0,87.45,47.7,137.54,38
CPT,80359,"HC AMPHETAMINE MDA CONFIRM, DRUG SCREEN, METHYLENEDIOXYAMPHETAMINES",188.0,103.4,56.4,162.62,38
CPT,80359,"HC AMPHETAMINE MDA, METHYLENEDIOXYAMPHETAMINES (MDA, MDEA, MDMA)",164.0,90.2,49.2,141.86,38
CPT,80359,"HC CONFIRMATION, DRUG SCREEN, METHYLENEDIOXYAMPHETAMINES (MDA, MDEA, MDMA)",163.0,89.65,48.9,141.0,38
CPT,80359,"HC ECSTACY (MDMA) URINE, DRUG SCREEN, METHYLENEDIOXYAMPHETAMINES",167.0,91.85,50.1,144.46,38
CPT,80359,"HC MDA QUANT URINE, METHYLENEDIOXYAMPHETAMINES, DRUG SCREEN",159.0,87.45,47.7,137.54,38
CPT,80359,"HC MECONIUM CONFIRMATION, METHYLENEDIOXYAMPHETAMINES (MDA, MDEA, MDMA)",159.0,87.45,47.7,137.54,38
CPT,80359,"HC MECONIUM, METHYLENEDIOXYAMPHETAMINES",131.0,72.05,39.3,114.28,38
CPT,80359,HC METHYLENEDIOXYAMPHETAMINES,174.0,95.7,52.2,150.51,38
CPT,80359,"HC METHYLENEDIOXYAMPHETAMINES, UMBILICAL TISSUE, DRUG SCREENING",131.0,72.05,39.3,114.28,38
CPT,80359,"HC TARGETED DRUG PANEL, METHYLENEDIOXYAMPHETAMINES",8.5,4.68,2.55,114.28,38
CPT,80360,"HC MECONIUM, METHYLPHENIDATE",131.0,72.05,39.3,114.28,38
CPT,80360,HC METHYLPHENIDATE RITALIN ASSAY,197.0,108.35,59.1,170.41,38
CPT,80360,"HC TARGETED DRUG PANEL, METHYLPHENIDATE",8.5,4.68,2.55,114.28,38
CPT,80361,"HC CONFIRMATION, DRUG SCREEN, OPIATES, 1 OR MORE (2)",163.0,89.65,48.9,141.0,38
CPT,80361,"HC DRUG SCREEN, OPIATES, 1 OR MORE",159.0,87.45,47.7,137.54,38
CPT,80361,"HC HYDROCODONE (VICODIN), DRUG SCREEN, OPIATES, 1 OR MORE",145.0,79.75,43.5,125.43,38
CPT,80361,"HC HYDROCODONE URINE, DRUG SCREEN, OPIATES, 1 OR MORE",196.0,107.8,58.8,169.54,38
CPT,80361,"HC HYDROCODONE, URINE, OPIATES, 1 OR MORE",126.0,69.3,37.8,114.28,38
CPT,80361,"HC HYDROMORPHONE URINE, DRUG SCREEN, OPIATES, 1 OR MORE",196.0,107.8,58.8,169.54,38
CPT,80361,"HC MECONIUM CONFIRMATION, OPIATES, 1 OR MORE",159.0,87.45,47.7,137.54,38
CPT,80361,"HC MECONIUM, OPIATES, 1 OR MORE",131.0,72.05,39.3,114.28,38
CPT,80361,"HC MORPHINE URINE, DRUG SCREEN, OPIATES, 1 OR MORE",196.0,107.8,58.8,169.54,38
CPT,80361,"HC MORPHINE, DRUG SCREEN, OPIATES, 1 OR MORE",171.0,94.05,51.3,147.92,38
CPT,80361,"HC OPIATE UNCONJUGATE, OPIATES, 1 OR MORE",145.0,79.75,43.5,125.43,38
CPT,80361,"HC OPIATES 1 OR MORE, UMBILICAL TISSUE, DRUG SCREENING",131.0,72.05,39.3,114.28,38
CPT,80361,"HC OPIATES, 1 OR MORE, URINE, CONFIRMATION",134.0,73.7,40.2,115.91,76
CPT,80361,"HC SERUM, DRUG SCREEN, OPIATES, 1 OR MORE",160.0,88.0,48.0,138.4,38
CPT,80361,"HC URINE QUANT, OPIATES, 1/MORE",140.0,77.0,42.0,121.1,38
CPT,80362,"HC BUTORPHANOL, OPIOIDS AND OPIATE ANALOGS, 1/2",493.0,271.15,114.28,426.45,38
CPT,80362,"HC DEXTROMETHORPHAN URINE, OPIOIDS AND OPIATE ANALOGS, 1 OR 2",201.0,110.55,60.3,173.87,38
CPT,80362,"HC DRUG SCREEN, OPIOIDS AND OPIATE ANALOGS, 1 OR 2",173.0,95.15,51.9,149.65,38
CPT,80362,"HC MECONIUM, OPIOIDS AND OPIATE ANALOGS, 1 OR 2",131.0,72.05,39.3,114.28,38
CPT,80363,"HC OPIOID AND OPIATE ANALOGS 3 OR 4, UMBILICAL TISSUE, DRUG SCREENING",131.0,72.05,39.3,113.32,38
CPT,80364,"HC MECONIUM, OPIOIDS AND OPIATE ANALOGS, 5/MORE",139.0,76.45,41.7,120.24,38
CPT,80364,"HC NOVEL PSYCHOA DRUGS, OPIATES AND OPIATE ANALOGS, 5/MORE",126.0,69.3,37.8,108.99,38
CPT,80364,"HC OPIOID TESTING, OPIOID &OPIATE ANALOG 5/MORE",312.0,171.6,93.6,269.88,38
CPT,80364,"HC TARGETED DRUG PANEL, OPIOIDS AND OPIATE",8.5,4.68,2.55,7.35,38
CPT,80364,"HC TARGETED DRUG PANEL, OPIOIDS AND OPIATE ANALOGS, 5/MORE",18.0,9.9,5.4,15.57,38
CPT,80364,"HC UMBILICAL TISSUE, OPIOIDS AND OPIATE ANALOGS, 5/MORE",134.0,73.7,40.2,115.91,38
CPT,80365,"HC DRUG SCREEN, OXYCODONE URINE",196.0,107.8,58.8,169.54,38
CPT,80365,"HC DRUG SCREEN, OXYCODONE, SERUM",185.0,101.75,55.5,160.03,38
CPT,80365,"HC MECONIUM CONFIRMATION, OXYCODONE",159.0,87.45,47.7,137.54,38
CPT,80365,"HC MECONIUM CONFIRMATION, OXYCODONE, DRUG SCREEN",162.0,89.1,48.6,140.13,38
CPT,80365,"HC MECONIUM, OXYCODONE",131.0,72.05,39.3,114.28,38
CPT,80365,"HC OPIATE UNCONJUGATE, OXYCODONE",145.0,79.75,43.5,125.43,38
CPT,80365,HC OXYCODONE,159.0,87.45,47.7,137.54,38
CPT,80365,HC OXYCODONE CONFIRMATION,163.0,89.65,48.9,141.0,38
CPT,80365,"HC OXYCODONE, OPIATES, URINE, CONFIRMATION",134.0,73.7,40.2,115.91,76
CPT,80365,"HC OXYCODONE, UMBILICAL TISSUE, DRUG SCREENING",131.0,72.05,39.3,114.28,38
CPT,80365,"HC OXYCODONE/OXYMORPHONE, URINE, CONFIRMATION",134.0,73.7,40.2,115.91,76
CPT,80365,"HC TARGETED DRUG PANEL, OXYCODONE",8.5,4.68,2.55,114.28,38
CPT,80365,"HC URINE QUANT, OXYCODONE",140.0,77.0,42.0,121.1,38
CPT,80366,HC PREGABALIN ASSAY,82.0,45.1,24.6,114.28,38
CPT,80366,"HC TARGETED DRUG PANEL, PREGABALIN",8.5,4.68,2.55,114.28,38
CPT,80367,DRUG SCREENING PROPOXYPHENE,,,114.28,114.28,2
CPT,80368,"HC MECONIUM, SEDATIVE HYPNOTICS (NON-BENZODIAZEPINES)",131.0,72.05,39.3,114.28,38
CPT,80368,"HC METHAQUALONE, SEDATIVE HYPNOTICS (NON-BENZODIAZEPINES)",286.0,157.3,85.8,247.39,38
CPT,80368,"HC SEDATIVE HYPNOTICS UMBILICAL TISSUE, DRUG SCREENING",131.0,72.05,39.3,114.28,38
CPT,80368,"HC TARGETED DRUG PANEL, SEDATIVE HYPNOTICS (NON-BENZODIAZEPINES)",8.5,4.68,2.55,114.28,38
CPT,80369,"HC ANTIDEPRESSANT URINE, SKELETAL MUSCLE RELAXANTS, 1 OR 2",164.0,90.2,49.2,141.86,38
CPT,80369,"HC CARISOPRODOL, SKELETAL MUSCLE RELAXANTS, 1/2",145.0,79.75,43.5,125.43,38
CPT,80371,"NOVEL PSYCHOA DRUGS, STIMULANTS, SYNTHETIC",126.0,69.3,37.8,114.28,38
CPT,80372,"HC MECONIUM, TAPENTADOL",131.0,72.05,39.3,114.28,38
CPT,80372,"HC TAPENTADOL UMBILICAL TISSUE,  DRUG SCREENING",131.0,72.05,39.3,114.28,38
CPT,80372,"HC TARGETED DRUG PANEL, TAPENTADOL",8.5,4.68,2.55,114.28,38
CPT,80373,"HC CONFIRMATION, DRUG SCREEN, TRAMADOL",163.0,89.65,48.9,141.0,38
CPT,80373,"HC DRUG SCREEN, TRAMADOL",163.0,89.65,48.9,141.0,38
CPT,80373,"HC MECONIUM, TRAMADOL",131.0,72.05,39.3,114.28,38
CPT,80373,"HC TRAMADOL URINE, DRUG SCREENING",160.0,88.0,48.0,138.4,38
CPT,80373,"HC TRAMADOL, UMBILICAL TISSUE, DRUG SCREENING",131.0,72.05,39.3,114.28,38
CPT,80374,STEREOISOMER ANALYSIS,,,114.28,114.28,2
CPT,80375,"HC AMANTADINE, DRUG(S)/SUBST(S), DEFTV, QUAL/QUANT, NOS, 1-3",168.0,92.4,50.4,145.32,38
CPT,80375,"HC BENZTROPINE, DRUG(S)/SUBST(S), DEFTV, QUAL/QUANT, NOS, 1-3",159.0,87.45,47.7,137.54,38
CPT,80375,"HC BRIVARACETAM, DRUG/SUBSTANCE DEFINITIVE QUAL/QUANT NOS 1-3",238.0,130.9,71.4,205.87,38
CPT,80375,"HC BRODIFACOUM (D-CON), DRUG(S)/SUBST(S), DEFTV, QUAL/QUAN, NOS, 1-3",163.0,89.65,48.9,141.0,38
CPT,80375,"HC BUPIVACAINE, DRUG OR SUB, DEFINITIVE, QUAL OR QUANT, NOS, 1-3",159.0,87.45,47.7,137.54,38
CPT,80375,"HC BUSPIRONE (BUSPAR), DRUG/SUBSTANCE DEFINITIVE QUAL/QUANT NOS",151.0,83.05,45.3,130.62,38
CPT,80375,"HC CARBIDOPA ANF LEVODOPA, DRUG/SUBSTANCE, QUANT/QUAL,  NOS 1-3",560.0,308.0,114.28,484.4,38
CPT,80375,"HC DABIGATRAN, DRUG(S)/SUBST(S), DEFTV, QUAL/QUANT, NOS, 1-3",159.0,87.45,47.7,137.54,38
CPT,80375,"HC GOLD, DRUG(S)/SUBST(S), DEFTV, QUAL/QUANT, NOS, 1-3",231.0,127.05,69.3,199.82,38
CPT,80375,"HC HYDROXYCHLOROQUINE, DRUG/SUBST, DEFTV, QUAL/QUANT, NOS, 1-3",444.0,244.2,114.28,384.06,38
CPT,80375,"HC ISAVUCONAZOLE, DRUG(S)/SUBST(S), DEFTV, QUAL/QUANT, NOS, 1-3",730.0,401.5,114.28,631.45,38
CPT,80375,"HC ISOTRETINOIN (ACCUTANE), DRUG(S)/SUBST(S), DEFTV, QUAL/QUANT, NOS, 1-3",504.0,277.2,114.28,435.96,38
CPT,80375,"HC LEVAMISOLE, DRUG(S)/SUBST(S), DEFTV, QUAL/QUANT, NOS, 1-3",398.0,218.9,114.28,344.27,38
CPT,80375,"HC MAGNESIUM, DRUG(S)/SUBST(S), DEFTV, QUAL/QUANT, NOS, 1-3",130.0,71.5,39.0,114.28,38
CPT,80375,"HC MELATONIN, DRUG/SUBSTANCE DEFINITIVE QUAL/QUANT NOS 1-3",497.0,273.35,114.28,429.91,38
CPT,80375,"HC METFORMIN, DRUG(S)/SUBST(S), DEFTV, QUAL/QUANT, NOS, 1-3",381.0,209.55,114.28,329.57,38
CPT,80375,"HC METOPROLOL, DRUG/SUBSTANCE DEFINITIVE QUAL/QUANT NOS 1-3",159.0,87.45,47.7,137.54,38
CPT,80375,"HC MITOTANE, DRUG(S)/SUBST(S), DEFTV, QUAL/QUANT, NOS, 1-3",163.0,89.65,48.9,141.0,38
CPT,80375,"HC PROPRANOLOL, DRUG(S)/SUBST(S), DEFTV, QUAL/QUANT, NOS, 1-3",163.0,89.65,48.9,141.0,38
CPT,80375,"HC RIFAMPIN, DRUG(S)/SUBST(S), DEFTV, QUAL/QUANT, NOS, 1-3",259.0,142.45,77.7,224.04,38
CPT,80375,"HC ROPIVACAINE, DRUG(S)/SUBST(S), DEFTV, QUAL/QUANT, NOS, 1-3",546.0,300.3,114.28,472.29,38
CPT,80375,"HC SULFONAMIDE (SULFAS), DRUG/SUBSTANCE DEFINITIVE QUAL/QUANT NOS 1-3",228.0,125.4,68.4,197.22,38
CPT,80375,"HC TAMOXIFEN, DRUG/SUBST, DEFTV, QUAL/QUANT, NOS, 1-3",684.0,376.2,114.28,591.66,38
CPT,80375,"HC WARFARIN, DRUG(S)/SUBST(S), DEFTV, QUAL/QUANT, NOS, 1-3",159.0,87.45,47.7,137.54,38
CPT,80376,"HC LAXATIVE PROFILE, DRUG(S)/SUBSTANCE(S), DEFINITIVE, QUAL/QUANT, NOS, 4-6",499.0,274.45,114.28,431.64,38
CPT,80376,"HC NOVEL PSYCHOA DRUGS, DEFINITIVE 4-6",126.0,69.3,37.8,114.28,38
CPT,80377,"HC ANTICOAG POISON PNL, DRUG(S)/ SUBST(S), DEFINTV, QUAL/QUANT, NOS, 7/MORE",489.0,268.95,114.28,422.99,38
CPT,80377,"HC DIURETIC SCREEN URINE, DRUG(S)/SUBST(S), DEFTV, QUAL/QUANT, NOS, 7/MORE",264.0,145.2,79.2,228.36,38
CPT,80377,"HC SULFOYLUREA SCRN, DRUG(S)/SUBST(S), DEFINITV, QUAL/QUANT, NOS, 7 OR MORE",173.0,95.15,51.9,149.65,38
CPT,80400,ACTH STIMULATION PANEL,,,31.71,163.1,23
CPT,80402,ACTH STIMULATION PANEL,,,84.53,434.8,23
CPT,80406,ACTH STIMULATION PANEL,,,76.07,391.3,23
CPT,80408,ALDOSTERONE SUPPRESSION EVAL,,,121.99,627.5,23
CPT,80410,CALCITONIN STIMUL PANEL,,,78.12,401.85,23
CPT,80412,CRH STIMULATION PANEL,,,779.18,4008.1,23
CPT,80414,TESTOSTERONE RESPONSE PANEL,,,50.19,258.2,23
CPT,80415,TOT ESTRADIOL RESPONSE PANEL,,,54.32,279.45,23
CPT,80416,RENIN STIMULATION PANEL,,,203.45,1046.6,23
CPT,80417,RENIN STIMULATION PANEL,,,42.76,219.95,23
CPT,80418,PITUITARY EVALUATION PANEL,,,563.26,2897.4,23
CPT,80420,DEXAMETHASONE PANEL,,,157.35,809.4,23
CPT,80422,GLUCAGON TOLERANCE PANEL,,,44.78,230.35,23
CPT,80424,GLUCAGON TOLERANCE PANEL,,,49.09,252.5,23
CPT,80426,GONADOTROPIN HORMONE PANEL,,,144.25,742.05,23
CPT,80428,GROWTH HORMONE PANEL,,,64.84,333.5,23
CPT,80430,GROWTH HORMONE PANEL,,,125.71,646.65,23
CPT,80432,INSULIN SUPPRESSION PANEL,,,160.97,828.05,23
CPT,80434,INSULIN TOLERANCE PANEL,,,277.06,1425.15,23
CPT,80435,INSULIN TOLERANCE PANEL,,,100.12,515.0,23
CPT,80436,METYRAPONE PANEL,,,88.61,455.8,23
CPT,80438,TRH STIMULATION PANEL,,,49.0,252.05,23
CPT,80439,TRH STIMULATION PANEL,,,65.33,336.05,23
CPT,80503,PATH CLIN CONSLTJ SF 5-20,,,48.74,130.26,22
CPT,80504,PATH CLIN CONSLTJ MOD 21-40,,,152.85,256.11,22
CPT,80505,PATH CLIN CONSLTJ HIGH 41-60,,,152.85,460.85,22
CPT,80506,PATH CLIN CONSLTJ PROLNG SVC,,,39.31,206.89,22
CPT,81000,HC URINALYSIS NONAUTO W MICROSCOPY,75.0,41.25,3.91,64.88,106
CPT,81001,HC URINALYSIS AUTO W SCOPE,72.0,39.6,3.08,62.28,265
CPT,81002,HC URINALYSIS NONAUTO WO SCOPE,48.0,26.4,3.38,41.52,53
CPT,81003,HC URINALYSIS DIPSTICK,66.0,36.3,2.19,57.09,371
CPT,81003,"HC URINALYSIS DIPSTICK/TABLET REAGENT, AUTOMATED, W/O MICROSCOPY",66.0,36.3,2.19,57.09,424
CPT,81003,HC URINALYSIS PH,60.0,33.0,2.19,51.9,53
CPT,81003,HC URINALYSIS SPECIFIC GRAVITY,60.0,33.0,2.19,51.9,53
CPT,81005,URINALYSIS,,,2.11,10.85,23
CPT,81007,URINE SCREEN FOR BACTERIA,,,29.14,149.9,23
CPT,81015,HC MICROSCOPIC EXAM OF URINE,43.0,23.65,2.96,37.2,159
CPT,81020,URINALYSIS GLASS TEST,,,4.57,23.5,23
CPT,81025,"HC POC URINE PREGNANCY TEST, BY VISUAL COLOR COMPARISON METHODS",129.0,70.95,8.37,111.59,106
CPT,81025,HC URINE PREGNANCY TEST,117.5,64.625,8.37,111.59,159
CPT,81025,HC URINE PREGNANCY TEST POC,135.0,74.25,8.37,116.78,53
CPT,81025,"HC URINE PREGNANCY TEST, BY VISUAL COLOR COMPARISON METHODS",128.5,70.67500000000001,8.37,111.59,1219
CPT,81050,HC URINALYSIS VOLUME MEASURE,50.0,27.5,3.54,43.25,53
CPT,81105,"HC NATP, HPA-1 GENOTYP, ITGB3, GENE ANLYS, COMMON VAR, HPA-1A/B",193.0,106.15,57.9,611.1,53
CPT,81105,HC PLATELET ANTIGEN HPA-1 GENOTYPING GENE ANALYSIS COMMON VARIANT,542.0,298.1,118.79,611.1,53
CPT,81106,"HC NATP, HPA-2 GENOTYP, GP1BA, GENE ANLYS, COMMON VAR, HPA-2A/B",193.0,106.15,57.9,611.1,53
CPT,81106,HC PLATELET ANTIGEN HPA-2 GENOTYPING GENE ANALYSIS COMMON VARIANT,542.0,298.1,118.79,611.1,53
CPT,81107,"HC NATP, HPA-3 GENOTYP, ITGA2B, GENE ANLYS, COMMON VAR, HPA-3A/B",193.0,106.15,57.9,611.1,53
CPT,81107,HC PLATELET ANTIGEN HPA-3 GENOTYPING GENE ANALYSIS COMMON VARIANT,542.0,298.1,118.79,611.1,53
CPT,81108,"HC NATP, HPA-4 GENOTYP, ITGB3, GENE ANLYS, COMMON VAR, HPA-4A/B",193.0,106.15,57.9,611.1,53
CPT,81108,HC PLATELET ANTIGEN HPA-4 GENOTYPING GENE ANALYSIS COMMON VARIANT,542.0,298.1,118.79,611.1,53
CPT,81109,"HC NATP, HPA-5 GENOTYP, ITGA2, GENE ANLYS, COMMON VAR, HPA-5A/B",193.0,106.15,57.9,611.1,53
CPT,81109,HC PLATELET ANTIGEN HPA-5 GENOTYPING GENE ANALYSIS COMMON VARIANT,542.0,298.1,118.79,611.1,53
CPT,81110,"HC NATP, HPA-6W GENOTYP, ITGB3, GENE ANLYS, COMMON VAR, HPA-6A/B",193.0,106.15,57.9,611.1,53
CPT,81110,HC PLATELET ANTIGEN HPA-6 GENOTYPING GENE ANALYSIS COMMON VARIANT,542.0,298.1,118.79,611.1,53
CPT,81111,"HC NATP, HPA-9W GENOTYP, ITGA2B, GENE ANLYS, COMMON VAR, HPA-9A/B",193.0,106.15,57.9,611.1,53
CPT,81111,HC PLATELET ANTIGEN HPA-9 GENOTYPING GENE ANALYSIS COMMON VARIANT,542.0,298.1,118.79,611.1,53
CPT,81112,"HC HPA-15 GENOTYP, CD109, GENE ANLYS, COMMON VAR, HPA-15A/B",298.0,163.9,89.4,611.1,53
CPT,81112,HC PLATELET ANTIGEN HPA-15 GENOTYPING GENE ANALYSIS COMMON VARIANT,542.0,298.1,118.79,611.1,53
CPT,81120,"HC EXON 4 MUTATION, IDH1, COMMON VARIANTS",261.0,143.55,78.3,966.25,53
CPT,81120,"HC IDH1 ABBOTT REAL TIME PCR, COMMON VARIANTS",892.0,490.6,187.84,966.25,53
CPT,81120,"HC IDH1 EXON 4 MUTATION (BCW), IDH1, COMMON VARIANTS",329.0,180.95,98.7,966.25,53
CPT,81120,"HC IDH1 MUTATION TUMOR, COMMON VARIANTS",644.0,354.2,187.84,966.25,53
CPT,81121,"HC EXON 4 MUTATION, IDH2, COMMON VARIANTS",416.0,228.8,124.8,1478.95,53
CPT,81121,"HC IDH2 ABBOT REAL TIME PCR, COMMON VARIANTS",930.0,511.5,279.0,1478.95,53
CPT,81121,"HC IDH2 EXON 4 MUTATION (BCW), IDH2, COMMON VARIANTS",523.0,287.65,156.9,1478.95,53
CPT,81121,"HC IDH2 MUTATION TUMOR, COMMON VARIANTS",974.0,535.7,287.51,1478.95,53
CPT,81161,DMD DUP/DELET ANALYSIS,,,271.19,1395.0,23
CPT,81162,"HC BRCA1, BRCA2 GENE ANALYSIS, FULL SEQUENCE AND FULL DUPL/DEL ANALYSIS",4416.0,2428.8,1324.8,9124.4,53
CPT,81163,BRCA1&2 GENE FULL SEQ ALYS,,,454.9,2340.0,23
CPT,81164,BRCA1&2 GEN FUL DUP/DEL ALYS,,,567.87,2921.15,23
CPT,81165,BRCA1 GENE FULL SEQ ALYS,,,274.96,1414.4,23
CPT,81166,BRCA1 GENE FULL DUP/DEL ALYS,,,292.91,1506.75,23
CPT,81167,BRCA2 GENE FULL DUP/DEL ALYS,,,274.96,1414.4,23
CPT,81168,CCND1/IGH TRANSLOCATION ALYS,,,201.5,1036.55,23
CPT,81170,"HC ABL1, GENE ANALYSIS, VARIANTS IN THE KINASE DOMAIN, BCR ABL",641.0,352.55,192.3,1500.0,53
CPT,81170,"HC BCR MUTATION, ABL 1, GENE ANALYSIS, VARIANTS IN KINASE DOMAIN",578.0,317.9,173.4,1500.0,53
CPT,81170,"HC BCR TYROSINE, ABL1, GENE ANALYSIS, VARIANTS IN THE KINASE DOMAIN",1014.0,557.7,291.6,1500.0,53
CPT,81171,AFF2 GEN ALY DETC ABNL ALLEL,,,133.16,685.0,23
CPT,81172,AFF2 GEN ALYS CHARAC ALLELES,,,267.14,1374.15,23
CPT,81173,AR GENE FULL GENE SEQUENCE,,,292.91,1506.75,23
CPT,81174,AR GENE KNOWN FAMIL VARIANT,,,180.02,926.0,23
CPT,81175,ASXL1 FULL GENE SEQUENCE,,,657.56,3382.5,23
CPT,81176,ASXL1 GENE TARGET SEQ ALYS,,,235.13,1209.5,23
CPT,81177,ATN1 GENE DETC ABNOR ALLELES,,,133.16,685.0,23
CPT,81178,"HC SPINOCEREBELLAR, ATXN1 GENE ANLYS, EVAL DETECT ABNORM ALLELES",301.0,165.55,90.3,685.0,53
CPT,81179,"HC SPINOCEREBELLAR, ATXN2 GENE ANLYS, EVAL DETECT ABNORM ALLELES",301.0,165.55,90.3,685.0,53
CPT,81180,"HC SPINOCEREBELLAR, ATXN3 GENE ANLYS, EVAL DETECT ABNORM ALLELES",301.0,165.55,90.3,685.0,53
CPT,81181,"HC SPINOCEREBELLAR, ATXN7 GENE ANLYS, EVAL DETECT ABNORM ALLELES",301.0,165.55,90.3,685.0,53
CPT,81182,ATXN8OS GEN DETC ABNOR ALLEL,,,133.16,685.0,23
CPT,81183,ATXN10 GENE DETC ABNOR ALLEL,,,133.16,685.0,23
CPT,81184,"HC SPINOCEREBELLAR, CACNA1A GENE ANLYS, EVAL DETECT ABNORM ALLELES",301.0,165.55,90.3,685.0,53
CPT,81185,CACNA1A GENE FULL GENE SEQ,,,822.57,4231.35,23
CPT,81186,CACNA1A GEN KNOWN FAMIL VRNT,,,180.02,926.0,23
CPT,81187,"HC DM2 DNA, CNBP GENE ANLYS, EVAL DETECT ABNORM ALLELES",2209.0,1214.95,133.16,1910.79,53
CPT,81188,CSTB GENE DETC ABNOR ALLELE,,,133.16,685.0,23
CPT,81189,CSTB GENE FULL GENE SEQUENCE,,,267.14,1374.15,23
CPT,81190,CSTB GENE KNOWN FAMIL VRNT,,,180.02,926.0,23
CPT,81191,NTRK1 TRANSLOCATION ANALYSIS,,,201.5,1036.55,23
CPT,81192,NTRK2 TRANSLOCATION ANALYSIS,,,201.5,1036.55,23
CPT,81193,NTRK3 TRANSLOCATION ANALYSIS,,,201.5,1036.55,23
CPT,81194,"HC NTRK GENE FUSION PANEL, TRANSLOCATION ANALYSIS",2264.0,1245.2,503.78,2591.4,53
CPT,81195,CYTOG GENOM-WID ALYS HEM MAL,,,1228.16,6317.65,23
CPT,81200,HC ASPA CANAVAN MUTATION GENE ANALYSIS COMMON VARIANTS,265.0,145.75,45.93,236.25,53
CPT,81201,HC APC MUTATION GENE ANALYSIS FULL GENE SEQUENCE,1979.0,1088.45,593.7,3900.0,53
CPT,81202,APC GENE KNOWN FAM VARIANTS,,,272.16,1400.0,23
CPT,81203,APC GENE DUP/DELET VARIANTS,,,194.4,1000.0,23
CPT,81204,AR GENE CHARAC ALLELES,,,133.16,685.0,23
CPT,81205,HC BCKDHB MSUD MUTATION GENE ANALYSIS COMMON VARIANTS,542.0,298.1,92.33,474.95,53
CPT,81206,"HC AMPLIFICATION CONF, BCR-ABL1 TRANSLOCATION ANLYS MJR BREAKPT QUAL/QUANT",976.0,536.8,159.37,844.24,53
CPT,81206,"HC BCR-ABL QUANT BLOOD, TRANSLOCATION ANLYS, MAJOR BREAKPOINT",806.0,443.3,159.37,819.8,53
CPT,81206,"HC BCR-ABL1 P210 QUANT, TRANSLOCATION ANALYSIS, MAJOR BREAKPOINT",379.0,208.45,113.7,819.8,53
CPT,81206,"HC BCR-ABL1 QUAL W/REFLEX TO P190/P210 QUANT,MAJOR BREAKPT",379.0,208.45,113.7,819.8,53
CPT,81206,HC BCR-ABL1 TRANSLOCATION ANALYSIS MAJOR BREAKPT QUAL OR QUANT,801.0,440.55,159.37,819.8,53
CPT,81206,HC BCR-ABL1 TRANSLOCATION ANALYSIS MAJOR BREAKPT QUANT (2),2138.0,1175.9,159.37,1849.37,53
CPT,81206,"HC BCR-ABL1 TRANSLOCATION ANALYSIS, MAJOR BREAKPT, QUAL OR QUANT (1)",732.0,402.6,159.37,819.8,53
CPT,81206,"HC P210 QUANT, BCR/ABL1 TRANSLOC ANLYS, MAJOR BREAKPT",813.0,447.15,159.37,819.8,53
CPT,81206,"HC QUAL W REFLEX TO QUANT, BCR/ABL1 TRANSLOC ANLYS, MAJOR BREAKPT",310.0,170.5,93.0,819.8,53
CPT,81207,"HC BCR-ABL1 P190 QUANT, TRANSLOCATION ANALYSIS, MINOR BREAKPOINT",379.0,208.45,113.7,724.2,53
CPT,81207,"HC BCR-ABL1 QUAL W/REFLEX TO P190/P210 QUANT, MINOR BREAKPT",379.0,208.45,113.7,724.2,53
CPT,81207,"HC BCR-ABL1 TRANSLOCATN ANALYS, MINOR BREAKPT, QUAL OR QUANT",680.0,374.0,140.79,724.2,53
CPT,81207,"HC BCR/ABL 1 T(9,22), QUAL, MINOR BREAKPOINT, TRANSLOCATION ANALYSIS",406.0,223.3,121.8,724.2,53
CPT,81207,"HC P190 QUANT, BCR/ABL1 TRANSLOC ANLYS, MINOR BREAKPT",857.0,471.35,140.79,741.31,53
CPT,81207,"HC QUAL W REFLEX TO QUANT, BCR/ABL1 TRANSLOC ANLYS, MINOR BREAKPT",327.0,179.85,98.1,724.2,53
CPT,81208,"HC BCR ABL1 TRANSLOCATION ANALYSIS, OTHER BREAKPT, QUAL OR QUANT, GENE P230",521.0,286.55,156.3,1073.1,53
CPT,81208,"HC BCR-ABL1 QUAL W/REFLEX TO P190/P210 QUANT, OTHER BREAKPT",379.0,208.45,113.7,1073.1,53
CPT,81208,"HC BCR-ABL1 TRANSLOCATN ANALYS, OTHER BREAKPT, QUAL OR QUANT",643.0,353.65,192.9,1073.1,53
CPT,81208,"HC QUAL W REFLEX TO QUANT, BCR/ABL1 TRANSLOC ANLYS, OTHER BREAKPT",351.0,193.05,105.3,1073.1,53
CPT,81209,HC BLM BLOOM MUTATION GENE ANALYSIS,160.0,88.0,38.21,196.55,53
CPT,81210,"HC ARUP BRAF GENE ANALYSIS, V600 VARIANT(S), LIQUID",1061.0,583.55,170.49,917.77,53
CPT,81210,"HC BRAF MUTATION DETECTION BY IDYLLA, GENE ANLYS, V600 VARIANT",473.0,260.15,141.9,877.0,53
CPT,81210,"HC BRAF MUTATION MELANOMA, GENE ANALYSIS, V600 VARIANT(S)",476.0,261.8,142.8,877.0,53
CPT,81210,"HC MELANOMA PNL, BRAF GENE ANALYSIS, V600 VARIANT(S)",476.0,261.8,142.8,877.0,53
CPT,81210,"HC SOMATIC MUTATION, BRAF GENE ANLYS, V600 VARIANT",2496.0,1372.8,170.49,2159.04,53
CPT,81210,"HC UPMC BRAIN TUMOR, BRAF GENE ANALYSIS, V600 VARIANT(S)",456.0,250.8,136.8,877.0,53
CPT,81212,BRCA1&2 185&5385&6174 VRNT,,,427.68,2200.0,23
CPT,81215,BRCA1 GENE KNOWN FAMIL VRNT,,,364.74,1876.25,23
CPT,81216,BRCA2 GENE FULL SEQ ALYS,,,179.94,925.6,23
CPT,81217,BRCA2 GENE KNOWN FAMIL VRNT,,,364.74,1876.25,23
CPT,81218,"HC CEBPA, GENE ANALYSIS, FULL GENE SEQUENCE",693.0,381.15,207.9,1209.5,53
CPT,81218,"HC HEMOPHILIA (F9) SEQ, CEBPA, GENE ANALYSIS, FULL GENE SEQUENCE",1427.0,784.85,235.13,1234.36,53
CPT,81219,"HC CALR (CALRETICULIN), GENE ANALYSIS, COMMON VARIANTS IN EXON 9",831.0,457.05,118.22,718.82,53
CPT,81219,"HC CALRETICULIN MUTATION (BCW), GENE ANALYSIS COMMON VARIANTS IN EXON 9",1508.0,829.4,118.22,1304.42,53
CPT,81220,HC CYSTIC FIBROSIS TR GENE ANALYSIS COMMON VARIANT,636.0,349.8,190.8,2783.0,53
CPT,81220,HC CYSTIC FIBROSIS TR MUTATION GENE ANALYSIS COMMON VARIANTS,636.0,349.8,190.8,2783.0,53
CPT,81221,CFTR GENE KNOWN FAM VARIANTS,,,94.49,486.1,23
CPT,81222,CFTR GENE DUP/DELET VARIANTS,,,422.88,2175.35,23
CPT,81223,"HC CFTR, GENE ANALYSIS, FULL GENE SEQUENCE",1924.0,1058.2,485.03,2495.0,53
CPT,81223,HC CYSTIC FIBROSIS TR GENE ANLY FULL GENE SEQUENCE (2),3093.0,1701.15,485.03,2675.45,53
CPT,81224,CFTR GENE INTRON POLY T,,,164.03,843.75,23
CPT,81225,HC CYTOCHROME P450 2C19 GENE ANALYSIS,762.0,419.1,228.6,1456.8,53
CPT,81225,"HC CYTOCHROME P450 GENOTYPE PANEL, CYP2C19 GENE ANLYS, COMMON VAR",320.5,176.28,96.15,1456.8,53
CPT,81226,HC CYTOCHROME P450 2D6 GENE ANALYSIS,813.0,447.15,243.9,2254.55,53
CPT,81226,"HC CYTOCHROME P450 GENOTYPE PANEL, CYP2D6 GENE ANLYS, COMMON VAR",496.0,272.8,148.8,2254.55,53
CPT,81227,"HC CYTOCHROME P450 2C9, GENE ANALYSIS, COMMON VARIANTS",567.0,311.85,169.91,874.05,53
CPT,81227,"HC CYTOCHROME P450 GENOTYPE PANEL, CYP2C9 GENE ANLYS, COMMON VAR",192.5,105.88,57.75,874.05,53
CPT,81227,"HC WARFARIN, CYP2C9 GENE ANLYS, COMMON VAR",198.0,108.9,59.4,874.05,53
CPT,81228,"HC CONGENIT HEART, CYTOGENOM ANLYS CONST CHR ABNORM, INTERROG COPY NUM VAR",3100.0,1705.0,874.8,4500.0,106
CPT,81228,"HC FAMILIAL MUTAT, CYTOGENOM ANLYS CONST CHR ABNORM, INTERROG COPY NUM VAR",1491.0,820.05,447.3,4500.0,53
CPT,81228,"HC HERED EPILEPSY, CYTOGENOM ANLYS CONST CHR ABNORM, INTERROG COPY NUM VAR",3100.0,1705.0,874.8,4500.0,106
CPT,81229,"HC CYTOGENOM ANLYS CONST CHR ABNORM, INTERROG COPY NUM & SNP VAR",3419.0,1880.45,1025.7,5800.0,53
CPT,81229,"HC DNA DELET DUP, CYTOGENOM ANLYS CONST CHR ABNORM,INTERROG COPY NUM&SNP V",11105.0,6107.75,1127.52,9605.83,53
CPT,81230,HC CYP3A4 GENE ANALYSIS COMMON VARIANTS,191.25,105.19,57.0,874.05,106
CPT,81231,HC CYP3A5 GENE ANALYSIS COMMON VARIANTS,191.25,105.19,57.0,874.05,106
CPT,81232,"HC DIHYDROPYRIMIDINE DEHYDROGENASE (DPYD), GENE ANALYSIS, COMMON VARIANT(S)",597.0,328.35,169.91,874.05,53
CPT,81233,BTK GENE COMMON VARIANTS,,,170.49,877.0,23
CPT,81234,DMPK GENE DETC ABNOR ALLELE,,,133.16,685.0,23
CPT,81235,"HC EGFR MUTATION DETECTION BY IDYLLA, GENE ANLYS, COMMON VAR",788.0,433.4,236.4,1622.9,53
CPT,81235,HC EGFR MUTATION GENE ANALYSIS COMMON VARIANTS,733.0,403.15,219.9,1622.9,53
CPT,81235,HC EGFR MUTATION GENE ANALYSIS COMMON VARIANTS_NSCLC,1696.0,932.8,315.5,1622.9,53
CPT,81235,"HC UPMC, EGFR GENE ANALYSIS, COMMON VARIANTS",638.0,350.9,191.4,1622.9,53
CPT,81236,EZH2 GENE FULL GENE SEQUENCE,,,274.96,1414.4,23
CPT,81237,EZH2 GENE COMMON VARIANTS,,,170.49,877.0,23
CPT,81238,F9 FULL GENE SEQUENCE,,,583.2,3000.0,23
CPT,81239,DMPK GENE CHARAC ALLELES,,,267.14,1374.15,23
CPT,81240,HC PROTHROMBIN FACTOR II GENE MUTATION ANALYSIS,446.0,245.3,63.86,385.79,53
CPT,81241,HC FACTOR V GENE MUTATION ANALYSIS LEIDEN VARIANT,382.0,210.1,71.32,366.85,53
CPT,81242,"HC ANEMIA C, FANCC GENE ANALYSIS, COMMON VARIANT",366.0,201.3,35.6,316.59,53
CPT,81242,"HC FANCC GENE ANALYSIS, COMMON VARIANT (2)",129.0,70.95,35.6,183.1,53
CPT,81242,"HC FANCC GENE ANALYSIS, COMMON VARIANT (3)",251.0,138.05,35.6,217.12,53
CPT,81243,"HC FMR1 GENE ANALYSIS, EVALUATION TO DETECT ABNORMAL ALLELES",589.0,323.95,55.45,509.49,53
CPT,81244,"HC SOUTHERN BLOT, FMR1 GENE ANALYSIS, CHARACTERIZATION OF ALLELES",290.0,159.5,43.63,250.85,53
CPT,81245,"HC FLT3 MUTATION DETECTION GENE (BCW), FLT3, GENE ANALYSIS, ITD VARIANTS",384.0,211.2,115.2,827.55,53
CPT,81245,"HC FLT3 MUTATION DUPLICATION, GENE ANALYSIS, ITD VARIANTS",697.0,383.35,160.88,827.55,53
CPT,81245,HC FLT3 MUTATION GENE ANALYSIS (1),687.0,377.85,160.88,827.55,53
CPT,81245,HC FLT3 MUTATION GENE ANALYSIS (2),194.0,106.7,58.2,827.55,53
CPT,81245,HC FLT3 MUTATION GENE ANALYSIS (3),343.0,188.65,102.9,827.55,53
CPT,81246,"HC FLT3 MUTATION D836, GENE ANALYSIS, TKD VARIANTS",365.0,200.75,80.68,415.0,53
CPT,81246,"HC FLT3 MUTATION DETECTION TKD (BCW), FLT3, GENE ANALYSIS, TKD VARIANTS",200.0,110.0,60.0,415.0,53
CPT,81246,"HC FLT3 MUTATION, GENE ANALYSIS, TKD VARIANTS",178.0,97.9,53.4,415.0,53
CPT,81247,G6PD GENE ALYS CMN VARIANT,,,169.91,874.05,23
CPT,81248,G6PD KNOWN FAMILIAL VARIANT,,,364.74,1876.25,23
CPT,81249,G6PD FULL GENE SEQUENCE,,,583.2,3000.0,23
CPT,81250,HC G6PC GLYCOGEN STORAGE GENE ANALYSIS COMMON VARIANTS,290.0,159.5,56.85,292.45,53
CPT,81251,HC GBA GAUCHER MUTATION GENE ANALYSIS COMMON VARIANTS,290.0,159.5,45.93,250.85,53
CPT,81252,"HC CONNEXIN 26, GJB2, NONSYNDROMIC, GENE ANALYSIS, FULL GENE SEQ",939.0,516.45,98.29,812.24,53
CPT,81252,"HC GJB2 SEQUENCE ANALYSIS, FULL GENE SEQ",158.0,86.9,47.4,505.6,53
CPT,81253,"HC GJB2 SEQUENCE ANALYSIS, KNOWN FAMILIAL VAR",158.0,86.9,47.4,307.6,53
CPT,81254,"HC GJB2 SEQUENCE ANALYSIS, COMMON VAR",158.0,86.9,34.02,175.0,53
CPT,81255,HEXA GENE,,,50.01,257.25,23
CPT,81256,HC HEMOCHROMATOSIS DNA GENE ANALYSIS,454.0,249.7,63.53,392.71,53
CPT,81257,HBA1/HBA2 GENE,,,99.4,511.3,23
CPT,81258,HBA1/HBA2 GENE FAM VRNT,,,364.74,1876.25,23
CPT,81259,HC HBA1/HBA2 GENE ANALYSIS FULL GENE SEQUENCE,1582.0,870.1,474.6,3000.0,53
CPT,81260,HC IKBKAP FAMILIAL DYSAUTONOMIA GENE ANALYSIS COMMON VARIANTS,362.0,199.1,38.21,313.13,53
CPT,81261,"HC B CELL IGH CLONALITY, IGH@ REARRANGE ABNORMAL CLONAL POP AMPLIFIED",563.0,309.65,168.9,989.95,53
CPT,81261,"HC B CELL, IGH GENE REARRANG ANLYS, AMP METHOD",893.0,491.15,192.45,989.95,53
CPT,81262,IGH GENE REARRANG DIR PROBE,,,66.63,342.75,23
CPT,81263,HC IGH@ VARIABLE REGION SOMATIC HYPERMUTATION ANLY,1281.0,704.55,286.27,1472.6,53
CPT,81264,"HC B CELL IGK CLONALITY, IGK@ GENE REARRANGE DETECT ABNORMAL CLONAL POP",405.0,222.75,121.5,863.65,53
CPT,81264,"HC B CELL, IGK GENE REARRANG ANLYS",406.0,223.3,121.8,863.65,53
CPT,81265,"HC COMPARTV ANLYS W STR MRK, PAT & COMPARTV SPCMN",943.0,518.65,226.54,1165.35,53
CPT,81265,"HC ENGRAFTMENT/CHIMERISM-PRE TRANSPLANT, COMP ANLYS STR MRK, PAT&COMP SPCMN",795.0,437.25,226.54,1165.35,106
CPT,81265,"HC ENGRFT-CHIMER PRE-TRNSPL, COMPARTV ANLYS W STR MRK, PAT & COMPARTV SPCMN",1201.0,660.55,226.54,1165.35,53
CPT,81265,"HC HLA HAPLOTYPE PRE-TRNSPL, COMPARTV ANLYS W STR MRK, PAT & COMPARTV SPCMN",650.0,357.5,195.0,1165.35,53
CPT,81265,"HC MATERNAL CELL CONTAM(1), COMPARTV ANLYS W STR MRK, PAT & COMPARTV SPCMN",907.0,498.85,226.54,1165.35,53
CPT,81265,"HC MATERNAL CELL CONTAM(3), COMPARTV ANLYS W STR MRK, PAT & COMPARTV SPCMN",428.0,235.4,128.4,1165.35,53
CPT,81265,"HC MATERNAL CELL CONTAM(4), COMPARTV ANLYS W STR MRK, PAT & COMPARTV SPCMN",811.0,446.05,226.54,1165.35,53
CPT,81265,"HC MOLAR PREGNANCY 16 DNA, COMPARTV ANLYS W/ STR MRKS, PAT&COMPARTV SPCMN",436.0,239.8,130.8,1165.35,53
CPT,81265,"HC SPECIMEN SOURCE IDENTIFICATION, COMPARATIVE ANALYSIS USING STR MARKERS",990.0,544.5,226.54,1165.35,53
CPT,81266,STR MARKERS SPEC ANAL ADDL,,,296.27,1524.05,23
CPT,81267,HC ENGRAFT-CHIMERISM ANLYS POST-TRNSPL SPECIMEN WO CELL SELECTION,1153.0,634.15,201.65,1037.3,53
CPT,81267,HC ENGRAFTMENT/CHIMERISM POST (BONE MARROW) SPECIMEN WO CELL SELECTION,795.0,437.25,201.65,1037.3,106
CPT,81267,HC ENGRAFTMENT/CHIMERISM-POST TRANSPLANT SPECIMEN WO CELL SELECTION,795.0,437.25,201.65,1037.3,106
CPT,81268,HC CD3/CD33 ENRICHMENT (ENGRAFTMENT) W/ COMP TO BASELINE W/ CELL SELECT EA,1817.5,999.63,253.49,1572.14,106
CPT,81268,HC ENGRAFT-CHIMERISM ANLYS POST-TRNSPL CD3-CD33 ENRICH,569.0,312.95,170.7,1303.95,53
CPT,81268,HC ENGRAFT-CHIMERISM ANLYS POST-TRNSPL SPECIMEN W CELL SELECTION,1087.0,597.85,253.49,1303.95,53
CPT,81268,"HC ENGRAFT-CHIMERISM ANLYS,POST-TRANSPL SPEC, INCL CD33/CD56 ENRICHMENT",1912.0,1051.6,253.49,1653.88,53
CPT,81268,"HC ENGRAFTMENT CD 19/CD 56, CHIMERISM ANLYS POST-TRNSPL SPEC W CELL SELECT",1412.0,776.6,253.49,1303.95,53
CPT,81268,"HC ENGRAFTMENT CD3/CD33, CHIMERISM W/ COMP TO BASELINE W/ CELL SELECTION EA",1379.0,758.45,253.49,1303.95,53
CPT,81269,"HC ALPHA-THALASSEMIA, HBA1/HBA2, GENE ANLYS, DUPLICATION/DELETION VARIANTS",1063.0,584.65,196.73,1012.0,53
CPT,81270,"HC JAK2 FISH, GENE ANALYSIS, GENE ANALYSIS, P.VAL617PHE (V617F) VARIANT",627.0,344.85,89.09,542.36,53
CPT,81270,HC JAK2 V617F GENE MUTATION ANALYSIS,648.0,356.4,89.09,560.52,106
CPT,81270,HC JAK2 V617F MUTATION (BCW) GENE ANALYSIS,719.0,395.45,89.09,621.94,53
CPT,81270,HC JAK2 V617F MUTATION GENE ANALYSIS,705.0,387.75,89.09,609.83,53
CPT,81270,"HC JAK2 V617F MUTATION QUANTITATIVE, GENE ANALYSIS VARIANT",641.0,352.55,89.09,554.47,53
CPT,81271,"HC HUNTINGTON MUTATION, GENE ANALYSIS DETECT ABNORMAL ALLELES",629.0,345.95,133.16,685.0,53
CPT,81272,"HC C-KIT MUTATION HEMATOPOIETIC TISSUE, KIT GENE ANLYS, TARGET SEQ",1565.0,860.75,320.28,1647.55,53
CPT,81272,"HC C-KIT MUTATION MELANOMA, GENE ANALYSIS, TARGETED SEQUENCE ANALYSIS",760.0,418.0,228.0,1647.55,53
CPT,81272,"HC CKIT MUTATION, KIT GENE ANLYS, TARGET SEQ",974.0,535.7,292.2,1647.55,53
CPT,81272,"HC GIST MUTATION, KIT, GENE ANALYSIS, TARGETED SEQUENCE ANALYSIS",1413.0,777.15,320.28,1647.55,53
CPT,81272,"HC KIT, EXONS 8 AND 17, GENE ANALYSIS, TARGETED SEQUENCE ANALYSIS",1565.0,860.75,320.28,1647.55,53
CPT,81272,"HC KIT, EXONS 8-11 AND 17, GENE ANALYSIS, TARGETED SEQUENCE ANALYSIS",1563.0,859.65,320.28,1647.55,53
CPT,81272,"HC MAYO GIST MUTATION, KIT GENE ANLYS, TARGET SEQ,",1105.0,607.75,320.28,1647.55,53
CPT,81272,"HC MELANOMA PNL, CKIT, EXONS 8, 11, 13, 17, 18, GENE ANLYS, TGTD SEQ ANLYS",760.0,418.0,228.0,1647.55,53
CPT,81273,"HC ASM, KIT, GENE ANALYSIS, D816 VARIANT(S)",678.0,372.9,121.37,624.35,53
CPT,81273,"HC KIT, D816 VARIANTS, GENE ANALYSIS",935.0,514.25,121.37,808.78,53
CPT,81274,HTT GENE CHARAC ALLELES,,,267.14,1374.15,23
CPT,81275,"HC KRAS CODON 12/13 SEQ, GENE ANALYSIS, VARIANTS IN EXON 2",778.0,427.9,187.84,966.25,53
CPT,81275,"HC KRAS CODON 12/13 SEQUENCING GENE ANALYSIS, VARIANTS IN EXON 2",778.0,427.9,187.84,966.25,53
CPT,81275,"HC KRAS GENE ANALYSIS, VARIANTS IN EXON 2 (1)",1149.0,631.95,187.84,993.89,53
CPT,81275,"HC KRAS GENE ANALYSIS, VARIANTS IN EXON 2 (3)",716.0,393.8,187.84,966.25,53
CPT,81275,"HC KRAS GENE ANALYSIS, VARIANTS IN EXON 2, CRC",1888.0,1038.4,187.84,1633.12,53
CPT,81275,"HC KRAS MUTATION DETECTION BY IDYLLA, VARIANTS IN EXON 2",221.0,121.55,66.3,966.25,53
CPT,81275,"HC UPMC KRAS GENE ANALYSIS, VARIANTS IN EXON 2 (4)",355.0,195.25,106.5,966.25,53
CPT,81276,"HC KRAS GENE ANALYSIS, ADDITIONAL VARIANT(S)",480.0,264.0,144.0,966.25,53
CPT,81276,"HC KRAS MUTATION (MELANOMA), GENE ANALYSIS, ADDITIONAL VARIANT(S)",503.0,276.65,150.9,966.25,53
CPT,81276,"HC KRAS MUTATION DETECTION BY IDYLLA, GENE ANLYS, ADL VARIANT",221.0,121.55,66.3,966.25,53
CPT,81276,"HC MELANOMA PNL, KRAS GENE ANALYSIS, ADDITIONAL VARIANT(S)",503.0,276.65,150.9,966.25,53
CPT,81277,"HC CHROMOSOMAL MICROARRAY, TUMOR, CYTOGENOMIC NEOPLASIA ANLYS",5539.0,3046.45,1127.52,5800.0,53
CPT,81277,HC CYTOGENOMIC MIP ARRAY FFPE ANALYSIS,3800.0,2090.0,1127.52,5800.0,53
CPT,81278,IGH@/BCL2 TRANSLOCATION ALYS,,,201.5,1036.55,23
CPT,81279,"HC JAK2 EXON 12 MUTATION, TARGETED SEQUENCE ANALYSIS",628.0,345.4,180.02,926.0,53
CPT,81283,"HC INTERLEUKIN 28B (IL28B), IFNL3, GENE ANALYSIS, RS12979860 VARIANT",444.0,244.2,71.32,384.06,53
CPT,81284,FXN GENE DETC ABNOR ALLELES,,,133.16,685.0,23
CPT,81285,FXN GENE CHARAC ALLELES,,,267.14,1374.15,23
CPT,81286,FXN GENE FULL GENE SEQUENCE,,,267.14,1374.15,23
CPT,81287,"HC CARIS MGMT, PROMOTER METHYLATION ANLYS",243.0,133.65,72.9,623.2,53
CPT,81287,HC MGMT PROMOTER METHYLATION ANALYSIS,296.0,162.8,88.8,623.2,53
CPT,81287,"HC UPMC, MGMT PROMOTER METHYLATION ANALYSIS",413.0,227.15,121.15,623.2,53
CPT,81288,HC ARUP MLH1 GENE ANALYSIS PROMOTER HYPERMETHYLATION PB,536.0,294.8,160.8,961.6,53
CPT,81289,FXN GENE KNOWN FAMIL VARIANT,,,180.02,926.0,23
CPT,81290,HC MCOLN1 MUCOLIPIDOSIS GENE ANALYSIS COMMON VARIANTS,362.0,199.1,38.21,313.13,53
CPT,81291,MTHFR GENE,,,63.51,326.7,23
CPT,81292,HC MLH1 FULL SEQUENCE GENE ANALYSIS,1402.0,771.1,420.6,3377.0,53
CPT,81293,MLH1 GENE KNOWN VARIANTS,,,321.73,1655.0,23
CPT,81294,HC MLH1 GENE ANALYSIS DUPLICATION VARIANTS,414.0,227.7,124.2,1012.0,53
CPT,81295,HC MSH2 FULL SEQUENCE GENE ANALYSIS,605.0,332.75,181.5,1908.5,53
CPT,81296,MSH2 GENE KNOWN VARIANTS,,,328.28,1688.65,23
CPT,81297,HC MSH2 GENE ANALYSIS DUPLICATION VARIANTS,338.0,185.9,101.4,1066.5,53
CPT,81298,HC MSH6 FULL SEQUENCE GENE ANALYSIS,1016.0,558.8,304.8,3209.25,53
CPT,81299,MSH6 GENE KNOWN VARIANTS,,,299.38,1540.0,23
CPT,81300,HC MSH6 GENE ANALYSIS DUPLICATION VARIANTS,378.0,207.9,113.4,1190.0,53
CPT,81301,"HC MICROSATELLITE INSTABILITY (MSI) PCR, ANALYSIS MISMATCH REPAIR DEF",1900.0,1045.0,338.8,1742.8,53
CPT,81301,HC MICROSATELLITE INSTABL ANLY MISMATCH REPR DEFIC,916.0,503.8,274.8,1742.8,53
CPT,81302,MECP2 GENE FULL SEQ,,,513.09,2639.35,23
CPT,81303,MECP2 GENE KNOWN VARIANT,,,116.64,600.0,23
CPT,81304,MECP2 GENE DUP/DELET VARIANT,,,145.8,750.0,23
CPT,81305,"HC MYD88 265 MUTATION PCR QUANT, GENE ANALYSIS",661.0,363.55,170.49,877.0,53
CPT,81305,HC MYD88 GENE ANALYSIS L265 VARIANT,1367.0,751.85,170.49,1182.46,53
CPT,81306,"HC NUDT15 MUTATION, GENE ANLYS, COMMON VAR",300.5,165.28,90.15,1456.8,53
CPT,81307,PALB2 GENE FULL GENE SEQ,,,657.56,3382.5,22
CPT,81308,PALB2 GENE KNOWN FAMIL VRNT,,,292.91,1506.75,22
CPT,81309,PIK3CA GENE TRGT SEQ ALYS,,,267.14,1374.15,22
CPT,81310,HC NPM1 GENE MUTATION ANALYSIS EXON 12 VARIANTS,573.0,315.15,171.9,1232.6,53
CPT,81310,HC NPM1 MUTATION GENE ANALYSIS EXON 12 VARIANTS,471.0,259.05,141.3,1232.6,53
CPT,81310,"HC NPM1 MUTATION TISSUE, GENE ANALYSIS, EXON 12 VARIANTS",771.0,424.05,231.3,1232.6,53
CPT,81311,"HC MELANOMA PNL, NRAS GENE ANALYSIS, VARIANTS IN EXON 2 AND EXON 3",446.0,245.3,133.8,1478.95,53
CPT,81311,"HC NRAS GENE ANALYSIS, VARIANTS IN EXON 2 AND EXON 3 (1)",640.0,352.0,192.0,1478.95,53
CPT,81311,"HC NRAS GENE ANALYSIS, VARIANTS IN EXON 2 AND EXON 3 (2)",891.0,490.05,267.3,1478.95,53
CPT,81311,"HC NRAS MUTATION (MELANOMA), GENE ANLYS, VARIANTS IN EXON 2 AND EXON 3 (1)",446.0,245.3,133.8,1478.95,53
CPT,81311,"HC NRAS, GENE ANALYSIS, VARIANTS IN EXON 2 AND EXON 3",1066.0,586.3,287.51,1478.95,53
CPT,81312,PABPN1 GENE DETC ABNOR ALLEL,,,133.16,685.0,23
CPT,81313,"HC PCA3 BY TMA, PCA3/KLK3 PROSTATE SPECIFIC AG RATIO",673.0,370.15,201.9,1275.25,53
CPT,81314,"HC GIST MUTATION, PDGFRA, GENE ANALYSIS, TARGETED SEQUENCE ANALYSIS",1411.0,776.05,320.28,1647.55,53
CPT,81314,"HC KIT MELANOMA, PDGFRA GENE ANALYS TARGETED SEQUENCE ANALYS",822.0,452.1,246.6,1647.55,53
CPT,81314,"HC MAYO GIST MUTATION, PDGFRA GENE ANLYS, TARGET SEQ",1103.0,606.65,320.28,1647.55,53
CPT,81315,HC PML-RAR ALPHA (T15;17) MUTATION TRANSLOCATION ANALYSIS COMMON BREAKPT,628.0,345.4,188.4,1036.55,53
CPT,81315,HC PML-RAR ALPHA (T15;17) TRANSLOCATION ANALYSIS COMMON BREAKPT,950.0,522.5,201.5,1036.55,53
CPT,81316,PML/RARALPHA 1 BREAKPOINT,,,201.5,1036.55,23
CPT,81317,PMS2 GENE FULL SEQ ANALYSIS,,,657.56,3382.5,23
CPT,81318,PMS2 KNOWN FAMILIAL VARIANTS,,,321.73,1655.0,23
CPT,81319,PMS2 GENE DUP/DELET VARIANTS,,,197.8,1017.5,23
CPT,81320,PLCG2 GENE COMMON VARIANTS,,,283.2,1456.8,23
CPT,81321,HC PTEN FULL SEQUENCE GENE ANALYSIS,1301.0,715.55,390.3,3000.0,53
CPT,81322,"HC UPMC PTEN GENE MUTATION, PTEN GENE ANALYSIS, KNOWN FAMILIAL VARIANT",122.0,67.1,36.6,233.0,53
CPT,81323,HC PTEN GENE ANALYSIS DUPLICATION VARIANT,475.0,261.25,142.5,1500.0,53
CPT,81324,"HC CHARCOT-MARIE-TOOTH NEUROPATHY PMP22 GENE ANLYS, DUPL/DEL ANLYS",799.0,439.45,239.7,3791.8,53
CPT,81325,PMP22 GENE FULL SEQUENCE,,,748.04,3847.9,23
CPT,81326,PMP22 GENE KNOWN FAM VARIANT,,,45.3,233.0,23
CPT,81327,SEPT9 GEN PRMTR MTHYLTN ALYS,,,186.62,960.0,23
CPT,81328,"HC SLCO1B1, GENE ANLYS, COMMON VAR",266.5,146.58,79.95,874.05,53
CPT,81329,"HC SPINAL MUSCULAR ATROPHY COPY NUMBER, SMN1 GENE DOS/DELET ALYS W/ SMN2",629.0,345.95,133.16,685.0,53
CPT,81330,HC SMPD1 NIEMANN-PICK MUTATION GENE ANALYSIS COMMON VARIANTS,474.0,260.7,45.68,410.01,53
CPT,81331,"HC ANGELMAN/PRADER WILLI BY PCR, SNRPN-UBE3A METHYLATION ANALYSIS",613.0,337.15,49.64,530.25,53
CPT,81332,"HC A1ANTITRYPSIN GENOTYPING, SERPINA1, GENE ANALYSIS, COMMON VARIANTS",506.0,278.3,42.43,437.69,53
CPT,81333,TGFBI GENE COMMON VARIANTS,,,133.16,685.0,23
CPT,81334,"HC RUNX1 GENE ANALYSIS, TARGETED SEQUENCE ANALYSIS",1720.0,946.0,320.28,1647.55,53
CPT,81335,"HC TPMT MUTAT GENE ANLYS, COMMON VAR",300.5,165.28,90.15,874.05,53
CPT,81335,"TPMT, GENE ANLYS, COMMON VAR",352.0,193.6,105.6,874.05,53
CPT,81336,SMN1 GENE FULL GENE SEQUENCE,,,292.91,1506.75,23
CPT,81337,SMN1 GEN NOWN FAMIL SEQ VRNT,,,180.02,926.0,23
CPT,81338,"HC MPL GENE ANLYS, COMMON VAR",592.0,325.6,146.12,751.65,53
CPT,81339,"HC MPL GENE ANLYS, SEQ ANLYS, EXON 10",509.0,279.95,152.7,926.0,53
CPT,81340,HC MAYO T CELL ANTG RECPT BETA GENE REARRNGMNT ANLY AMP,682.0,375.1,203.07,1044.6,53
CPT,81340,"HC T CELL CLONALITY PANEL BETA, TRB GENE REARRANG ANLYS, AMP METHOD",773.0,425.15,203.07,1044.6,53
CPT,81340,"HC T-CELL RECEPTOR GENE REARRANGEMENT, BETA,TRB GENE REARRANG ANLYS AMP MET",1068.5,587.68,203.07,1044.6,53
CPT,81341,TRB@ GENE REARRANGE DIRPROBE,,,48.2,247.95,23
CPT,81342,HC MAYO T CELL ANTG RECPT GAMMA GENE REARRNGMNT ANLY(1),997.0,548.35,195.86,1007.5,53
CPT,81342,HC T CELL ANTG RECPT GAMMA GENE REARRNGMNT ANLY(2),997.0,548.35,195.86,1007.5,53
CPT,81342,"HC T CELL CLONALITY PANEL GAMMA, TRG GENE REARRANG ANLYS",950.0,522.5,195.86,1007.5,53
CPT,81342,"HC T-CELL ANTG RECPT GAMMA, GENE REARRNGMNT ANLY",972.0,534.6,195.86,1007.5,53
CPT,81342,"HC T-CELL CLONALITY, TRG@ GENE REARRANGEMENT ANALYSIS",997.0,548.35,195.86,1007.5,53
CPT,81342,"HC T-CELL RECEPTOR GENE REARRANGEMENT, GAMMA,TRG GENE REARRANG ANLYS",1068.5,587.68,195.86,1007.5,53
CPT,81343,PPP2R2B GEN DETC ABNOR ALLEL,,,133.16,685.0,23
CPT,81344,TBP GENE DETC ABNOR ALLELES,,,133.16,685.0,23
CPT,81345,"HC TERT PROMOTER ANALYSIS TUMOR, GENE TARGETED SEQUENCE ANALYSIS",1109.0,609.95,180.02,959.29,53
CPT,81346,TYMS GENE COM VARIANTS,,,169.91,874.05,23
CPT,81347,SF3B1 GENE COMMON VARIANTS,,,187.84,966.25,23
CPT,81348,SRSF2 GENE COMMON VARIANTS,,,170.49,877.0,23
CPT,81349,CYTOG ALYS CHRML ABNR LW-PS,,,1127.52,5800.0,23
CPT,81350,"HC UGT1A1 GENE ANALYSIS, COMMON VARIANTS",500.0,275.0,150.0,1170.0,53
CPT,81351,"HC TP53 EXON 4-9, GENE ANALYSIS, FULL GENE SEQUENCE",2880.0,1584.0,623.88,3209.25,53
CPT,81352,"HC TP53 EXONS 2-11 MUTATION TUMOR, MOL PATH PROC, LEVEL 6",1192.0,655.6,320.28,1647.55,53
CPT,81352,"HC TP53 MUTATION EXONS 4-9 PARAFFIN BLOCK GENE ANLYS, TARGETED SEQ ANS",1983.0,1090.65,320.28,1715.3,53
CPT,81353,TP53 GENE KNOWN FAMIL VRNT,,,299.38,1540.0,23
CPT,81355,"HC VKORC1 GENE ANALYSIS, COMMON VARIANT(S), WARFARIN",129.0,70.95,38.7,441.0,53
CPT,81357,U2AF1 GENE COMMON VARIANTS,,,187.84,966.25,23
CPT,81360,ZRSR2 GENE COMMON VARIANTS,,,187.84,966.25,23
CPT,81361,"HC HBB, COMMON VARIANT(S), HBS, HBC, HBE",546.0,300.3,163.8,874.05,53
CPT,81362,"HC HBB, KNOWN FAMILIAL VARIANT(S)",708.0,389.4,212.4,1876.25,53
CPT,81363,HBB GENE DUP/DEL VARIANTS,,,196.73,1012.0,23
CPT,81364,"HC HBB, FULL GENE SEQUENCE",1376.0,756.8,315.5,1622.9,53
CPT,81370,HLA I & II TYPING LR,,,390.86,2010.6,23
CPT,81371,HLA I & II TYPE VERIFY LR,,,393.19,2022.6,23
CPT,81372,HC HLA CLS I TYP LOW RES COMPLETE_HLA A-B-C,879.0,483.45000000000005,207.3,2017.95,106
CPT,81373,"HC HLA B51 DISEASE ASSOCIATION, HLA CLS I TYP, LOW RES, ONE LOCUS, EA",543.0,298.65,123.87,637.15,53
CPT,81373,HC HLA CLS I TYP LOW RES ONE LOC EA_HLA A,419.0,230.45,123.87,637.15,53
CPT,81373,HC HLA CLS I TYP LOW RES ONE LOC EA_HLA B,419.0,230.45,123.87,637.15,53
CPT,81373,HC HLA CLS I TYP LOW RES ONE LOC EA_HLA B DIS ASSC,2054.0,1129.7,123.87,1776.71,53
CPT,81373,HC HLA CLS I TYP LOW RES ONE LOCUS EA_HLA-B VERIFC,443.0,243.65,123.87,637.15,53
CPT,81373,HC HLA CLS I TYP LOW RES ONE LOC_FACTOR VIII INVRS,1266.0,696.3,123.87,1095.09,53
CPT,81374,"HC ANKYLOSING SPONDYLITIS GENOTYPING, HLA I TYPING 1 ANTIGEN LOW RESOLUTION",584.0,321.2,72.25,505.16,53
CPT,81375,HC HLA CLS II TYP LOW RES_HLA DRB-DQB,549.0,301.95,164.7,1103.7,53
CPT,81376,"HC CELIAC, HLA CLS II TYP, LOW RES, ONE LOCUS, EACH",313.0,172.15,93.9,611.1,53
CPT,81376,"HC DQA1, HLA CLS II TYPE, LOW RES, ONE LOCUS, EACH",337.0,185.35,101.1,611.1,53
CPT,81376,"HC DQB1*02 CELIAC, HLA CLS II TYPE, LOW RES, ONE LOCUS, EACH",253.0,139.15,75.9,611.1,53
CPT,81376,"HC DQB1, HLA CLS II TYPE, LOW RES, ONE LOCUS, EACH",337.0,185.35,101.1,611.1,53
CPT,81376,"HC DRB1, HLA CLS II TYPE, LOW RES, ONE LOCUS, EACH",337.0,185.35,101.1,611.1,53
CPT,81376,HC HLA CLS II TYP LOW RES ONE LOC EA_HLA DPB1,878.0,482.9,118.79,759.47,53
CPT,81376,HC HLA CLS II TYP LOW RES ONE LOC EA_HLA-B & DRB1,362.0,199.1,108.6,611.1,53
CPT,81377,HC HLA CLS II TYP LOW RES ONE ANTG EQUIV EA_CELIAC,270.0,148.5,81.0,473.7,53
CPT,81377,"HC RISKIMMUNE HLA DQA, LOW RES, ONE AG EQUIVALENT, EA",316.0,173.8,92.09,473.7,53
CPT,81378,"HC HLA CLASS I AND II TYPING, HIGH RESOLUTION, HLA-A, B, C, AND -DRB1",2981.0,1639.55,335.89,2578.57,53
CPT,81379,"HC ABC, HLA CLASS I TYPING HIGH RESOLUTION COMPLETE",3170.0,1743.5,325.99,2742.05,53
CPT,81380,"HC HLA-A GENOTYPE, HLA CLASS I TYPING HIGH RESOLUTION ONE LOCUS EA",640.0,352.0,172.29,886.25,53
CPT,81380,"HC HLA-B GENOTYPE , HLA CLASS I TYPING HIGH RESOLUTION ONE LOCUS EA",670.0,368.5,172.29,886.25,53
CPT,81380,"HC HLA-C GENOTYPE, HLA CLASS I TYPING HIGH RESOLUTION ONE LOCUS EA",640.0,352.0,172.29,886.25,53
CPT,81380,"HC LOCUS, HLA CLASS I TYPING, HIGH RESOLUTION",1146.0,630.3,172.29,991.29,53
CPT,81381,"HC ALLELE, HLA CLASS I TYPING, HIGH RESOLUTION",333.0,183.15,99.9,849.5,53
CPT,81381,"HC HLA A 02:01 DETERMINATION, HLA CL I TYP, HIGH RES, ONE ALLELE/GRP, EA",449.0,246.95,134.7,849.5,53
CPT,81381,HC HLA A29 UVEITIS,838.0,460.9,165.14,849.5,53
CPT,81381,"HC HLA B5801 GENOTYP ALLOPURINOL, HLA CLS I TYP HIGH RES ONE ALLELE EA",1023.0,562.65,165.14,884.9,53
CPT,81381,HC HLA CLS I TYP HIGH RES ONE ALLELE EA_HLA B1502,570.0,313.5,165.14,849.5,53
CPT,81381,HC HLA CLS I TYP HIGH RES ONE ALLELE EA_HLA B5701,416.0,228.8,124.8,849.5,53
CPT,81382,"HC CELIAC DISEASE HLA D GENOTYP, HLA CL II TYP, HIGH RES, ONE LOCUS, EA",379.0,208.45,113.7,618.4,53
CPT,81382,"HC DPB1, HLA CLASS II TYPING HIGH RESOLUTION ONE LOCUS EA",4374.0,2405.7,120.22,3783.51,53
CPT,81382,"HC DQB1, HLA CLASS II TYPING HIGH RESOLUTION ONE LOCUS EA",4374.0,2405.7,120.22,3783.51,53
CPT,81382,"HC DRB1, HLA CLASS II TYPING HIGH RESOLUTION, ONE LOCUS EA",4374.0,2405.7,120.22,3783.51,53
CPT,81382,"HC DRB3/4/5, HLA CL II TYP, HIGH RES, ONE LOCUS, EA",301.0,165.55,90.3,618.4,53
CPT,81382,"HC HLA-DPA1 CLASS II TYPING, HIGH RESOLUTION, ONE LOCUS, EACH",1646.0,905.3,120.22,1423.79,53
CPT,81382,"HC HLA-DPB1 CLASS II TYPING, HIGH RESOLUTION, ONE LOCUS, EACH",892.0,490.6,120.22,771.58,53
CPT,81382,"HC HLA-DQ GENOTYPE, HLA CLASS II TYPING HIGH RESOLUTION ONE LOCUS EA",1901.0,1045.55,120.22,1644.37,53
CPT,81382,"HC HLA-DQA1 CLASS II TYPING, HIGH RESOLUTION, ONE LOCUS, EACH",1973.0,1085.15,120.22,1706.65,53
CPT,81382,"HC HLA-DQB1 CLASS II TYPING, HIGH RESOLUTION, ONE LOCUS, EACH",892.0,490.6,120.22,771.58,53
CPT,81382,"HC HLA-DR GENOTYPE, HLA CLASS II TYPING HIGH RESOLUTION ONE LOCUS EA",1138.0,625.9,120.22,984.37,53
CPT,81382,"HC HLA-DRB3/4/5 CLASS II TYPING, HIGH RESOLUTION, ONE LOCUS, EACH",892.0,490.6,120.22,771.58,53
CPT,81382,"HC NARCOLEPSY GENOTYPING, HLA CL II TYP, HIGH RES, ONE LOCUS, EA",426.0,234.3,120.22,618.4,53
CPT,81383,HC HLA CLASS II TYPING HIGH RES ONE ALLELE EA,742.0,408.1,106.07,641.83,53
CPT,81400,"HC 5FU DPYD MUTATION 1679 T>G, MOL PATH PROC, LEVEL 1",424.0,233.2,62.17,366.76,53
CPT,81400,"HC HPA-1 PLATELET AG IGG TYPNG. MOL PATH PROC, LEVEL 1",591.0,325.05,62.17,511.22,53
CPT,81400,"HC INTERLEUKIN 28B GENOTYPE, MOL PATH PROC, LEVEL 1",844.0,464.2,62.17,730.06,53
CPT,81400,"HC NATP, MOL PATH PROC, LEVEL 1",163.5,89.925,46.5,319.8,106
CPT,81400,"HC NEMALINE MYOPATHY, MOL PATH PROC, LEVEL 1",313.0,172.15,62.17,319.8,53
CPT,81400,"HC PAI-1 GENOTYPE, MOL PATH PROC, LEVEL 1",278.0,152.9,62.17,319.8,53
CPT,81400,"HC USHER SYNDROME TYPE IF, MOL PATH PROC, LEVEL 1",313.0,172.15,62.17,319.8,53
CPT,81400,"HC USHER SYNDROME TYPE III, MOL PATH PROC, LEVEL 1",313.0,172.15,62.17,319.8,53
CPT,81401,"HC 5FU DPYD MUTATION 1905+1 G>A, MOL PATH PROC, LEVEL 2",656.0,360.8,133.16,685.0,53
CPT,81401,"HC ACHIONDROPLASIA (FGFR3) MUTATION, MOL PATH PROC, LEVEL 2",831.0,457.05,133.16,718.82,53
CPT,81401,"HC APOLIPOPROTEIN E ALZHEIMER RISK, MOL PATH PROC, LEVEL 2",324.0,178.2,97.2,685.0,53
CPT,81401,"HC BETA-2-ADRENERGIC MUTATIONS, MOL PATH PROC, LEVEL 2",559.0,307.45,133.16,685.0,53
CPT,81401,"HC CBFB-MYH1 INV BY PCR, MOL PATH PROC, LEVEL 2",971.0,534.05,133.16,839.92,53
CPT,81401,"HC FIP1I1/PDGFRA TRANSLOCATION, MOL PATH PROC, LEVEL 2",3315.0,1823.25,133.16,2867.48,53
CPT,81401,"HC HEMOGLOBIN SC MUTATION, MOL PATH PROC, LEVEL 2",837.0,460.35,133.16,724.01,53
CPT,81401,"HC LEBER HEREDITARY OPTIC NEUROPATHY, MOL PATH PROC, LEVEL 2",500.0,275.0,133.16,685.0,53
CPT,81401,"HC MEDIUM CHAIN ACYL-COA DEHYDORGENASE, MOL PATH PROC, LEVEL 2",764.0,420.2,133.16,685.0,53
CPT,81401,"HC RUNX1-RUNX1T1 (AML1-ETO), MOL PATH PROC, LEVEL 2",1441.0,792.55,133.16,1246.47,53
CPT,81401,"HC SEPTIN 9 METHYLATED DNA PCR, MOL PATH PROC, LEVEL 2",585.0,321.75,133.16,685.0,53
CPT,81401,"HC SICKLE CELL DNA AMNIOTIC FLUID, MOL PATH PROC, LEVEL 2",780.0,429.0,133.16,685.0,53
CPT,81401,"HC SPINAL MUSCULAR ATROPHY SMA CARRIER, MOL PATH PROC, LEVEL 2",2675.0,1471.25,133.16,2313.88,53
CPT,81401,"HC SYNHC OVIAL SARCOMA PCR, MOL PATH PROC, LEVEL 2",1262.0,694.1,133.16,1091.63,53
CPT,81401,"HC UPMC, MOL PATH PROC, LEVEL 2",312.0,171.6,93.6,685.0,53
CPT,81402,"HC CAH COMMON MUTATIONS, MOL PATH PROC, LEVEL 3",1516.0,833.8,146.12,1311.34,53
CPT,81402,"HC MPL MUTATION ANALYSIS, MOL PATH PROC, LEVEL 3",1541.0,847.55,146.12,1332.97,53
CPT,81402,"HC MPL MUTATION, MOL PATH PROC, LEVEL 3",1604.0,882.2,146.12,1387.46,53
CPT,81402,"HC UNIPARENTAL DISOMY DNA, MOL PATH PROC, LEVEL 3",671.0,369.05,146.12,751.65,53
CPT,81402,"HC UPMC, MOL PATH PROC, LEVEL 3",393.0,216.15,117.9,751.65,53
CPT,81403,"HC DMTT3 EXON 23 SEQUENCE ANALYSIS, MOL PATH PROC, LEVEL 4",981.0,539.55,180.02,926.0,53
CPT,81403,"HC FAMILIAL MUTATION TARGETED TEST, MOL PATH PROC, LEVEL 4",981.0,539.55,180.02,926.0,53
CPT,81403,"HC GENETICS, MOL PATH PROC, LEVEL 4",357.0,196.35,107.1,926.0,53
CPT,81403,"HC IDH1, MOL PATH PROC, LEVEL 4",443.0,243.65,132.9,926.0,53
CPT,81403,"HC JAK2 EXON 12 MUTATION (2), MOL PATH PROC, LEVEL 4",905.0,497.75,180.02,926.0,53
CPT,81403,"HC MPL W515 & S505N MUTATION ANALYSIS, MOL PATH PROC, LEVEL 4",1028.0,565.4,180.02,926.0,53
CPT,81403,"HC SDH KNOWN MUTATION, MOL PATH PROC, LEVEL 4",869.0,477.95,180.02,926.0,53
CPT,81403,"HC TSC2 TARGETED TESTING, MOL PATH PROC, LEVEL 4",537.0,295.35,161.1,926.0,53
CPT,81403,"HC UPMC, MOL PATH PROC, LEVEL 4",321.0,176.55,96.3,926.0,53
CPT,81403,"HC Y CHROMOSOME DELETION, MOL PATH PROC, LEVEL 4",580.0,319.0,174.0,926.0,53
CPT,81404,"HC AMYLOIDOSIS FAM DNA SEQ, MOL PATH PROC, LEVEL 5",2213.0,1217.15,267.14,1914.25,53
CPT,81404,"HC AMYLOIDOSIS FAMILLIAL TRANSTHYRETIN, MOL PATH PROC, LEVEL 5",1349.0,741.95,267.14,1374.15,53
CPT,81404,"HC BLEEDING DISORDER, MOL PATH PROC, LEVEL 5",655.0,360.25,196.5,1374.15,53
CPT,81404,"HC BLOOD DISORDER PANEL, MOL PATH PROC, LEVEL 5",897.0,493.35,267.14,1374.15,53
CPT,81404,"HC INH THROMBOCYTOPENIA, MOL PATH PROC, LEVEL 5",1688.0,928.4,267.14,1460.12,53
CPT,81404,"HC MAYO PDGFRA MUTATION ANALYSIS, MOL PATH PROC, LEVEL 5",1222.0,672.1,267.14,1374.15,53
CPT,81404,"HC MEN1 DELETION DUPLICATION, MOL PATH PROC, LEVEL 5",1114.0,612.7,267.14,1374.15,53
CPT,81404,"HC PERIODIC FEVER SEQUENCING, MOL PATH PROC, LEVEL 5",2293.0,1261.15,267.14,1983.45,53
CPT,81404,"HC PRSS SPINK SEQUENCING, MOL PATH PROC, LEVEL 5",2069.0,1137.95,267.14,1789.69,53
CPT,81404,"HC PRSS1 FULL GENE SEQUENCE, MOL PATH PROC, LEVEL 5",1330.0,731.5,267.14,1374.15,53
CPT,81404,"HC SPINK 1 VARIANT, MOL PATH PROC, LEVEL 5",1330.0,731.5,267.14,1374.15,53
CPT,81404,"HC UPMC, MOL PATH PROC, LEVEL 5",644.0,354.2,193.2,1374.15,53
CPT,81404,"HC VHL GENE ERYTHROCYTOSIS MUTATION, MOL PATH PROC, LEVEL 5",2172.0,1194.6,267.14,1878.78,53
CPT,81404,"HC VON HIPPEL LINDAU SEQUENCING, MOL PATH PROC, LEVEL 5",1121.0,616.55,267.14,1374.15,53
CPT,81405,"HC BLEEDING DISORDER, MOL PATH PROC, LEVEL 6",435.0,239.25,130.5,1506.75,53
CPT,81405,"HC CARDIOMYOPATHY MUTATION, MOL PATH PROC, LEVEL 6",640.0,352.0,192.0,1506.75,53
CPT,81405,"HC CARISIL HTRA1 SEQUENCING, MOL PATH PROC, LEVEL 6",724.0,398.2,217.2,1506.75,53
CPT,81405,"HC CTRC SEQUENCING, MOL PATH PROC, LEVEL 6",642.0,353.1,192.6,1506.75,53
CPT,81405,"HC FOCUSED ADPKD GENE, MOLECULAR PATHOLOGY LEVEL 6",806.5,443.58,241.95,1506.75,53
CPT,81405,"HC MEN1 DNA SEQUENCING, MOL PATH PROC, LEVEL 6",958.0,526.9,287.4,1506.75,53
CPT,81405,"HC NEUROFIBROMATOSIS TYP 1 & LEGIUS SYNDROME PANEL, MOL PATH PROC, LEVEL 6",1187.0,652.85,292.91,1506.75,53
CPT,81405,"HC NEUROFIBROMATOSIS, MOL PATH PROC, LEVEL 6",585.0,321.75,175.5,1506.75,53
CPT,81405,"HC PANCREATITIS (CTRC) SEQUENCING, MOL PATH PROC, LEVEL 6",806.0,443.3,241.8,1506.75,53
CPT,81405,"HC RESISTANCE TO THYROID HORMONE MUTATION, MOL PATH PROC, LEVEL 6",1448.0,796.4,292.91,1506.75,53
CPT,81405,"HC SUDDEN CARDIAC ARREST, MOL PATH PROC, LEVEL 6",804.0,442.2,241.2,1506.75,53
CPT,81405,"HC TUBEROUS SCLEROSIS TSC1 MPLA, MOL PATH PROC, LEVEL 6",594.0,326.7,178.2,1506.75,53
CPT,81405,"HC UPMC, MOL PATH PROC, LEVEL 6",479.0,263.45,143.7,1506.75,53
CPT,81405,"HC UREA CYCLE, MOL PATH PROC, LEVEL 6",526.0,289.3,157.8,1506.75,53
CPT,81406,"HC ACGH DELETION DUPLICATION, MOL PATH PROC, LEVEL 7",634.0,348.7,190.2,1414.4,53
CPT,81406,"HC AHUS/DDD GENETIC, MOL PATH PROC, LEVEL 7",5627.0,3094.85,274.96,4867.36,53
CPT,81406,"HC CARDIOMYOPATHY MUTATION, MOL PATH PROC, LEVEL 7",1690.0,929.5,274.96,1461.85,53
CPT,81406,"HC CARDISIL NOTCH 3 SEQUENCING, MOL PATH PROC, LEVEL 7",2396.0,1317.8,274.96,2072.54,53
CPT,81406,"HC CDH1 SEQUENCING, MOL PATH PROC, LEVEL 7",986.0,542.3,274.96,1414.4,53
CPT,81406,"HC FOCUSED ADPKD GENE, MOLECULAR PATHOLOGY LEVEL 7",760.0,418.0,228.0,1414.4,53
CPT,81406,"HC INH THROMBOCYTOPENIA, MOL PATH PROC, LEVEL 7",1688.0,928.4,274.96,1460.12,53
CPT,81406,"HC NEUROFIBROMATOSIS, MOL PATH PROC, LEVEL 7",904.0,497.2,271.2,1414.4,53
CPT,81406,"HC SUDDEN CARDIAC ARREST, MOL PATH PROC, LEVEL 7",2124.0,1168.2,274.96,1837.26,53
CPT,81406,"HC TUBEROUS SCLEROSIS TSC1 SEQUENCE, MOL PATH PROC, LEVEL 7",1571.0,864.05,274.96,1414.4,53
CPT,81406,"HC TUBEROUS SCLEROSIS TSC2 MPLA, MOL PATH PROC, LEVEL 7",1571.0,864.05,274.96,1414.4,53
CPT,81406,"HC UREA CYCLE, MOL PATH PROC, LEVEL 7",816.0,448.8,244.8,1414.4,53
CPT,81406,"HC WILSON DISEASE MUTATION, MOL PATH PROC, LEVEL 7",2219.0,1220.45,274.96,1919.44,53
CPT,81407,"HC ACGH DELETION DUPLICATION, MOL PATH PROC, LEVEL 8",1745.0,959.75,523.5,4231.35,53
CPT,81407,"HC BLEEDING DISORDER, MOL PATH PROC, LEVEL 8",1901.0,1045.55,570.3,4231.35,53
CPT,81407,"HC CARDIOMYOPATHY MUTATION, MOL PATH PROC, LEVEL 8",2728.0,1500.4,818.4,4231.35,53
CPT,81407,"HC FOCUSED ADPKD GENE, MOLECULAR PATHOLOGY LEVEL 8",2200.5,1210.28,660.15,4231.35,53
CPT,81407,"HC SUDDEN CARDIAC ARREST, MOL PATH PROC, LEVEL 8",3423.0,1882.65,822.57,4231.35,53
CPT,81407,"HC TUBEROUS SCLEROSIS TSC2 SEQUENCING, MOL PATH PROC, LEVEL 8",2532.0,1392.6,759.6,4231.35,53
CPT,81408,"HC BLEEDING DISORDER, MOL PATH PROC, LEVEL 9",4416.0,2428.8,1324.8,10000.0,53
CPT,81408,"HC NEUROFIBROMATOSIS, MOL PATH PROC, LEVEL 9",2320.0,1276.0,696.0,10000.0,53
CPT,81410,AORTIC DYSFUNCTION/DILATION,,,489.89,2520.0,23
CPT,81411,AORTIC DYSFUNCTION/DILATION,,,1312.39,6750.95,23
CPT,81412,ASHKENAZI JEWISH ASSOC DIS,,,2380.0,12242.8,23
CPT,81413,"HC CARDIAC ION CHANNELOPATH, GENOMIC SEQ ANALYS PANEL, AT LEAST 10 GENES",1724.0,948.2,517.2,2924.5,53
CPT,81414,"HC CARDIAC ION CHANNELOPATH, DUPL/DEL GENE ANALYS PANEL, AT LEAST 2 GENES",1724.0,948.2,517.2,2924.5,53
CPT,81415,"HC CONGENITAL ANOMALIES PANEL, EXONE; SEQUENCE ANALYSIS",9428.0,5185.4,2828.4,23900.0,53
CPT,81415,"HC WHOLE EXOME, SEQUENCE ANALYSIS",7562.0,4159.1,2268.6,23900.0,53
CPT,81416,"HC WHOLE EXOME, SEQUENCE ANALYSIS, EA COMPARATOR EXOME, EA ADDL",18982.0,10440.1,5694.6,60000.0,53
CPT,81417,EXOME RE-EVALUATION,,,311.04,1600.0,23
CPT,81418,RX METAB GEN SEQ ALYS PNL 6,,,891.41,4585.4,23
CPT,81419,EPILEPSY GEN SEQ ALYS PANEL,,,2380.0,12242.8,23
CPT,81420,"HC NON-INVASIVE PRENATAL FOR ANEUPLOIDY, FETAL CHRMOML ANPLDY GEN SEQ ANLYS",1640.0,902.0,492.0,3795.25,53
CPT,81422,FETAL CHRMOML MICRODELTJ,,,737.79,3795.25,23
CPT,81425,GENOME SEQUENCE ANALYSIS,,,4890.33,25156.0,23
CPT,81426,GENOME SEQUENCE ANALYSIS,,,2634.08,13549.75,23
CPT,81427,GENOME RE-EVALUATION,,,2272.19,11688.25,23
CPT,81430,HEARING LOSS SEQUENCE ANALYS,,,1579.5,8125.0,23
CPT,81431,HEARING LOSS DUP/DEL ANALYS,,,660.54,3397.85,23
CPT,81432,HRDTRY BRST CA-RLATD DO 5+,,,660.03,3395.25,23
CPT,81433,APC,,,438.93,452.1,15
CPT,81433,Lab/Pathology,,,2194.65,2194.65,1
CPT,81433,Laboratory,,,2194.65,2194.65,1
CPT,81434,HERED RTA DO GEN SEQ 15,,,581.17,2989.55,23
CPT,81435,HERED COLON CA-RLATD DO 5+,,,568.52,2924.5,23
CPT,81436,APC,,,584.9,602.45,15
CPT,81436,Lab/Pathology,,,2924.5,2924.5,1
CPT,81436,Laboratory,,,2924.5,2924.5,1
CPT,81437,HERED NEUROEND TUM-RLT DO 5+,,,426.65,2194.65,23
CPT,81438,APC,,,438.93,452.1,15
CPT,81438,Lab/Pathology,,,2194.65,2194.65,1
CPT,81438,Laboratory,,,2194.65,2194.65,1
CPT,81439,HRDTRY CARDMYPY GENE PANEL,,,568.52,2924.5,23
CPT,81440,MITOCHONDRIAL GENE,,,3230.93,16620.0,23
CPT,81441,IBMFS SEQ ALYS PNL 30 GENES,,,2380.0,12242.8,23
CPT,81442,NOONAN SPECTRUM DISORDERS,,,2083.58,10718.0,23
CPT,81443,"HC DIAMOND BLACKFAN ANEMIA, GENETIC TST SEVERE INHER COND, GENOM SEQ ANLYS",8627.0,4744.85,2380.0,12242.8,53
CPT,81443,"HC HEREDITARY HEMOLYTIC ANEMIA SEQ, GENETIC TSTG FOR SEVERE INHERITED COND",4025.0,2213.75,1207.5,12242.8,53
CPT,81443,"HC HLH GENE MUTAT, GENE TST SEVERE INHER COND, GENOM SEQ ANLY PNL, 15 GENES",6492.0,3570.6,1947.6,12242.8,53
CPT,81443,"HC MAYO HERED HA, GENET TST SEVERE INHER COND,GENOM SEQ ANLYS PNL, 15 GENES",8721.0,4796.55,2380.0,12242.8,53
CPT,81443,"HC TELOMERE DISORD GENE PNL, GENOM SEQ ANLYS, 15 GENES",3612.0,1986.6,1083.6,12242.8,53
CPT,81445,"HC BREAST, SOL ORG NEOPL, GEN SEQ PNL, 5-50 GENES, DNA/DNA & RNA",3456.0,1900.8,581.17,2989.55,53
CPT,81445,"HC CNS, SOL ORG NEOPL, GEN SEQ PNL, 5-50 GENES, DNA/DNA & RNA",3456.0,1900.8,581.17,2989.55,53
CPT,81445,"HC COLON, SOL ORG NEOPL, GEN SEQ PNL, 5-50 GENES, DNA/DNA & RNA",3456.0,1900.8,581.17,2989.55,53
CPT,81445,"HC COMPL, SOL ORG NEOPL, GEN SEQ PNL, 5-50 GENES, DNA/DNA & RNA",3456.0,1900.8,581.17,2989.55,53
CPT,81445,"HC FULL, SOL ORG NEOPL, GEN SEQ PNL, 5-50 GENES, DNA/DNA & RNA",2797.0,1538.35,581.17,2989.55,53
CPT,81445,"HC GIST, SOL ORG NEOPL, GEN SEQ PNL, 5-50 GENES, DNA/DNA & RNA",3456.0,1900.8,581.17,2989.55,53
CPT,81445,"HC LUNG, SOL ORG NEOPL, GEN SEQ PNL, 5-50 GENES, DNA/DNA & RNA",3456.0,1900.8,581.17,2989.55,53
CPT,81445,"HC MAYOCOMPL GIST, SOL ORG NEOPL, GEN SEQ PNL, 5-50 GENES, DNA/DNA & RNA",2104.0,1157.2,581.17,2989.55,53
CPT,81445,"HC MELANOMA, SOL ORG NEOPL, GEN SEQ PNL, 5-50 GENES, DNA/DNA & RNA",2736.5,1505.0749999999998,581.17,2989.55,106
CPT,81445,"HC OCCRA, SOL ORG NEOPL, GEN SEQ PNL, 5-50 GENES, DNA/DNA & RNA",3525.0,1938.75,581.17,3049.13,53
CPT,81445,"HC OVARIAN, SOL ORG NEOPL, GEN SEQ PNL, 5-50 GENES, DNA/DNA & RNA",3456.0,1900.8,581.17,2989.55,53
CPT,81445,"HC RENAL, SOL ORG NEOPL, GEN SEQ PNL, 5-50 GENES, DNA/DNA & RNA",3456.0,1900.8,581.17,2989.55,53
CPT,81445,"HC SALIV GLAND, SOL ORG NEOPL, GEN SEQ PNL, 5-50 GENES, DNA/DNA & RNA",2017.0,1109.35,581.17,2989.55,53
CPT,81445,"HC SOL ORG NEOPL, GEN SEQ PNL, 5-50 GENES, DNA/DNA & RNA",2017.0,1109.35,581.17,2989.55,53
CPT,81445,"HC THYROID, SOL ORG NEOPL, GEN SEQ PNL, 5-50 GENES, DNA/DNA & RNA",3456.0,1900.8,581.17,2989.55,53
CPT,81448,"HC CHARCOT-MARIE-TOOTH HERED NEUROPATHY, GENOM SEQ ANLYS PNL, 5 GENES",2211.0,1216.05,568.52,2924.5,53
CPT,81449,SO NEO GSAP 5-50 RNA ALYS,,,581.17,2989.55,23
CPT,81450,"HC MYELOID, HEMLYMPH NEOPL/DISORD, GEN SEQ PNL, 5-50 GENES, DNA/DNA&RNA",2646.0,1455.3,738.27,3797.65,53
CPT,81450,"HC NEOTYP FOLL, HEMLYMPH NEOPL/DISORD, GEN SEQ PNL, 5-50 GENES, DNA/DNA&RNA",2608.0,1434.4,738.27,3797.65,53
CPT,81451,HL NEO GSAP 5-50 RNA ALYS,,,738.27,3797.65,23
CPT,81455,"HC MAYO SARCOMA, SOL ORG/HEMLYMPH NEOPL, 51+GENES, GEN SEQ PNL, DNA/DNA&RNA",6760.0,3718.0,2028.0,14598.0,53
CPT,81455,"HC MYELOID, SOL ORG/HEMLYMPH NEOPL, 51+GENES, GEN SEQ PNL, DNA/DNA&RNA",4664.0,2565.2,1399.2,14598.0,53
CPT,81455,"HC NEURO EXP, SOL ORG/HEMLYMPH NEOPL, 51+GENES, GEN SEQ PNL, DNA/DNA&RNA",9500.0,5225.0,2837.85,14598.0,53
CPT,81456,"HC MAYO SARCOMA, SOL ORG/HEMLYMPH NEOPL, 51+GENES, GEN SEQ PNL, RNA",5294.0,2911.7,1588.2,14598.0,53
CPT,81457,"HC MAYOCOMPLETE GYN PANEL, DNA ANLYS, MICROSATELLITE INSTABILITY",4009.5,2205.23,871.76,4484.35,53
CPT,81457,"HC MAYOCOMPLETE LUNG CANCER PANEL, DNA ANLYS, MICROSATELLITE INSTABILITY",5223.5,2872.93,871.76,4518.33,53
CPT,81457,"HC MAYOCOMPLETE SARCOMA PANEL,DNA ANLYS, MICROSATELLITE INSTABILITY",6441.0,3542.55,871.76,5571.47,53
CPT,81458,SO GSAP DNA CPY NMBR&MCRSTL,,,1017.05,5231.75,23
CPT,81459,"HC MAYOCOMPLETE SOL TUMOR PNL, ORGAN NEOPLAS, GEN SEQ; DNA ANLYS",7301.0,4015.55,2190.3,14947.75,53
CPT,81460,"HC MITOCHONDRIAL DISORDER SEQUENCING, GENOME SEQ, MUST INCL SEQ ANLYS",3948.0,2171.4,1184.4,6435.0,53
CPT,81462,SO GSAP CLL FR DNA/DNA&RNA,,,1162.35,5979.15,23
CPT,81463,SO GSAP CL FR CPY NMBR&MCRST,,,1307.64,6726.55,23
CPT,81464,SO GSAP CLL FR MCRSTL INS,,,3196.43,16442.55,23
CPT,81465,"HC MITOCHONDRIAL DISORDER DELETION DUPLICATE, GENOME LRG DEL ANLYS PNL",3418.0,1879.9,909.79,4680.0,53
CPT,81465,"HC MTDNA POINT MUTATION AND DEL, WHOLE MITOCHOND GENOME LRG DEL ANLY PNL",3515.0,1933.25,909.79,4680.0,53
CPT,81470,X-LINKED INTELLECTUAL DBLT,,,888.41,4570.0,23
CPT,81471,X-LINKED INTELLECTUAL DBLT,,,888.41,4570.0,23
CPT,81479,"HC ASSAY FOR CIRCULATING TUMOR DNA, UNLIST MOL PATH PROC",5173.0,2845.15,1551.9,4474.65,76
CPT,81479,"HC B CATENIN MUTATION ANALYSIS, UNLIST MOL PATH PROC",2587.0,1422.85,776.1,2237.76,38
CPT,81479,"HC BC PARTIAL D, UNLIST MOL PATH PROC",708.0,389.4,212.4,612.42,76
CPT,81479,"HC BLEEDING DISORDER, UNLIST MOL PATH PROC",218.0,119.9,65.4,188.57,38
CPT,81479,"HC BLOOD DISORDER PAN MOLECULAR, UNLIST MOL PATH PROC",312.0,171.6,93.6,269.88,38
CPT,81479,"HC BPGM FULL GENE SEQUENCING, UNLIST MOL PATH PROC",1282.0,705.1,384.6,1108.93,38
CPT,81479,"HC BTK INHIBITOR RESISTANCE PANEL, UNLIST MOL PATH PROC",1521.0,836.55,456.3,1315.67,38
CPT,81479,"HC C9ORF72 ALS GENE, UNLIST MOL PATH PROC",559.0,307.45,167.7,483.54,38
CPT,81479,HC CARIS NGS UNLIST MOL PATH PROC,4767.0,2621.85,1430.1,4123.46,38
CPT,81479,"HC CARIS WES/WTS HYBRID ASSAY, UNLIST MOL PATH PROC",5494.0,3021.7,1648.2,4752.31,38
CPT,81479,"HC CARISIL HTRA1 MOLECULAR, UNLIST MOL PATH PROC",99.0,54.45,29.7,85.64,38
CPT,81479,"HC CD16A(FCGR3A) F158V POLYMORPHISM ANALYSIS, UNLIST MOL PATH PROC",809.0,444.95,242.7,699.79,38
CPT,81479,"HC CDH1 CNV DETECTION, UNLIST MOL PATH PROC",397.0,218.35,119.1,343.41,38
CPT,81479,"HC COMP GENOMIC PROFILE ASSAY FOR HEMATOLOGIC MALG, UNLIST MOL PATH PROC",5173.0,2845.15,1551.9,4474.65,76
CPT,81479,"HC COMPREHENSIVE GENOMIC PROFILE FOR SOLID TUMOR, UNLIST MOL PATH PROC",5173.0,2845.15,1551.9,4474.65,76
CPT,81479,"HC CUSTOM VARIANT DETECTION BY SANGER SEQUENCING, UNLIST MOL PATH PROC",315.0,173.25,94.5,272.48,38
CPT,81479,"HC CXCR4 MUTATION ANALYSIS LPL, UNLIST MOL PATH PROC",1311.0,721.05,393.3,1134.02,38
CPT,81479,"HC CXCR4 SEQUENCE ANALYSIS, UNLIST MOL PATH PROC",1913.0,1052.15,573.9,1654.75,38
CPT,81479,"HC CYTOCHROME P450 2C8, UNLISTED MOLECULAR PATHOLOGY PROCEDURE",158.0,86.9,47.4,136.67,38
CPT,81479,"HC CYTOCHROME P450 GENOTYPE PANEL, CYP2B6, UNLIST MOL PATH PROC",792.5,435.88,237.75,685.51,38
CPT,81479,"HC CYTOCHROME P450 GENOTYPE PANEL, CYP2C8, UNLIST MOL PATH PROC",147.5,81.13,44.25,127.59,38
CPT,81479,"HC DDD GENETIC EVAL AHUS, UNLIST MOL PATH PROC",1941.0,1067.55,582.3,1678.97,38
CPT,81479,"HC DYSKERATOSIS DKC1 SEQ, UNLIST MOL PATH PROC",3711.0,2041.05,1113.3,3210.02,38
CPT,81479,"HC DYSKERATOSIS TERC SEQ, UNLIST MOL PATH PROC",730.0,401.5,219.0,631.45,38
CPT,81479,"HC EPILEPSY GENETIC PANEL, UNLIST MOL PATH PROC",2887.0,1587.85,866.1,2497.26,38
CPT,81479,"HC EPOR MUTATION DETECTION, UNLISTED MOLECULAR PATHOLOGY PROCEDURE",649.0,356.95,194.7,561.39,38
CPT,81479,"HC ETV6 SEQUENCE ANALYSIS, UNLIST MOL PATH PROC",1913.0,1052.15,573.9,1654.75,38
CPT,81479,"HC FAMILIAL HYPERCHOLESTEROL PANEL, UNLIST MOL PATH PROC",1667.0,916.85,500.1,1441.96,38
CPT,81479,"HC FOCUSED ADPKD GENE, UNLISTED MOLECULAR PATHOLOGY",35.5,19.53,10.65,30.71,38
CPT,81479,"HC GENETICS, UNLIST MOL PATH PROC",271.0,149.05,81.3,234.42,38
CPT,81479,"HC HEREDITARY ERYTHROCYTOSIS MUTATION, UNLIST MOL PATH PROC",1321.0,726.55,396.3,1142.67,38
CPT,81479,"HC IBD SNP, UNLIST MOL PATH PROC",61.0,33.55,18.3,52.77,38
CPT,81479,"HC INH THROMBOCYTOPENIA, UNLIST MOL PATH PROC",1330.0,731.5,399.0,1150.45,38
CPT,81479,"HC LCHAD MUTATION, UNLIST MOL PATH PROC",693.0,381.15,207.9,599.45,38
CPT,81479,"HC MESENCHYMAL CHRONDROSARCOMA, UNLIST MOL PATH PROC",1722.0,947.1,516.6,1489.53,38
CPT,81479,"HC NEUROFIBROMATOSIS, UNLIST MOL PATH PROC",1187.0,652.85,356.1,1026.76,38
CPT,81479,"HC ONCOLOGY CUSTOM MGENE PANEL, UNLIST MOL PATH PROC",2674.0,1470.7,802.2,2313.01,38
CPT,81479,"HC PANCREATITIS (PRSS1) DELETION, UNLIST MOL PATH PROC",651.0,358.05,195.3,563.12,38
CPT,81479,"HC PANCREATITIS PRSS1 DELETION, UNLIST MOL PATH PROC",651.0,358.05,195.3,563.12,38
CPT,81479,"HC PATHOGEN NUCLEIC ACIDS MNGS, UNLIST MOL PATH PROC",4611.0,2536.05,1383.3,3988.52,38
CPT,81479,"HC PERIODIC FEVER DEL/DUP, UNLISTED MOLECULAR PATHOLOGY PROCEDURE",1806.0,993.3,541.8,1562.19,38
CPT,81479,"HC PNEUMONIA PANEL, BACTERICAL & VIRAL, UNLIST MOL PATH PROC",548.0,301.4,164.4,474.02,38
CPT,81479,"HC POLE MUTATION, UNLIST MOL PATH PROC",2505.0,1377.75,751.5,2166.83,38
CPT,81479,"HC PRIMARY IMMUNODEFICIENCY PANEL, UNLIST MOL PATH PROC",2887.0,1587.85,866.1,2497.26,38
CPT,81479,"HC SERPINC1 GENETIC ANALYSIS, UNLISTED MOLECULAR PATHOLOGY PROCEDURE",1527.0,839.85,458.1,1320.86,38
CPT,81479,"HC SF3B1 MUTATION ANALYSIS, UNLIST MOL PATH PROC",651.0,358.05,195.3,563.12,38
CPT,81479,"HC SHWACHMAN-DIAMOND SYNDROME SEQUENCING, UNLIST MOL PATH PROC",1238.0,680.9,371.4,1070.87,38
CPT,81479,"HC SINGLE GENE SEQUENCING, UNLIST MOL PATH PRO",604.0,332.2,181.2,522.46,38
CPT,81479,"HC SOMATIC OVERGROWTH NGS, UNLIST MOL PATH PROC",4817.0,2649.35,1445.1,4166.71,38
CPT,81479,"HC THROMBOSIS PANEL, UNLIST MOL PATH PROC",3606.0,1983.3,1081.8,3119.19,38
CPT,81479,"HC UPMC, UNLIST MOL PATH PROC",49.0,26.95,14.7,42.39,38
CPT,81479,"HC UREA CYCLE, UNLIST MOL PATH PROC",38.0,20.9,11.4,32.87,38
CPT,81479,"HC VASCULAR DISORDERS GENETIC PANEL, UNLIST MOL PATH PROC",5860.0,3223.0,1758.0,5068.9,38
CPT,81479,"HC WEAK RHD ANALYSIS BCW, UNLIST MOL PATH PROC",1031.0,567.05,309.3,891.82,38
CPT,81490,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score",,,817.11,4203.25,23
CPT,81493,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score",,,1020.6,5250.0,23
CPT,81500,ONCO (OVAR) TWO PROTEINS,,,253.21,1302.5,23
CPT,81503,ONCO (OVAR) FIVE PROTEINS,,,871.88,4485.0,23
CPT,81504,ONCOLOGY TISSUE OF ORIGIN,,,505.44,2600.0,23
CPT,81506,ENDO ASSAY SEVEN ANAL,,,66.99,344.6,23
CPT,81507,FETAL ANEUPLOIDY TRISOM RISK,,,772.74,3975.0,23
CPT,81508,FTL CGEN ABNOR TWO PROTEINS,,,52.78,271.5,23
CPT,81509,FTL CGEN ABNOR 3 PROTEINS,,,1445.72,7436.85,23
CPT,81510,FTL CGEN ABNOR THREE ANAL,,,53.99,277.7,23
CPT,81511,"HC PRENATAL RISK QUAD, FETAL CONGENIT ABNORM, BIOCHEM ASSAY FOUR ANALYTES",315.0,173.25,94.5,767.5,53
CPT,81512,FTL CGEN ABNOR FIVE ANAL,,,67.57,347.6,23
CPT,81513,NFCT DS BV RNA VAG FLU ALG,,,138.64,713.15,23
CPT,81514,NFCT DS BV&VAGINITIS DNA ALG,,,255.63,1314.95,23
CPT,81515,"HC INFCT DS, BV AND VAGINITIS REAL-TIME PCR AMP DNA MARKERS",289.5,159.23,86.85,1314.95,53
CPT,81517,LIVER DS ALYS 3 BMRK SRM ALG,,,171.26,880.95,23
CPT,81518,ONC BRST MRNA 11 GENES,,,3764.56,19365.0,23
CPT,81519,ONCOLOGY BREAST MRNA,,,3764.56,19365.0,23
CPT,81520,ONC BREAST MRNA 58 GENES,,,2439.93,12551.05,23
CPT,81521,ONC BREAST MRNA 70 GENES,,,3764.56,19365.0,23
CPT,81522,ONC BREAST MRNA 12 GENES,,,3764.56,19365.0,22
CPT,81523,ONC BRST MRNA 70 CNT 31 GENE,,,3764.56,19365.0,23
CPT,81525,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,3028.75,15580.0,23
CPT,81528,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,494.62,2544.35,23
CPT,81529,ONC CUTAN MLNMA MRNA 31 GENE,,,6991.6,35965.0,23
CPT,81535,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,563.24,2897.3,23
CPT,81536,ONCOLOGY GYNECOLOGIC,,,172.58,887.8,23
CPT,81538,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival",,,2790.61,14355.0,23
CPT,81539,"HC PSK, 4K SCORE, ONC, BIOCHEM ASSAY 4 PROTEINS",1286.0,707.3,385.8,3800.0,53
CPT,81540,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,3645.0,18750.0,23
CPT,81541,ONC PROSTATE MRNA 46 GENES,,,3764.56,19365.0,23
CPT,81542,ONC PROSTATE MRNA 22 CNT GEN,,,3764.56,19365.0,22
CPT,81546,"ONC THYR MRNA 10,196 GEN ALG",,,3499.2,18000.0,23
CPT,81551,ONC PROSTATE 3 GENES,,,1973.16,10150.0,23
CPT,81552,ONC UVEAL MLNMA MRNA 15 GENE,,,7558.27,38880.0,22
CPT,81554,PULM DS IPF MRNA 190 GEN ALG,,,5365.44,27600.0,23
CPT,81558,TRNSPL REJ KDN MRNA QPCR 139,,,3149.28,16200.0,23
CPT,81560,TRNSPLJ PD LVR&BWL CD154+CLL,,,622.79,3203.65,23
CPT,81595,CARDIOLOGY HRT TRNSPL MRNA,,,3149.28,16200.0,23
CPT,81596,NFCT DS CHRNC HCV 6 ASSAYS,,,70.17,360.95,23
CPT,81599,"HC PREDICTRPK ADA, UNLIST MULTIANALYTE ASSAY W ALGORITHMIC ANLYS",789.0,433.95,236.7,682.49,38
CPT,81599,"HC PREDICTRPK IFX INDUCTION,UNLIST MULTIANALYTE ASSAY W ALGORITHMIC ANLYS",789.0,433.95,236.7,682.49,38
CPT,81599,"HC PREDICTRPK IFX, UNLIST MULTIANALYTE ASSAY W ALGORITHMIC ANLYS",789.0,433.95,236.7,682.49,38
CPT,81599,"HC PREDICTRPK UST,UNLIST MULTIANALYTE ASSAY W ALGORITHMIC ANLYS",789.0,433.95,236.7,682.49,38
CPT,81599,"HC PREDICTRPK VDZ, UNLIST MULTIANALYTE ASSAY W ALGORITHMIC ANLYS",789.0,433.95,236.7,682.49,38
CPT,82009,KETONE BODYS QUAL,,,4.39,22.6,23
CPT,82010,"HC ACETOACETATE,  KETONE BODY(S) ASSAY QUANTITATIVE",615.0,338.25,7.94,531.98,53
CPT,82010,"HC BETA-HYDROXYBUTYRATE, KETONE BODY(S), QUANT",66.0,36.3,7.94,57.09,53
CPT,82010,HC KETONE BODY(S) ASSAY QUANTITATIVE,66.0,36.3,7.94,57.09,53
CPT,82013,"HC ACETYLCHOLINESTERASE AMNIOTIC FLUID, ACETYLCHOLINESTERASE ASSAY",204.0,112.2,11.95,176.46,53
CPT,82016,ACYLCARNITINES QUAL,,,16.03,82.45,23
CPT,82017,"HC ACYLCARNITINES PROFILE, QUANTITATIVE, EA SPECIMEN",331.0,182.05,16.4,286.32,53
CPT,82017,HC ACYLCARNITINES QUANTITATIVE,124.0,68.2,16.4,107.26,53
CPT,82017,"HC GLUTARYLCARNITINE QUANT URINE, ACYLCARNITINES QUANTIATIVE EACH SPECIMEN",481.0,264.55,16.4,416.07,53
CPT,82024,"HC 0 MIN, ACTH ASSAY",109.0,59.95,32.7,193.1,53
CPT,82024,"HC 10 MIN, ACTH ASSAY",109.0,59.95,32.7,193.1,53
CPT,82024,"HC 120 MIN, ACTH ASSAY",109.0,59.95,32.7,193.1,53
CPT,82024,"HC 20 MIN, ACTH ASSAY",109.0,59.95,32.7,193.1,53
CPT,82024,"HC 30 MIN, ACTH ASSAY",109.0,59.95,32.7,193.1,53
CPT,82024,"HC 45 MIN, ACTH ASSAY",109.0,59.95,32.7,193.1,53
CPT,82024,"HC 60 MIN, ACTH ASSAY",109.0,59.95,32.7,193.1,53
CPT,82024,"HC 90 MIN, ACTH ASSAY",109.0,59.95,32.7,193.1,53
CPT,82024,HC ACTH ASSAY,304.0,167.2,37.54,262.96,106
CPT,82030,ASSAY OF ADP & AMP,,,25.07,129.0,23
CPT,82040,HC SERUM ALBUMIN ASSAY,72.5,39.875,4.82,76.99,106
CPT,82042,"HC ALBUMIN CSF, ALBUMIN, OTHER SOURCE, QUANT, EA SPECIMEN",40.0,22.0,7.57,38.9,53
CPT,82042,HC ALBUMIN FLUID,30.0,16.5,7.57,38.9,53
CPT,82042,HC ALBUMIN FLUID ASSAY,40.0,22.0,7.57,38.9,53
CPT,82042,"HC CSF (2), ALBUMIN, OTHER SOURCE, QUANT, EA SPECIMEN",166.0,91.3,7.57,143.59,53
CPT,82043,"HC RANDOM, ALBUMIN, URINE, QUANT",99.0,54.45,5.63,85.64,53
CPT,82043,HC URINE ALBUMIN QUANTITATIVE,32.0,17.6,5.63,28.9,53
CPT,82044,UR ALBUMIN SEMIQUANTITATIVE,,,6.06,31.15,23
CPT,82045,ALBUMIN ISCHEMIA MODIFIED,,,32.99,169.7,23
CPT,82075,ASSAY OF BREATH ETHANOL,,,29.16,150.0,23
CPT,82077,HC ALCOHOL (ETHANOL) SPECIMEN EXCEPT URINE & BREATH IA AND ENZYMATIC METHOD,80.0,44.0,16.79,86.35,53
CPT,82085,HC ALDOLASE ASSAY,68.0,37.4,9.44,58.82,53
CPT,82088,HC ALDOSTERONE SERUM ASSAY,259.0,142.45,39.61,224.04,53
CPT,82088,HC ALDOSTERONE URINE ASSAY,108.0,59.4,32.4,203.75,53
CPT,82088,HC ASSSAY OF ALDOSTERONE (SPECIFIC SITE),402.0,221.1,39.61,347.73,53
CPT,82103,HC ALPHA-1-ANTITRYPSIN CLEARANCE,722.0,397.1,13.07,624.53,53
CPT,82103,HC ALPHA-1-ANTITRYPSIN FECES,718.0,394.9,13.07,621.07,53
CPT,82103,HC ALPHA-1-ANTITRYPSIN TOTAL,76.0,41.8,13.07,67.2,53
CPT,82103,"HC FECES, ALPHA-1-ANTITRYPSIN, TOTAL (2)",238.0,130.9,13.07,205.87,53
CPT,82104,HC ALPHA-1-ANTITRYPSIN PHENO,67.0,36.85,14.06,72.3,53
CPT,82104,"HC BILL, ALPHA-1-ANTITRYPSIN, PHENOTYPE",141.0,77.55,14.06,121.97,53
CPT,82105,HC ALPHA-FETOPROTEIN PREGNANCY,76.0,41.8,16.3,83.85,53
CPT,82105,HC ALPHA-FETOPROTEIN TUMOR FLUID,278.0,152.9,16.3,240.47,53
CPT,82105,HC MS ALPHA-FETOPROTEIN LEVEL,339.0,186.45,16.3,293.24,53
CPT,82106,"HC ALPHA-FETOPROTEIN (AFP), AMNIOTIC FLUID",68.0,37.4,16.52,85.0,53
CPT,82107,"HC HEPATOCELLULAR CARCINOMA, AFP-L3 FRACTION ISOFORM & TOTAL AFP W/RATIO",299.0,164.45,62.6,322.05,53
CPT,82108,HC ALUMINUM SERUM ASSAY,169.0,92.95,24.77,146.19,53
CPT,82120,AMINES VAGINAL FLUID QUAL,,,5.82,29.95,23
CPT,82127,AMINO ACID SINGLE QUAL,,,13.79,70.9,23
CPT,82128,AMINO ACIDS MULT QUAL,,,13.48,69.35,23
CPT,82131,HC AMINO ACIDS SGL QUANT CYSTINE URINE TIMED HPLC,76.0,41.8,22.34,114.9,53
CPT,82131,HC AMINO ACIDS SINGLE QUANTITATIVE CYSTINE URINE,70.0,38.5,21.0,114.9,53
CPT,82131,HC AMINO ACIDS SINGLE QUANTITATIVE CYSTINE WBC,228.0,125.4,22.34,197.22,53
CPT,82131,HC AMINO ACIDS SINGLE QUANTITATIVE TAURINE,174.0,95.7,22.34,150.51,53
CPT,82131,"HC PHENYLALANINE, AMINO ACIDS, SINGLE, QUANT, EA SPECIMEN",102.0,56.1,22.34,114.9,53
CPT,82131,"HC PHENYLALANINE, AMINO ACIDS, SINGLE, QUANT, EACH SPECIMEN",80.0,44.0,22.34,114.9,53
CPT,82135,HC AMINOLEVULENIC ACID DELTA URINE RANDOM ASSAY,229.0,125.95,15.99,198.09,53
CPT,82135,"HC AMINOLEVULENIC ACID URINE, AMINOLEVULINIC ACID, DELTA (ALA) ASSAY",147.0,80.85,15.99,127.16,53
CPT,82136,"HC PHENYLALANINE AND TYROSINE, AMINO ACIDS QUANT 2-5, EA SPECIMEN",261.0,143.55,19.06,225.77,53
CPT,82136,"HC TYROSINE, AMINO ACIDS, 2 TO 5 AMINO ACIDS, QUANTITATIVE , EACH SPECIMEN",143.0,78.65,19.06,123.7,53
CPT,82139,"HC AMINO ACID, URINE , 6/MORE, QUANT, EA SPCMN",987.5,543.13,16.4,854.19,53
CPT,82139,"HC AMINO ACIDS, 6 OR MORE QUANT (1)",258.0,141.9,16.4,223.17,53
CPT,82139,"HC AMINO ACIDS, 6 OR MORE QUANT URINE",281.0,154.55,16.4,243.07,53
CPT,82140,HC AMMONIA ASSAY,174.0,95.7,14.16,193.76,106
CPT,82140,HC SUPERSATURATION PANEL -AMMONIA,37.0,20.35,11.1,72.85,53
CPT,82143,AMNIOTIC FLUID SCAN,,,9.09,46.75,23
CPT,82150,HC AMYLASE ASSAY,103.0,56.65,6.3,89.1,53
CPT,82150,HC AMYLASE BODY FLUID,204.0,112.2,6.3,176.46,53
CPT,82150,HC AMYLASE BODY FLUID ASSAY,31.0,17.05,6.3,32.4,53
CPT,82150,HC AMYLASE FLUID ASSAY,121.0,66.55,6.3,104.67,53
CPT,82150,HC AMYLASE ISOENZYME ASSAY,24.0,13.2,6.3,32.4,53
CPT,82150,HC AMYLASE PANCREATIC CYST ASSAY,416.0,228.8,6.3,359.84,53
CPT,82150,HC AMYLASE SERUM ASSAY,24.0,13.2,6.3,32.4,53
CPT,82150,HC AMYLASE URINE ASSAY,92.0,50.6,6.3,79.58,53
CPT,82150,HC MACROAMYLASE AMYLASE TOTAL ASSAY,172.0,94.6,6.3,148.78,53
CPT,82154,HC 3A ANDROSTANEDIOL GLUCURONIDE ASSAY,109.0,59.95,28.03,144.15,53
CPT,82157,HC ANDROSTENEDIONE ASSAY,91.0,50.05,27.3,146.4,53
CPT,82160,ASSAY OF ANDROSTERONE,,,24.83,127.75,23
CPT,82163,ASSAY OF ANGIOTENSIN II,,,19.94,102.6,23
CPT,82164,HC ANGIOTENSIN I CONVERTING ENZYME,66.0,36.3,14.19,73.0,53
CPT,82164,HC ANGIOTENSIN I CONVERTING ENZYME CSF,138.0,75.9,14.19,119.37,53
CPT,82166,HC ANTI-MULLERIAN HORMONE,106.0,58.3,31.8,193.1,53
CPT,82172,HC APOLIPOPROTEIN A ASSAY,56.0,30.8,16.8,105.45,53
CPT,82172,HC APOLIPOPROTEIN B ASSAY,47.5,26.125,11.7,105.45,106
CPT,82175,HC ARSENIC BLOOD ASSAY,48.0,26.4,14.4,94.85,53
CPT,82175,"HC ARSENIC FRACTIONATED URINE, ARSENIC ASSAY",254.0,139.7,18.43,219.71,53
CPT,82175,HC ARSENIC URINE ASSAY,48.0,26.4,14.4,94.85,53
CPT,82180,HC ASCORBIC ACID ASSAY,75.0,41.25,9.61,64.88,53
CPT,82190,ATOMIC ABSORPTION,,,15.45,79.5,23
CPT,82232,HC BETA-2 MICROGLOBULIN AF ASSAY,161.0,88.55,15.73,139.27,53
CPT,82232,HC BETA-2 MICROGLOBULIN ASSAY,179.0,98.45,15.73,154.84,53
CPT,82232,"HC BETA-2 MICROGLOBULIN URINE, BETA-2 MICROGLOBULIN ASSAY",50.0,27.5,15.0,80.9,53
CPT,82232,"HC CSF, BETA-2 MICROGLOBULIN",63.0,34.65,15.73,80.9,53
CPT,82234,HC ALZHEIMER 1-42 ABETA,642.0,353.1,192.6,555.33,38
CPT,82239,HC BILE ACIDS TOTAL,114.0,62.7,16.64,98.61,53
CPT,82240,BILE ACIDS CHOLYLGLYCINE,,,25.84,132.9,23
CPT,82247,HC BILIRUBIN FLUID,21.0,11.55,4.88,25.1,53
CPT,82247,HC BILIRUBIN TOTAL,65.0,35.75,4.88,56.23,53
CPT,82248,HC BILIRUBIN DIRECT,68.0,37.4,4.88,58.82,53
CPT,82252,FECAL BILIRUBIN TEST,,,4.43,22.8,23
CPT,82261,HC BIOTINIDASE ASSAY,68.0,37.4,16.4,84.35,53
CPT,82270,OCCULT BLOOD FECES,,,4.26,21.9,23
CPT,82271,HC OCCULT BLOOD OTHER SOURCES,43.0,23.65,5.17,37.2,106
CPT,82272,OCCULT BLD FECES 1-3 TESTS,,,4.11,21.15,23
CPT,82274,HC BLOOD FECAL OCCULT IMMUNOASSAY DX,146.0,80.3,15.47,126.29,53
CPT,82286,ASSAY OF BRADYKININ,,,5.01,25.8,23
CPT,82300,HC CADMIUM BLOOD ASSAY,139.0,76.45,22.98,120.24,53
CPT,82300,HC CADMIUM URINE. CADMIUM ASSAY,30.0,16.5,9.0,118.2,53
CPT,82306,"HC CYP24A1, VITAMIN D 25 HYDROXY",84.0,46.2,25.2,148.0,53
CPT,82306,"HC D2 AND D3, VITAMIN D, 25 HYDROXY, INCL FRACTION(S)",195.0,107.25,28.77,168.68,53
CPT,82306,HC VITAMIN D 25 HYDROXY,261.0,143.55,28.77,225.77,53
CPT,82306,HC VITAMIN D 25 HYDROXY FRACTIONATED,261.0,143.55,28.77,225.77,53
CPT,82308,HC CALCITONIN ASSAY,168.0,92.4,26.05,145.32,53
CPT,82308,"HC FNA, CALCITONIN",343.0,188.65,26.05,296.7,53
CPT,82310,HC CALCIUM ASSAY TOTAL,57.0,31.35,5.01,49.31,106
CPT,82330,HC CALCIUM ASSAY IONIZED,130.0,71.5,13.3,112.45,53
CPT,82330,HC CALCIUM IONIZED ASSAY,121.0,66.55,13.3,104.67,159
CPT,82331,CALCIUM INFUSION TEST,,,12.97,66.7,23
CPT,82340,HC CALCIUM IN URINE ASSAY,128.0,70.4,5.87,110.72,53
CPT,82340,"HC CALCIUM, URINE",40.0,22.0,5.87,34.6,53
CPT,82340,"HC CALCIUM, URINE QUANT, TIMED SPECIMEN ASSAY",35.0,19.25,5.87,30.28,106
CPT,82340,"HC SUPERSATURATION PANEL, CALCIUM, URINE QUANT, TIMED SPCMN",20.0,11.0,5.87,30.15,53
CPT,82355,CALCULUS ANALYSIS QUAL,,,11.26,57.9,23
CPT,82360,CALCULUS ASSAY QUANT,,,12.51,64.35,23
CPT,82365,HC CALCULUS INFARED SPECTROSCOPY MCW,263.0,144.65,12.54,227.5,53
CPT,82365,"HC STONE ANALYSIS, CALCULUS, INFRARED SPECTROSCOPY",108.0,59.4,12.54,93.42,53
CPT,82370,X-RAY ASSAY CALCULUS,,,12.17,62.6,23
CPT,82373,HC CARBOHYDRYATE DEFICIENT (C-D) TRANSFERRIN ASSAY,468.0,257.4,17.55,404.82,53
CPT,82373,HC CARBOHYDRYATE DEFICIENT TRANSFERRIN,238.0,130.9,17.55,205.87,53
CPT,82374,HC BICARBONATE (CARBON DIOXIDE) ASSAY,53.0,29.15,4.74,45.85,53
CPT,82374,"HC POC, BICARBONATE (CARBON DIOXIDE) ASSAY",55.0,30.25,4.74,47.58,106
CPT,82375,HC ASSAY CARBOXYHB QUANT,135.0,74.25,11.97,116.78,53
CPT,82375,HC CARBOXYHEMOGLOBIN QUANT ASSAY,115.0,63.25,11.97,99.48,159
CPT,82376,ASSAY CARBOXYHB QUAL,,,13.67,70.35,23
CPT,82378,HC CARCINOEMBRYONIC ANTIGEN (CEA),183.0,100.65,18.43,224.9,106
CPT,82378,HC CARCINOEMBRYONIC ANTIGEN (CEA) PANCREATIC CYST,335.0,184.25,18.43,289.78,53
CPT,82379,HC CARNITINE TOTAL & FREE ASSAY,147.0,80.85,16.4,127.16,53
CPT,82380,HC CAROTENE ASSAY,144.0,79.2,8.96,124.56,53
CPT,82382,ASSAY URINE CATECHOLAMINES,,,26.53,136.5,23
CPT,82383,ASSAY BLOOD CATECHOLAMINES,,,28.27,145.4,23
CPT,82384,"HC CATECHOLAMINES FRACTIONATED URINE, CATECHOLAMINES, FRACTIONATED ASSAY",114.0,62.7,24.54,126.25,53
CPT,82384,HC CATECHOLAMINES PLASMA FRACTIONATED ASSAY,245.0,134.75,24.54,211.93,53
CPT,82384,"HC EPINEPHRINE, CATECHOLAMINES FRACTIONATED ASSAY",370.0,203.5,24.54,320.05,53
CPT,82387,ASSAY OF CATHEPSIN-D,,,17.55,90.3,23
CPT,82390,HC CERULOPLASMIN,48.0,26.4,10.44,53.7,53
CPT,82390,HC CERULOPLASMIN ASSAY,45.0,24.75,10.44,53.7,53
CPT,82397,"HC ADALIMIMAB ANTIBODY, CHEMILUMINESCENT ASSAY",667.0,366.85,13.73,576.96,53
CPT,82397,"HC CELIAC PROMETHEUS AGA IGA, CHEMILUMINESCENT",104.0,57.2,13.73,89.96,53
CPT,82397,"HC CELIAC PROMETHEUS AGA IGG, CHEMILUMINESCENT",104.0,57.2,13.73,89.96,53
CPT,82397,"HC CELIAC PROMETHEUS HU-TTG IGA, CHEMILUMINESCENT",104.0,57.2,13.73,89.96,53
CPT,82397,HC CHEMILUMINESCENT ASSAY,424.0,233.2,13.73,366.76,53
CPT,82397,"HC IBD, CHEMILUMINESCENT",104.0,57.2,13.73,89.96,53
CPT,82397,"HC IGF BINDING PROTEIN 3, CHEMILUMINESCENT ASSAY",90.0,49.5,13.73,77.85,53
CPT,82397,"HC INFLIXIMAB ANTIBODY, CHEMILUMINESCENT ASSAY",774.0,425.7,13.73,669.51,53
CPT,82397,"HC MONITR SAA, CHEMILUMINESCENT",126.0,69.3,13.73,108.99,53
CPT,82397,"HC NATALIZUMAB ANTIBODY, CHEMILUMINESCENT ASSAY",282.0,155.1,13.73,243.93,53
CPT,82397,"HC NECROTIZING MYOPATHY HMGC, CHEMILUMINESCENT",617.0,339.35,13.73,533.71,53
CPT,82397,"HC RITUXIMAB,CHEMILUMINESCENT",354.5,194.98,13.73,306.64,53
CPT,82415,ASSAY OF CHLORAMPHENICOL,,,12.31,63.35,23
CPT,82435,HC BLOOD CHLORIDE ASSAY,58.0,31.9,4.47,50.17,159
CPT,82435,HC WHOLE BLOOD CHLORIDE,21.0,11.55,4.47,23.0,53
CPT,82436,HC CHLORIDE URINE ASSAY,53.0,29.15,5.59,53.63,159
CPT,82436,"HC CHLORIDE, URINE",49.0,26.95,5.59,42.39,53
CPT,82436,HC SUPERSATURATION PANEL CHLORIDE URINE,19.0,10.45,5.59,28.75,53
CPT,82438,HC ASSAY OTHER FLUID CHLORIDES,89.0,48.95,4.86,76.99,53
CPT,82438,HC ASSAY OTHER FLUID CHLORIDES_FECAL,40.0,22.0,4.86,34.6,53
CPT,82441,TEST FOR CHLOROHYDROCARBONS,,,5.84,30.05,23
CPT,82465,HC ASSAY BLD SERUM CHOLESTEROL,67.0,36.85,4.23,57.96,53
CPT,82465,"HC CHOLESTEROL FLUID, SERUM/WHOLE BLOOD, TOTAL",12.0,6.6,3.6,21.75,106
CPT,82480,HC ASSAY SERUM CHOLINESTERASE,40.0,22.0,7.65,39.35,53
CPT,82482,HC RBC CHOLINESTERASE ASSAY,190.0,104.5,9.53,164.35,53
CPT,82485,ASSAY CHONDROITIN SULFATE,,,20.07,103.25,23
CPT,82495,HC CHROMIUM BLOOD ASSAY,95.0,52.25,19.72,101.4,53
CPT,82495,HC CHROMIUM FLUID ASSAY,316.0,173.8,19.72,273.34,53
CPT,82495,"HC RBC, CHROMIUM",97.0,53.35,19.72,101.4,53
CPT,82507,"HC CITRATE URINE (1), CITRATE ASSAY",64.0,35.2,19.2,139.0,53
CPT,82507,HC CITRATE URINE ASSAY (2),64.0,35.2,19.2,139.0,53
CPT,82507,"HC CITRIC ACID SERUM, CITRATE ASSAY",444.0,244.2,27.02,384.06,53
CPT,82507,HC SUPERSATURATION PANEL CITRATE,63.0,34.65,18.9,139.0,53
CPT,82523,HC C TELOPEPTIDE COLLAGEN CROSS LINKS,161.0,88.55,18.16,139.27,53
CPT,82523,"HC C-TELOPEPTIDE, BETA-CROSS-LINKED, SERUM",51.0,28.05,15.3,93.4,106
CPT,82523,HC COLLAGEN CROSS LNKS_PROCOLLGN INT NTERM PROPEP1,439.0,241.45,18.16,379.74,53
CPT,82523,HC N TELOPEPTIDE URINE COLLAGEN CROSS LINKS,267.0,146.85,18.16,230.96,53
CPT,82523,HC N-TELOPEPTIDE COLLAGEN CROSS LINKS,412.0,226.6,18.16,356.38,53
CPT,82525,HC COPPER FREE,335.0,184.25,12.06,289.78,53
CPT,82525,HC COPPER PLASMA ASSAY (2),121.0,66.55,12.06,104.67,53
CPT,82525,HC COPPER RBC ASSAY,393.0,216.15,12.06,339.95,53
CPT,82525,HC COPPER URINE ASSAY,70.0,38.5,12.06,62.05,53
CPT,82525,HC MAYO COPPER LIVER TISSUE ASSAY,1423.0,782.65,12.06,1230.9,53
CPT,82528,HC CORTICOSTERONE ASSAY,137.0,75.35,21.89,118.51,53
CPT,82530,HC CORTISOL FREE SERUM,210.0,115.5,16.25,181.65,53
CPT,82530,HC CORTISOL FREE URINE,298.0,163.9,16.25,257.77,53
CPT,82533,"HC 120 MIN, TOTAL CORTISOL",296.0,162.8,15.84,256.04,53
CPT,82533,"HC 30 MIN, TOTAL CORTISOL",296.0,162.8,15.84,256.04,53
CPT,82533,"HC 45 MIN, TOTAL CORTISOL",296.0,162.8,15.84,256.04,53
CPT,82533,"HC 60 MIN, TOTAL CORTISOL",296.0,162.8,15.84,256.04,53
CPT,82533,"HC 90 MIN, TOTAL CORTISOL",296.0,162.8,15.84,256.04,53
CPT,82533,"HC AM, TOTAL CORTISOL",296.0,162.8,15.84,256.04,53
CPT,82533,"HC LC-MS/MS, TOTAL CORTISOL",353.0,194.15,15.84,305.35,53
CPT,82533,"HC PM, TOTAL CORTISOL",296.0,162.8,15.84,256.04,53
CPT,82533,HC TOTAL CORTISOL,221.0,121.55000000000001,15.84,256.04,265
CPT,82540,HC CREATINE ASSAY (2),71.0,39.05,4.51,61.42,53
CPT,82540,HC CREATINE URINE ASSAY,66.0,36.3,4.51,57.09,53
CPT,82542,"HC 24 25 DIHYDROXY VIT D, COL CHRMTGRPH, MASS SPECT, NON-RX ANLYT, NES, EA",66.0,36.3,19.8,120.45,53
CPT,82542,"HC 3-METHOXYTYRAMINE, 24 HR URINE, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",552.0,303.6,23.42,477.48,53
CPT,82542,"HC 5-MTHF CSF, COL CHRMTGRPH, NON-RX ANALYTE NES QUAL/QUANT EA SPEC",203.0,111.65,23.42,175.6,53
CPT,82542,"HC 6MP THIOPURINE METABOLITES, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",236.0,129.8,23.42,204.14,53
CPT,82542,"HC 6TG, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",133.0,73.15,23.42,120.45,53
CPT,82542,"HC ACYGLYCINES URINE, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",470.0,258.5,23.42,406.55,53
CPT,82542,"HC AMYLOIDOSIS FAMILIAL, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",233.0,128.15,23.42,201.55,53
CPT,82542,"HC ANSER ADA (ADALIMUMAB) ANTIBODY, COL CHROMOTOGRAPHY QUAL/QUAN",713.0,392.15,23.42,616.75,53
CPT,82542,"HC ANSER IFX (INFLIXIMAB) ANTIBODY, COL CHROMOTOGRAPHY QUAL/QUAN",246.0,135.3,23.42,212.79,53
CPT,82542,"HC ANSER UST (USTEKINUMAB) ANTIBODY, COL CHROMOTOGRAPHY QUAL/QUAN",1087.0,597.85,23.42,940.26,53
CPT,82542,"HC ANSER VDZ (VEDOLOZUMAB) ANTIBODY, COL CHROMOTOGRAPHY QUAL/QUAN",252.0,138.6,23.42,217.98,53
CPT,82542,"HC APOLIPOPROTEIN L1 RISK VAR, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",525.0,288.75,23.42,454.13,53
CPT,82542,"HC ARGATROBAN, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",42.0,23.1,12.6,120.45,53
CPT,82542,"HC BACLOFEN, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",109.0,59.95,23.42,120.45,53
CPT,82542,"HC BILE ACID BOWEL DYSFUNCT FECES, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",467.0,256.85,23.42,403.96,53
CPT,82542,"HC BILE ACIDS FRACT, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",214.0,117.7,23.42,185.11,53
CPT,82542,"HC CANNABINOID URINE (1), COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",64.0,35.2,19.2,120.45,53
CPT,82542,"HC COENZYME Q10, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",70.0,38.5,21.0,120.45,53
CPT,82542,"HC DIETHYLENE GLYCOL, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",325.0,178.75,23.42,281.13,53
CPT,82542,"HC F2 ISOPROSTANES URINE, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",263.0,144.65,23.42,227.5,53
CPT,82542,"HC FATTY ACID PROFILE, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",348.0,191.4,23.42,301.02,53
CPT,82542,"HC GLIMEPIRIDE, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",84.0,46.2,23.42,120.45,53
CPT,82542,"HC GUANIDINOACETATE URINE, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",107.0,58.85,23.42,120.45,53
CPT,82542,"HC GUANIDINOACETATE, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",95.0,52.25,23.42,120.45,53
CPT,82542,"HC IOHEXOL, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",130.0,71.5,23.42,120.45,53
CPT,82542,"HC LEFLUNOMIDE (ARAVA), COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",100.0,55.0,23.42,120.45,53
CPT,82542,"HC LEUKOTREINE E4 URINE, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",252.0,138.6,23.42,217.98,53
CPT,82542,"HC LSD URINE, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",94.0,51.7,23.42,120.45,53
CPT,82542,"HC LYSO-GB3, COL-CHR/MS NONDRUG ANALYTE NES QUAL/QUAN EA SPEC",230.0,126.5,23.42,198.95,53
CPT,82542,"HC LYSOPHOSPHATIDYLCHOLINE, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",64.0,35.2,19.2,120.45,53
CPT,82542,"HC MAYO AMYLOID PROTEIN ID, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",168.0,92.4,23.42,145.32,53
CPT,82542,"HC MELLARIL+MESORIDAZINE, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",45.0,24.75,13.5,120.45,53
CPT,82542,"HC METHYL BROMIDE METABOLITE, COL-CHR/MS NONDRUG ANALYTE NES QUAL/QUAN EA",103.0,56.65,23.42,120.45,53
CPT,82542,"HC N-METHYLHISTAMINE, URINE, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",341.0,187.55,23.42,294.97,53
CPT,82542,"HC OMD NUEROTRANS CSF, COL CHRMTGRPH, NON-RX ANALYTE NES QUAL/QUANT EA SPEC",87.0,47.85,23.42,120.45,53
CPT,82542,"HC OMEGA CHECK, COL-CHR/MS NONDRUG ANALYTE NES QUAL/QUAN EA SPEC",57.0,31.35,17.1,120.45,53
CPT,82542,"HC PARALDEHYDE+ACETALDEHYDE BLOOD, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",97.0,53.35,23.42,120.45,53
CPT,82542,"HC PAROXETINE (PAXIL), COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",37.0,20.35,11.1,120.45,53
CPT,82542,"HC PORPHYRIN FRACT BLOOD, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",233.0,128.15,23.42,201.55,53
CPT,82542,"HC PORPHYRIN FRACT PLASMA, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",116.0,63.8,23.42,120.45,53
CPT,82542,"HC PYRIDOXINE-DEPEND EPILEPSY PNL, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",335.0,184.25,23.42,289.78,53
CPT,82542,"HC RIVAROXABAN, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",42.0,23.1,12.6,120.45,53
CPT,82542,"HC SMITH LEMLI OPITZ PLASMA SCRN, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",206.0,113.3,23.42,178.19,53
CPT,82542,"HC SMITH LEMLI OPITZ, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",273.0,150.15,23.42,236.15,53
CPT,82542,"HC STEROLS, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",516.0,283.8,23.42,446.34,53
CPT,82542,"HC THYMIDINE AND DEOXYURIDINE, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",412.0,226.6,23.42,356.38,53
CPT,82542,"HC TRIMETHYLAMINE N OXIDE, COL-CHR/MS NONDRUG ANALYTE NES QUAL/QUAN EA SPEC",57.0,31.35,17.1,120.45,53
CPT,82542,"HC ZIPRASIDONE, COL CHRMTGRPH, NES, QUAL/QUANT, EA SPCMN",72.0,39.6,21.6,120.45,53
CPT,82550,HC CREATINE KINASE TOTAL ASSAY,60.5,33.275,6.33,77.85,106
CPT,82552,HC CREATINE KINASE (CK CPK) ISOENZYME ASSAY,44.0,24.2,13.01,66.95,53
CPT,82553,HC CREATINE KINASE MB FRACTION (2),153.0,84.15,11.22,132.35,53
CPT,82554,CREATINE ISOFORMS,,,11.54,59.35,23
CPT,82565,HC CREATININE BLOOD ASSAY,99.0,54.45,4.98,85.64,106
CPT,82565,HC CREATININE WHOLE BLOOD ASSAY,43.0,23.65,4.98,37.2,53
CPT,82565,"HC CREATININE, BLOOD ASSAY",61.0,33.55,4.98,52.77,424
CPT,82570,HC CREATININE FLUID ASSAY,77.0,42.35,5.04,66.61,53
CPT,82570,"HC CREATININE FLUID, CREATININE, OTHER SOURCE ASSAY",126.0,69.3,5.04,108.99,53
CPT,82570,HC CREATININE URINE,41.0,22.55,5.04,35.47,53
CPT,82570,HC CREATININE URINE ASSAY,91.0,50.05,5.04,78.72,53
CPT,82570,HC CREATININE URINE ASSAY (1),61.0,33.55,5.04,52.77,53
CPT,82570,HC CREATININE URINE ASSAY (3),71.0,39.05,5.04,61.42,53
CPT,82570,"HC SUPERSATURATION PANEL, CREATININE, OTHER SOURCE",17.0,9.35,5.04,25.9,53
CPT,82570,"HC URINE, CREATININE, OTHER SOURCE",221.0,121.55,5.04,191.17,53
CPT,82575,HC CREATININE CLEARANCE TEST,148.0,81.4,9.2,128.02,53
CPT,82585,HC CRYOFIBRINOGEN ASSAY,83.0,45.65,13.74,71.8,53
CPT,82595,HC CRYOGLOBULIN ASSAY,109.0,59.95,6.28,94.29,106
CPT,82600,HC CYANIDE ASSAY,136.0,74.8,18.86,117.64,53
CPT,82607,HC VITAMIN B-12,185.0,101.75,14.66,160.03,106
CPT,82608,HC B-12 BINDING CAPACITY,58.0,31.9,13.91,71.6,53
CPT,82610,HC CYSTATIN C,155.5,85.525,18.0,148.78,106
CPT,82615,HC TEST FOR URINE CYSTINES,40.0,22.0,9.28,47.75,53
CPT,82626,HC DEHYDROEPIANDROSTERONE,79.0,43.45,23.7,126.35,53
CPT,82627,HC DEHYDROEPIANDROSTERONE-SULFATE,179.0,98.45,21.61,154.84,159
CPT,82633,HC DESOXYCORTICOSTERONE,82.0,45.1,24.6,154.9,53
CPT,82634,HC DEOXYCORTISOL,112.0,61.6,28.47,146.4,53
CPT,82638,ASSAY OF DIBUCAINE NUMBER,,,11.91,61.25,23
CPT,82642,HC DIHYDROTESTOSTERONE,184.0,101.2,28.47,159.16,53
CPT,82652,"HC CYP24A1, VIT D 1 25-DIHYDROXY",102.0,56.1,30.6,192.5,53
CPT,82652,HC VIT D 1 25-DIHYDROXY,261.0,143.55,37.42,225.77,53
CPT,82653,"HC ELASTASE, PANCREATIC (EL-1), FECAL, QUANT",157.0,86.35,22.32,135.81,53
CPT,82656,EL-1 FECAL QUAL/SEMIQ,,,11.21,57.65,23
CPT,82657,HC ACID MALTASE ENZYME ACTIVITY,611.0,336.05,21.55,528.52,53
CPT,82657,"HC ACID MALTASE MUSCLE, NZYME ACTIV BLD CELLS/TISS, NONRADACT SUBSTRATE EA",1084.0,596.2,21.55,937.66,53
CPT,82657,HC ALA DEHYDRATASE ENZYME ACTIVITY,654.0,359.7,21.55,565.71,53
CPT,82657,HC ALPHA-GALACTOSIDASE ENZYME ACTIVITY,776.0,426.8,21.55,671.24,53
CPT,82657,"HC ALPHS GALACTOSIDASE LEUKOCYTES, ENZYME CELL ACTIVITY",907.0,498.85,21.55,784.56,53
CPT,82657,HC ARYLSULFATASE A LEUKOCYTES ENZYME ACTIVITY,68.0,37.4,20.4,110.85,53
CPT,82657,HC DISACCHARIDE PANEL TISSUE ENZYME ACTIVITY,318.0,174.9,21.55,275.07,53
CPT,82657,"HC ETC, ENZ ACTV BLD CEL, CULT CEL/TIS, NONRADACTV",1023.0,562.65,21.55,884.9,53
CPT,82657,"HC GALACTOCEREBROSIDASE LEUKCYT, ENZ ACTV BLD CEL, CULT CEL/TIS, NONRADACTV",1231.0,677.05,21.55,1064.82,53
CPT,82657,"HC GAUCHER LEUKOCYTE, ENZ ACTV BLD CEL, CULT CEL/TIS, NONRADACTV",347.0,190.85,21.55,300.16,53
CPT,82657,HC L-ASPARAGINASE ENZYME ACTIVITY,506.0,278.3,21.55,437.69,53
CPT,82657,"HC L-ASPARAGINASE, NZYME ACTIV BLD CELLS/TISS, NES, NONRADACT SUBSTRATE, EA",437.0,240.35,21.55,378.01,53
CPT,82657,"HC LYS ACID LPS, NZYME ACTIV BLD CELLS/TISS, NES, NONRADACT SUBSTRATE, EA",1052.0,578.6,21.55,909.98,53
CPT,82657,"HC LYSOSOMAL, ENZ ACTV BLD CEL, CULT CEL/TIS, NONRADACTV",715.0,393.25,21.55,618.48,53
CPT,82657,"HC LYSOSOMAL/GSD MUSCLE, NZYME ACTIV BLD CELLS/TISS, NONRADACT SUBSTRATE EA",2076.0,1141.8,21.55,1795.74,53
CPT,82657,"HC LYSOSOMAL/GSD, NZYME ACTIV BLD CELLS/TISS, NES, NONRADACT SUBSTRATE, EA",585.0,321.75,21.55,506.03,53
CPT,82657,HC NEUTROPHIL OXIDATIVE BURST ENZYME ACTIVITY,559.0,307.45,21.55,483.54,53
CPT,82657,"HC POMPE GAA, NZYME ACTIV BLD CELLS/TISS, NES, NONRADACT SUBSTRATE, EA",469.0,257.95,21.55,405.69,53
CPT,82657,HC PORPHOBILINOGEN DEAMINASE ENZYME ACTIVITY,778.0,427.9,21.55,672.97,53
CPT,82657,HC RBC HEXOAMINIDASE ENZYME ACTIVITY,1003.0,551.65,21.55,867.6,53
CPT,82657,HC THIOPURINE METHYLTRANSFERASE ENZYME ACTIVITY,250.0,137.5,21.55,216.25,53
CPT,82657,"HC THYMIDINE PHOSPHORYLASE, ENZ ACTV BLD CEL, CULT CEL/TIS, NONRADACTV",757.0,416.35,21.55,654.81,53
CPT,82657,HC UROPORPHYRINOGEN DECARBOXYLASE ENZYME ACTIVITY,1105.0,607.75,21.55,955.83,53
CPT,82657,HC UROPORPHYRINOGEN III SYNTHASE ENZYME ACTIVITY,342.0,188.1,21.55,295.83,53
CPT,82658,"HC GALACTOSYLCERAMIDE BGALAC WBC, ENZYME ACTIVITY BLD/CULT CELLS/TISS, NES",637.0,350.35,42.8,551.01,53
CPT,82664,"HC CHYLOMICRON SCREEN BODY FLUID, ELECTROPHORETIC TECHNIQUE, NOS",144.0,79.2,43.2,307.5,53
CPT,82664,"HC ELECTROPHORESIS BODY FLUID, ELECTROPHORETIC TECHNIQUE, NOS",625.0,343.75,59.78,540.63,53
CPT,82664,"HC HEMOGLOBIN IEF CONFIRM, ELECTROPHORETIC TECHNIQUE, NOS",277.0,152.35,59.78,307.5,53
CPT,82668,HC ERYTHROPOIETIN ASSAY,167.0,91.85,18.27,144.46,53
CPT,82670,"HC 17 BETA, ESTRADIOL, TOTAL",181.0,99.55,27.16,156.57,53
CPT,82670,"HC SENSITIVE, ESTRADIOL, TOTAL",79.0,43.45,23.7,139.7,53
CPT,82671,HC ESTROGENS FRACTIONATED ASSAY,102.0,56.1,30.6,161.5,53
CPT,82672,HC ESTROGEN ASSAY TOTAL ASSAY,277.0,152.35,21.1,239.61,53
CPT,82677,HC ESTRIOL ASSAY,58.0,31.9,17.4,120.9,53
CPT,82677,HC UNCONJUGATED E3 LEVEL ASSAY,344.0,189.2,23.51,297.56,53
CPT,82679,HC ESTRONE ASSAY,83.0,45.65,24.26,124.75,53
CPT,82679,"HC SULFATE, ESTRONE",200.0,110.0,24.26,173.0,53
CPT,82681,"HC FREE ESTRADIOL, FREE, DIRECT MEASUREMENT",301.0,165.55,27.16,260.37,53
CPT,82693,HC ETHYLENE GLYCOL ASSAY,107.0,58.85,14.48,92.56,106
CPT,82696,ASSAY OF ETIOCHOLANOLONE,,,25.51,131.2,23
CPT,82705,HC FATS LIPIDS FECES QUAL,53.0,29.15,4.96,45.85,53
CPT,82710,"HC 24 HOURS, FAT OR LIPIDS, FECES, QUANT",74.0,40.7,16.33,84.0,53
CPT,82710,"HC 48 HOURS, FAT OR LIPIDS, FECES, QUANT",102.0,56.1,16.33,88.23,53
CPT,82710,"HC 72 HOURS, FAT OR LIPIDS, FECES, QUANT",92.0,50.6,16.33,84.0,53
CPT,82710,"HC FAT OR LIPIDS, FECES, QUANT",444.0,244.2,16.33,384.06,53
CPT,82715,ASSAY OF FECAL FAT,,,22.32,114.85,23
CPT,82725,HC BLOOD FATTY ACIDS ASSAY,128.0,70.4,18.24,110.72,53
CPT,82726,HC VERY LONG CHAIN FATTY ACIDS,703.0,386.65,19.2,608.1,53
CPT,82728,HC FERRITIN ASSAY,191.0,105.05,13.25,165.22,53
CPT,82731,ASSAY OF FETAL FIBRONECTIN,,,62.6,322.05,23
CPT,82735,HC FLUORIDE ASSAY,166.0,91.3,18.03,143.59,53
CPT,82735,HC FLUORIDE URINE ASSAY,135.0,74.25,18.03,116.78,53
CPT,82746,HC BLOOD FOLIC ACID SERUM,184.0,101.2,14.29,159.16,53
CPT,82747,HC FOLIC ACID RBC ASSAY,240.0,132.0,17.15,207.6,53
CPT,82757,ASSAY OF SEMEN FRUCTOSE,,,16.86,86.7,23
CPT,82759,ASSAY OF RBC GALACTOKINASE,,,20.88,107.4,23
CPT,82760,ASSAY OF GALACTOSE,,,10.89,56.0,23
CPT,82775,HC GALACTOSE-1-PHOSPHATE URIDYL TRANSFERASE ASSAY,331.0,182.05,20.48,286.32,53
CPT,82775,HC GALACTOSE-1-PHOSPHATE URIDYL TRANSFERASE ENZYME,122.0,67.1,20.48,105.53,53
CPT,82776,GALACTOSE TRANSFERASE TEST,,,11.41,58.7,23
CPT,82777,HC GALECTIN-3,340.0,187.0,43.01,294.1,53
CPT,82784,"HC CELIAC PROMETHEUS IGA TOTAL, IGA, IGD, IGG, IGM, EA",78.0,42.9,9.04,67.47,53
CPT,82784,"HC GAMMAGLOBULIN, IGA, IGD, IGG, IGM, EA",64.0,35.2,9.04,55.36,53
CPT,82784,HC IMMUNOGLOBULIN A ASSAY,122.0,67.1,9.04,105.53,106
CPT,82784,HC IMMUNOGLOBULIN A CSF ASSAY,23.0,12.65,6.9,46.5,53
CPT,82784,HC IMMUNOGLOBULIN A QUANT ASSAY,18.0,9.9,5.4,46.5,53
CPT,82784,HC IMMUNOGLOBULIN A TOTAL ASSAY (2),118.0,64.9,9.04,102.07,53
CPT,82784,HC IMMUNOGLOBULIN D ASSAY,94.0,51.7,9.04,81.31,53
CPT,82784,"HC IMMUNOGLOBULIN D, IGA, IGD, IGG, IGM, EA",568.0,312.4,9.04,491.32,53
CPT,82784,HC IMMUNOGLOBULIN G ASSAY,22.0,12.1,6.6,46.5,53
CPT,82784,HC IMMUNOGLOBULIN G CSF ASSAY,165.0,90.75,9.04,142.73,53
CPT,82784,HC IMMUNOGLOBULIN G CSF ASSAY (2),102.0,56.1,9.04,88.23,53
CPT,82784,HC IMMUNOGLOBULIN G QUANT ASSAY,22.0,12.1,6.6,46.5,53
CPT,82784,HC IMMUNOGLOBULIN G SERUM ASSAY,148.5,81.675,9.04,142.73,159
CPT,82784,HC IMMUNOGLOBULIN M ASSAY,55.5,30.525000000000002,6.6,76.99,159
CPT,82784,HC IMMUNOGLOBULIN M CSF ASSAY,23.0,12.65,6.9,46.5,53
CPT,82784,HC IMMUNOGLOBULIN M QUANT ASSAY,22.0,12.1,6.6,46.5,53
CPT,82784,"HC IMMUNOGLOBULIN, CSF, IGA, IGD, IGG, IGM, EA",68.0,37.4,9.04,58.82,53
CPT,82785,HC IMMUNOGLOBULIN E ASSAY,242.0,133.1,16.0,209.33,53
CPT,82785,HC IMMUNOGLOBULIN E TOTAL (ABPA) ASSAY,671.0,369.05,16.0,580.42,53
CPT,82785,HC IMMUNOGLOBULIN E TOTAL (BIRD) ASSAY,191.0,105.05,16.0,165.22,53
CPT,82785,"HC IMMUNOGLOBULIN E, IGE",320.0,176.0,16.0,276.8,53
CPT,82785,HC IMMUNOGLOBULIN IGE,74.0,40.7,16.0,82.3,53
CPT,82787,"HC IGA SUBCLASS 1, GAMMAGLOBULIN, IMMUNOGLOBULIN SUBCLASSES, EACH",79.0,43.45,7.79,68.34,53
CPT,82787,"HC IGA SUBCLASS 2, GAMMAGLOBULIN, IMMUNOGLOBULIN SUBCLASSES, EACH",79.0,43.45,7.79,68.34,53
CPT,82787,HC IMMUNOGLOBULIN G SUBCLASS 1,35.0,19.25,7.79,40.1,53
CPT,82787,HC IMMUNOGLOBULIN G SUBCLASS 2,35.0,19.25,7.79,40.1,53
CPT,82787,HC IMMUNOGLOBULIN G SUBCLASS 3,35.0,19.25,7.79,40.1,53
CPT,82787,HC IMMUNOGLOBULIN G SUBCLASS 4,32.0,17.6,7.79,40.1,53
CPT,82787,HC IMMUNOGLOBULIN G SUBCLASS 4 (2),58.0,31.9,7.79,50.17,53
CPT,82800,HC BLOOD GAS PH ONLY STAT,98.0,53.9,10.69,84.77,53
CPT,82803,BLOOD GASES ANY COMBINATION,,,25.34,130.35,23
CPT,82805,HC BLOOD GASES W O2 SATURATION,234.0,128.7,70.2,393.85,265
CPT,82810,"HC ECMO, PO2 POST-OXYGENERATOR, GASES BLOOD O2 SAT ONLY DIRECT MEASUREMENT",19.0,10.45,5.7,48.85,53
CPT,82810,"HC ECMO, PO2 PRE-OXYGENATOR, GASES BLOOD O2 SATURATION ONLY DIR MEASUREMENT",16.0,8.8,4.8,48.85,53
CPT,82810,HC MEASURED ART O2 SATURATION ONLY,48.0,26.4,9.5,48.85,53
CPT,82810,"HC POC, MEASURED ART O2 SATURATION ONLY",102.0,56.1,9.5,88.23,106
CPT,82820,"HC OXYGEN DISSOCIATION (P50), HEMOGLOBIN-OXYGEN AFFINITY",393.0,216.15,12.97,352.92,106
CPT,82930,HC GASTRIC ANALY W PH EA SPEC,70.0,38.5,6.53,60.55,53
CPT,82938,GASTRIN TEST,,,17.2,88.45,23
CPT,82941,HC GASTRIN ASSAY,128.0,70.4,17.14,110.72,53
CPT,82943,HC GLUCAGON ASSAY,216.0,118.8,13.9,186.84,53
CPT,82945,HC GLUCOSE AMNIOTIC FLUID,235.0,129.25,3.83,203.28,53
CPT,82945,HC GLUCOSE BODY FLUID,84.0,46.2,3.83,72.66,53
CPT,82945,"HC GLUCOSE BODY FLUID, GLUCOSE BODY FLUID OTHER THAN BLOOD",213.0,117.15,3.83,184.25,53
CPT,82945,HC GLUCOSE CSF,84.0,46.2,3.83,72.66,53
CPT,82945,HC GLUCOSE URINE,62.0,34.1,3.83,53.63,53
CPT,82945,"HC GLUCOSE, BODY FLUID, OTHER THAN BLOOD",35.0,19.25,3.83,30.28,53
CPT,82946,GLUCAGON TOLERANCE TEST,,,17.27,88.85,23
CPT,82947,"HC GLUCOSE, QUANT, BLOOD",45.0,24.75,3.83,41.52,318
CPT,82947,HC WHOLE BLOOD GLUCOSE; QUANTITATIVE (EXCEPT REAGENT STRIP),15.0,8.25,3.83,19.65,53
CPT,82948,REAGENT STRIP/BLOOD GLUCOSE,,,4.91,25.2,23
CPT,82950,HC 1 HR POST GLUCOSE DOSE PRANDIAL,23.0,12.65,4.62,23.75,53
CPT,82950,HC POST GLUCOSE DOSE,64.0,35.2,4.62,55.36,53
CPT,82950,HC POST GLUCOSE DOSE O'SULLIVAN,64.0,35.2,4.62,55.36,53
CPT,82951,HC GLUCOSE TOLERANCE TEST 3 SPECIMENS,182.5,100.375,12.51,173.0,106
CPT,82952,"HC 3 HR PREGNANCY, GTT-ADDED SAMPLES",55.0,30.25,3.81,47.58,53
CPT,82952,HC GTT-ADDED SAMPLES,55.0,30.25,3.81,47.58,53
CPT,82955,HC GLUCOSE-6-PHOSPHATE DEHYDROGENASE ASSAY,121.0,66.55,9.43,104.67,53
CPT,82955,HC GLUCOSE-6-PHOSPHATE DEHYDROGENASE RBC ENZYM ASY,489.0,268.95,9.43,422.99,53
CPT,82960,HC TEST FOR G6PD ENZYME,183.0,100.65,5.88,158.3,159
CPT,82962,HC DX GLUCOSE BLOOD TEST,35.0,19.25,3.2,30.28,53
CPT,82962,HC GLUCOSE BLOOD TEST,35.0,19.25,3.2,30.28,53
CPT,82962,"HC GLUCOSE, BLOOD BY GLUCOSE MONITORING DEVICE",35.0,19.25,3.2,30.28,53
CPT,82962,"HC GLUCOSE, BLOOD BY GLUCOSE MONITORING DEVICE(S) CLEARED BY FDA, HOME USE",34.5,18.975,3.2,30.28,2597
CPT,82962,HC MR GLUCOSE BLOOD TEST,35.0,19.25,3.2,30.28,53
CPT,82963,HC GLUCOSIDASE BETA ASSAY,338.0,185.9,20.88,292.37,53
CPT,82963,HC LYSOSOMAL BETA GLUCOSIDASE,373.0,205.15,20.88,322.65,53
CPT,82965,ASSAY OF GDH ENZYME,,,12.78,65.75,23
CPT,82977,HC GGT ASSAY,77.0,42.35,7.0,66.61,53
CPT,82978,HC GLUTATHIONE,673.0,370.15,15.02,582.15,53
CPT,82978,HC GLUTATHIONE ASSAY,198.0,108.9,15.02,171.27,53
CPT,82979,ASSAY RBC GLUTATHIONE,,,9.18,47.2,23
CPT,82985,"HC ALPHA 1 ACID GLYCOPROTEIN, ASSAY OF GLYCATED PROTEIN",347.0,190.85,16.29,300.16,53
CPT,82985,HC FRUCTOSAMINE,57.0,31.35,16.29,83.8,53
CPT,83001,HC GONADOTROPIN (FSH),182.0,100.1,18.06,157.43,53
CPT,83002,HC GONADOTROPIN (LH),179.0,98.45,18.0,154.84,53
CPT,83002,"HC PEDIATRIC, GONADOTROPIN, LUTEINIZING HORMONE",40.0,22.0,12.0,92.6,53
CPT,83003,HC HUMAN GROWTH HORMONE (SOMATOTROPIN) ASSAY,52.0,28.6,15.6,83.35,53
CPT,83006,GROWTH STIMULATION GENE 2,,,73.49,378.0,23
CPT,83009,H PYLORI (C-13) BLOOD,,,65.48,336.8,23
CPT,83010,HC HAPTOGLOBIN QUANT ASSAY,125.0,68.75,12.23,108.13,106
CPT,83012,ASSAY OF HAPTOGLOBINS,,,26.14,134.45,23
CPT,83013,HC H PYLORI BREATH TEST,451.0,248.05,65.48,390.12,53
CPT,83014,H PYLORI DRUG ADMIN,,,7.64,39.3,23
CPT,83015,HEAVY METAL QUAL ANY NUMBER,,,20.36,104.7,23
CPT,83018,"HC ANTIMONY, HEAVY METAL, QUANTITATIVE, EACH, NES",116.0,63.8,21.35,109.8,53
CPT,83018,"HC BARIUM, HEAVY METAL, QUANTITATIVE, EACH, NES",449.0,246.95,21.35,388.39,53
CPT,83018,"HC BISMUTH BLOOD, HEAVY METAL, QUANTITATIVE, EACH, NES",374.0,205.7,21.35,323.51,53
CPT,83018,"HC COBALT FLUID, HEAVY METAL, QUANTITATIVE, EACH, NES",845.0,464.75,21.35,730.93,53
CPT,83018,"HC COBALT, HEAVY METAL, QUANTITATIVE, EACH, NES",161.0,88.55,21.35,139.27,53
CPT,83018,"HC GADOLINIUM, HEAVY METAL QUANT EACH NES",562.0,309.1,21.35,486.13,53
CPT,83018,"HC IODINE URINE, HEAVY METAL, QUANT, EA, NES",177.0,97.35,21.35,153.11,53
CPT,83018,"HC IODINE, HEAVY METAL QUANTITATIVE EACH NES",168.0,92.4,21.35,145.32,53
CPT,83018,"HC MOLYBDENUM, HEAVY METAL, QUANTITATIVE, EACH, NES",117.0,64.35,21.35,109.8,53
CPT,83018,"HC THALLIUM BLOOD, HEAVY METAL, QUANTITATIVE, EACH, NES",374.0,205.7,21.35,323.51,53
CPT,83018,"HC THALLIUM URINE, HEAVY METAL, QUANTITATIVE, EACH, NES",90.0,49.5,21.35,109.8,53
CPT,83018,"HC TITANIUM, HEAVY METAL, QUANTITATIVE, EACH, NES",442.0,243.1,21.35,382.33,53
CPT,83020,"HC ERYTHROCYTOSIS EVALUATION, HEMOGLOBIN FRACTION/QUANT ELECTROPHORESIS",731.0,402.05,12.51,632.32,53
CPT,83020,HC HEMOGLOBIN ELECTROPHORESIS PATTERN,114.0,62.7,12.51,98.61,53
CPT,83020,HC HEMOGLOBIN FRACTIONATION AND QUANTITATION ELECTROPHORESIS,831.0,457.05,12.51,718.82,53
CPT,83020,"HC HEMOGLOBIN FRACTIONATION AND QUANTITATION, ELECTROPHORESIS",1193.0,656.15,12.51,1031.95,53
CPT,83020,"HC HEMOGLOBIN FRACTIONATION AND QUANTITATION, ELECTROPHORESIS II",193.0,106.15,12.51,166.95,53
CPT,83021,"HC A2 AND F, HEMOGLOBIN FRACTIONATION AND QUANTITATION, CHROMATOGRAPHY",442.0,243.1,17.55,382.33,53
CPT,83021,"HC ERYTHROCYTOSIS EVALUATION, HEMOGLOBIN FRACT & QUANT, CHRMTGRPH",524.0,288.2,17.55,453.26,53
CPT,83021,"HC HEMOGLOBIN A2 AND F, CHROMATOGRAPHY",502.0,276.1,17.55,434.23,53
CPT,83021,HC HEMOGLOBIN CHROMATOGRAPHY,105.0,57.75,17.55,90.83,159
CPT,83021,"HC HEMOGLOBIN FRACT & QUANT, CHROMATOGRAPHY",257.0,141.35,17.55,222.31,53
CPT,83026,HEMOGLOBIN COPPER SULFATE,,,3.9,20.05,23
CPT,83030,HEMOGLOBIN F FETAL CHEMICAL,,,10.44,53.7,23
CPT,83033,"HC FETAL HEMOGLOBIN AMNIOTIC FLUID, HEMOGLOBIN, F (FETAL), QUAL",117.0,64.35,7.78,101.21,53
CPT,83036,HC HEMOGLOBIN (A1C) GLYCOSYLATED,168.0,92.4,9.44,145.32,106
CPT,83036,HC HEMOGLOBIN (A1C) GLYCOSYLATED HPLC,32.0,17.6,9.44,48.55,53
CPT,83036,HC HEMOGLOBIN (A1C) GLYCOSYLATED UNSTABLE,232.0,127.6,9.44,200.68,53
CPT,83036,"HC HEMOGLOBIN, GLYCOSYLATED (A1C)",104.0,57.2,9.44,89.96,371
CPT,83037,HB GLYCOSYLATED A1C HOME DEV,,,9.44,48.55,23
CPT,83045,HGB METHEMOGLOBIN QUAL,,,6.31,32.45,23
CPT,83050,HC BLOOD METHEMOGLOBIN ASSAY,65.0,35.75,7.97,56.23,53
CPT,83050,HC HEMOGLOBIN METHEMOGLOBIN QUANT ASSAY,63.0,34.65,7.97,54.5,159
CPT,83051,HC FREE PLASMA HEMOGLOBIN,39.0,21.45,7.1,36.55,53
CPT,83051,HC PLASMA HEMOGLOBIN ASSAY,58.0,31.9,7.1,50.17,53
CPT,83060,HGB SULFHEMOGLOBIN QUAN,,,8.55,44.0,23
CPT,83065,HEMOGLOBIN THERMOLABILE,,,8.75,45.0,23
CPT,83068,HC HEMOGLOBIN UNSTABLE SCREEN,414.0,227.7,9.2,358.11,53
CPT,83069,"HC HEMOGLOBIN, URINE",36.0,19.8,3.84,31.14,53
CPT,83070,"HC HEMOSIDERIN URINE, QUAL",70.0,38.5,4.62,60.55,53
CPT,83080,"HC A & TOTAL SERUM, B-HEXOSAMINIDASE, EACH ASSAY",139.0,76.45,16.4,120.24,53
CPT,83080,"HC A & TOTAL WBC, B-HEXOSAMINIDASE, EACH ASSAY",576.0,316.8,16.4,498.24,53
CPT,83080,"HC A SERUM, B-HEXOSAMINIDASE, EA ASSAY",743.0,408.65,16.4,642.7,53
CPT,83080,HC B-HEXOSAMINIDASE EACH ASSAY,79.0,43.45,16.4,84.35,53
CPT,83088,HC BASOFUNCTION HISTAMINE ASSAY,119.0,65.45,28.71,147.65,53
CPT,83088,HC HISTAMINE,106.0,58.3,28.71,147.65,53
CPT,83088,HC HISTAMINE BLOOD ASSAY,78.0,42.9,23.4,147.65,53
CPT,83088,HC HISTAMINE URINE ASSAY,303.0,166.65,28.71,262.1,53
CPT,83090,HC HOMOCYSTEINE ASSAY,156.0,85.8,17.42,134.94,106
CPT,83150,HC HOMOVANILLIC ACID (HVA),190.0,104.5,21.78,164.35,53
CPT,83150,"HC NEUROTRANS CSF, HOMOVANILLIC ACID",142.0,78.1,21.78,122.83,53
CPT,83491,ASY HYDROXYCORTICOSTEROIDS17,,,17.4,89.5,23
CPT,83497,"HC 5-HIAA URINE, HYDROXYINDOLACETIC ACID, 5-(HIAA) ASSAY",77.0,42.35,12.54,66.61,53
CPT,83497,"HC NEUROTRANS CSF, HYDROXYINDOLACETIC ACID, 5-HIAA",216.0,118.8,12.54,186.84,53
CPT,83498,HC HYDROXYPROGESTERONE 17-D ASSAY,181.0,99.55,26.41,156.57,53
CPT,83498,HC PROGESTERONE 170H ASSAY,108.0,59.4,26.41,135.85,53
CPT,83500,ASSAY FREE HYDROXYPROLINE,,,22.01,113.25,23
CPT,83505,ASSAY TOTAL HYDROXYPROLINE,,,23.62,121.5,23
CPT,83516,"HC ACETYLCHOLINE RECEPTOR BLOCKING, IMMUN ANALYTE QUAL/SEMIQUAL MULT STEP",233.0,128.15,11.21,201.55,53
CPT,83516,"HC ACETYLCHOLINE RECEPTOR MODULATING, IMMUN ANALYTE QUAL/SEMIQUAL MULT STEP",438.0,240.9,11.21,378.87,53
CPT,83516,"HC ADRENAL 21-OH ANTIBODY, IA ANLYT OTH TH INFC AGNT AB/AG, MULT STEP",298.0,163.9,11.21,257.77,53
CPT,83516,"HC AHUS FACTOR H AUTOANTIBODY, IMMUNOASSAY MULTIPLE METHOD",2407.0,1323.85,11.21,2082.06,53
CPT,83516,"HC ANTI-FODRIN AB, IA ANLYT OTH TH INFC AGNT AB/AG, MULT STEP",224.0,123.2,11.21,193.76,53
CPT,83516,HC ANTI-IGE ANTIBODY IMMUNOASSAY MULTIPLE METHOD,453.0,249.15,11.21,391.85,53
CPT,83516,HC ANTI-PARIETAL CELL ANTBD IMUNASSY MULTIPL METHD,70.0,38.5,11.21,60.55,53
CPT,83516,"HC ANTIGLOMERULAR BASEMENT MEMBRANE MBA, IMMUNOASSAY ANALYTE QUAL/SEMIQUAL",166.0,91.3,11.21,143.59,53
CPT,83516,"HC BASEMENT MEMB ZONE, IA ANLYT OTH TH INFC AGNT AB/AG, MULT STEP",240.0,132.0,11.21,207.6,53
CPT,83516,HC BULLOUSPEMPHIGOID 180 IMMUNOASSY MULTIPLE METHD,367.0,201.85,11.21,317.46,53
CPT,83516,HC BULLOUSPEMPHIGOID 230 IMMUNOASSY MULTIPLE METHD,367.0,201.85,11.21,317.46,53
CPT,83516,"HC CHROMATIN AB IGG, IA ANLYT OTH TH INFC AGNT AB/AG, MULT STEP",182.0,100.1,11.21,157.43,53
CPT,83516,"HC COLLAGEN TYPE VII AB IGG, IA ANLYT OTH TH INFC AGNT AB/AG, MULT STEP",378.0,207.9,11.21,326.97,53
CPT,83516,HC CYCLIC CITRULLINATED PEPTIDE IMMUNASSY MULTIPLE,171.0,94.05,11.21,147.92,53
CPT,83516,"HC DEAMINATED GLIADIN IGA, IMMUNOASSAY ANALYTE, QUAL/SEMIQ, MULT STEP METH",55.0,30.25,11.21,57.65,106
CPT,83516,"HC DEAMINATED GLIADIN IGG, IMMUNOASSAY ANALYTE, QUAL/SEMIQ, MULT STEP METH",55.0,30.25,11.21,57.65,106
CPT,83516,"HC DERMATOMYOSITIS, IA ANLYT OTH TH INFC AGNT AB/AG, MULT STEP",129.0,70.95,11.21,111.59,53
CPT,83516,HC DESMOGLEIN 1 IMMUNOASSAY MULTIPLE METHOD,367.0,201.85,11.21,317.46,53
CPT,83516,HC DESMOGLEIN 3 IMMUNOASSAY MULTIPLE METHOD,367.0,201.85,11.21,317.46,53
CPT,83516,"HC EARLY SJOGREN'S SYNDROME, IA ANLYT OTH TH INFC AGNT AB/AG, MULT STEP",36.5,20.08,10.95,57.65,53
CPT,83516,"HC EPIDERM TRANSGLUTAMINASE IGA, IA ANLYT OTH TH INFC AGNT AB/AG, MULT STEP",236.0,129.8,11.21,204.14,53
CPT,83516,"HC FACTOR B C3 GLOMERULOPATHY PNL, IA ANLYT OTH TH INFC AGNT AB/AG, MULT",791.0,435.05,11.21,684.22,53
CPT,83516,"HC FACTOR H AUTO AB, IA ANLYT OTH TH INFC AGNT AB/AG, MULT",2632.0,1447.6,11.21,2276.68,53
CPT,83516,HC FACTOR H AUTO ANTIBODY IMMUNOASSAY MULT METHOD,1841.0,1012.55,11.21,1592.47,53
CPT,83516,"HC FH AUTOANTIBODY, IMMUNOASSAY ANALYTE QUAL/SEMIQUAL MULT STEP",1725.0,948.75,11.21,1492.13,53
CPT,83516,HC GANGLIOSIDE ANTIBODY IMMUNOASSAY MULTIPLE METHD,199.0,109.45,11.21,172.14,53
CPT,83516,HC GLIADIN IGA ANTIBODY IMMUNOASSAY MULTIPLE METHD,338.0,185.9,11.21,292.37,53
CPT,83516,"HC GM1 AB EACH, IA ANALY OTH TH INFC AB/AG, MULT",153.0,84.15,11.21,132.35,53
CPT,83516,"HC GM1 ANTIBODY IGM, IMMUNOASSAY ANALYTE QUAL/SEMIQUAL MULTIPLE STEP",183.0,100.65,11.21,158.3,53
CPT,83516,"HC GP210 ANTIBODY, IMMUNOASSAY ANALYTE QUAL/SEMIQUAN MULTIPLE STEP",186.0,102.3,11.21,160.89,53
CPT,83516,"HC GRANULOCYTE MAC COL STIM FAC CONFIRM, IA ANALYTE, QUAL, MULT STEP METHOD",365.0,200.75,11.21,315.73,53
CPT,83516,"HC GRANULOCYTE MAC COL STIM FAC, IA ANLYT OT INFCT AGNT, QUAL, MLT STEP MTH",425.0,233.75,11.21,367.63,53
CPT,83516,"HC HISTONE ANTIBODY, IMMUNOASSAY ANALYTE, QUAL/SEMIQ, MULT STEP",73.0,40.15,11.21,63.15,53
CPT,83516,"HC HMGCR AUTOANTIBODY, IMMUNOASSAY ANALYTE, QUAL/SEMIQ, MULT STEP",710.0,390.5,11.21,614.15,53
CPT,83516,"HC IMMUNOASSAY ANALYTE INFC AGNT ANTIBODY/ ANTIGEN QUAL, SEMI QUAL, MULTI",112.0,61.6,11.21,96.88,106
CPT,83516,"HC IMMUNOBULLOUS, IA ANLYT OTH TH INFC AGNT AB/AG, MULT STEP",162.0,89.1,11.21,140.13,53
CPT,83516,"HC MAG DUAL ANTIGEN AB, IA ANLYT OTH TH INFC AGNT AB/AG, MULT STEP",63.0,34.65,11.21,57.65,53
CPT,83516,HC MI-2 AUTO ANTIBODY IMMUNOASSAY MULTIPLE METHOD,383.0,210.65,11.21,331.3,53
CPT,83516,HC MITOCHONDRIAL ANTIBODY IMMUNASSY MULTIPLE METHD,92.0,50.6,11.21,79.58,53
CPT,83516,"HC MOTOR AND SENSORY NEUROPATHY, IMMUNOASSAY NONANTIBODY",80.0,44.0,11.21,69.2,53
CPT,83516,"HC MYELOPEROXIDASE & PROTEINASE 3 AB, IMMASSY ANALYTE, MULT STEP",37.0,20.35,11.1,57.65,53
CPT,83516,"HC MYELOPEROXIDASE AB, IMMUNOASSAY ANALYTE, MULT STEP",70.0,38.5,11.21,60.55,53
CPT,83516,"HC MYOMARKER EJ AB, IMMUNOASSAY ANALYTE, QUAL, MULT STEP METHOD",92.0,50.6,11.21,79.58,53
CPT,83516,"HC MYOMARKER KU AB, IMMUNOASSAY ANALYTE, QUAL, MULT STEP METHOD",92.0,50.6,11.21,79.58,53
CPT,83516,"HC MYOMARKER MI-2 AB, IMMUNOASSAY ANALYTE, QUAL, MULT STEP METHOD",92.0,50.6,11.21,79.58,53
CPT,83516,"HC MYOMARKER OJ AB, IMMUNOASSAY ANALYTE, QUAL, MULT STEP METHOD",92.0,50.6,11.21,79.58,53
CPT,83516,"HC MYOMARKER PL-12 AB, IMMUNOASSAY ANALYTE, QUAL, MULT STEP METHOD",92.0,50.6,11.21,79.58,53
CPT,83516,"HC MYOMARKER PL-7 AB, IMMUNOASSAY ANALYTE, QUAL, MULT STEP METHOD",92.0,50.6,11.21,79.58,53
CPT,83516,"HC MYOMARKER SEMI-QUANT, IA ANLYT OTH TH INFC AGNT AB/AG, MULT STEP",78.0,42.9,11.21,67.47,53
CPT,83516,"HC MYOMARKER SRP AB, IMMUNOASSAY ANALYTE, QUAL, MULT STEP METHOD",92.0,50.6,11.21,79.58,53
CPT,83516,"HC MYOMARKER U2 SNRNP AB, IMMUNOASSAY ANALYTE, QUAL, MULT STEP METHOD",92.0,50.6,11.21,79.58,53
CPT,83516,HC MYOSITIS IMMUNOASSAY ANALYTE QUAL/SEMIQUAL MULTIPLE STEP,199.0,109.45,11.21,172.14,53
CPT,83516,HC P140 ANTIBODY IMMUNOASSAY MULTIPLE METHOD,813.0,447.15,11.21,703.25,53
CPT,83516,"HC PEMPHIGOID AB, IA ANLYT OTH TH INFC AGNT AB/AG, MULT STEP",240.0,132.0,11.21,207.6,53
CPT,83516,"HC PHOSPHATIDYL PT AB, IA ANLYT OTH TH INFC AGNT AB/AG, MULT STEP",320.0,176.0,11.21,276.8,53
CPT,83516,HC PROTEINASE 3 ANTIBODY IMMUNOASSY MULTIPLE METHD,73.0,40.15,11.21,63.15,53
CPT,83516,"HC RHEUMATOID FACTOR IGA BY ELISA, IMMUN ANALYTE QUAL/SEMIQUAL MULT STEP",122.0,67.1,11.21,105.53,53
CPT,83516,HC RHEUMATOID FACTOR IGG BY ELISA IA ANLYT OTH TH INFC AGNT AB/AG MULT STEP,122.0,67.1,11.21,105.53,53
CPT,83516,"HC RHEUMATOID FACTOR IGM BY ELISA, IMMUN ANALYTE QUAL/SEMIQUAL MULT STEP",122.0,67.1,11.21,105.53,53
CPT,83516,"HC RIBOSOMAL AB CSF, IMMUNOASSAY ANALYTE, QUAL OR SEMIQ, MULT STEP METHOD",828.0,455.4,11.21,716.22,53
CPT,83516,HC RIBOSOMAL P ANTIBODY IMMUNOASSAY MULTIPLE METHD,125.0,68.75,11.21,108.13,106
CPT,83516,HC RNA POLYMERASE III IMMUNOASSAY MULTIPLE METHOD,897.0,493.35,11.21,775.91,53
CPT,83516,HC SIGNAL RECOGNTN PARTICLE IMUNASSY MULTIPL METHD,619.0,340.45,11.21,535.44,53
CPT,83516,"HC SMOOTH MUSCLE AB, IA ANALYTE OTH TH INFC AGNT AB/AG, QUAL/SEMIQ, MULT",89.0,48.95,11.21,76.99,53
CPT,83516,HC SOLUBLE LIVER ANTIG ANTIBD IGG IMUNASSY MULTIPL,82.0,45.1,11.21,70.93,53
CPT,83516,"HC SP100 ANTIBODY, IMMUNOASSAY ANALYTE QUAL/SEMIQUAN MULTIPLE STEP",186.0,102.3,11.21,160.89,53
CPT,83516,"HC SYNOVIAL FLUIDALPHA DEFENSIS, IMMUNOASSAY MULTIPLE METHOD",286.0,157.3,11.21,247.39,53
CPT,83516,HC T-TRANSGLUTAMINASE IGG IMMUNASSY MULTIPLE METHD,199.0,109.45,11.21,172.14,106
CPT,83516,HC T-TRANSGLUTAMINASE IMMUNOASSAY MULTIPLE METHOD,206.0,113.3,11.21,178.19,106
CPT,83516,"HC TH-TO ANTIBODY, IMMUNOASSAY ANALYTE QUAL/SEMIQUAL MULTIPLE STEP",400.0,220.0,11.21,346.0,53
CPT,83516,HC TIF-1 P155/140 ANTIBODY IMMUNOASSAY MULT METHOD,905.0,497.75,11.21,782.83,53
CPT,83516,"HC TISSUE TRANSLUTAMINASE IGA, IMMUNOASSAY ANALYTE, QUAL/SEMIQ, MULT STEP",55.0,30.25,11.21,57.65,106
CPT,83516,"HC TISSUE TRANSLUTAMINASE IGG, IMMUNOASSAY ANALYTE, QUAL/SEMIQ, MULT STEP",55.0,30.25,11.21,57.65,106
CPT,83516,HC TITIN ANTIBODY IMMUNOASSAY MULTIPLE METHOD,720.0,396.0,11.21,622.8,53
CPT,83516,HC TRYPSINOGEN IMMUNOASSAY MULTIPLE METHOD,156.0,85.8,11.21,134.94,53
CPT,83516,HC TYSABRI ANTIBODY IMMUNOASSAY MULTIPLE METHOD,879.0,483.45,11.21,760.34,53
CPT,83516,"HC U3 NP AB U3RNP AB, IMMUNOASSAY ANALYTE, QUAL, MULT STEP METHOD",92.0,50.6,11.21,79.58,53
CPT,83518,"HC ALPHA DEFENSIN, IA ANLYT OTH TH INFC AGNT AB/AG, SGL STEP",505.0,277.75,9.37,436.83,53
CPT,83519,"HC ACETYL RECEPTOR BINDING AB, IMMUNOASSAY ANALYTE QUANT RADIOIMMUNOASSAY",313.0,172.15,17.88,270.75,53
CPT,83519,"HC ACHR GANGLIONIC NEURONAL AB (1), IA ANLYT OTH TH INFC AGNT AB/AG, RIA",132.0,72.6,17.88,114.18,53
CPT,83519,"HC ACHR GANGLIONIC NEURONAL AB (2), IA ANLYT OTH TH INFC AGNT AB/AG, RIA",199.0,109.45,17.88,172.14,53
CPT,83519,"HC ACHR GANGLIONIC NEURONAL AB PN, IA ANLYT OTH TH INFC AGNT AB/AG, RIA",80.0,44.0,17.88,92.0,53
CPT,83519,"HC ACHR MODUL AB (1), IA ANLYT OTH TH INFC AGNT AB/AG, RIA",402.0,221.1,17.88,347.73,53
CPT,83519,"HC ACHR MODUL AB (3), IA ANLYT OTH TH INFC AGNT AB/AG, RIA",511.0,281.05,17.88,442.02,53
CPT,83519,"HC ACHR MUSCLE BIND ANTIBODY (1), IA ANLYT OTH TH INFC AGNT AB/AG, RIA",122.0,67.1,17.88,105.53,53
CPT,83519,"HC ACHR MUSCLE BIND ANTIBODY (2), IA ANLYT OTH TH INFC AGNT AB/AG, RIA",262.0,144.1,17.88,226.63,53
CPT,83519,"HC ACHR MUSCLE BIND ANTIBODY (3), IA ANLYT OTH TH INFC AGNT AB/AG, RIA",262.0,144.1,17.88,226.63,53
CPT,83519,"HC AMYLOID B-PROTEIN, IA ANLYT OTH TH INFC AGNT AB/AG, RIA",351.0,193.05,17.88,303.62,53
CPT,83519,"HC CALCIUM CHANNEL BINDING AB N, IA ANLYT OTH TH INFC AGNT AB/AG, RIA",39.0,21.45,11.7,92.0,53
CPT,83519,"HC CHOLECYSTOKININ, IA ANLYT OTH TH INFC AGNT AB/AG, RIA",290.0,159.5,17.88,250.85,53
CPT,83519,"HC DEMENTIA EVAL, IMMNOASSAY ANALYTE OT INFECT AGENT AB/AG, QUANT, RIA",132.0,72.6,17.88,114.18,53
CPT,83519,HC DYSAUTONOMIA ANTIBODIES RIA IMMUNOASSAY FOR ANALYT OTH THAN INFECT AB/AG,229.0,125.95,17.88,198.09,53
CPT,83519,"HC ENCEPHALOPATHY RIA AB CSF, IA ANLYT OTH THAN INFC AGNT AB/AG, QUANT, RIA",135.0,74.25,17.88,116.78,53
CPT,83519,"HC ENCEPHALOPATHY RIA AB, IA ANLYT OTH THAN INFC AGNT AB/AG, QUANT, RIA",139.0,76.45,17.88,120.24,53
CPT,83519,"HC EPILEPSY AUTOIMMUNE VGKC AB CSF, IA ANLYT OTH TH INFC AGNT AB/AG, RIA",216.0,118.8,17.88,186.84,53
CPT,83519,"HC GAD AB, IA ANLYT OTH TH INFC AGNT AB/AG, RIA",81.0,44.55,17.88,92.0,53
CPT,83519,"HC GANGLIONIC ACHR AB, IA ANLYT OTH TH INFC AGNT AB/AG, RIA",375.0,206.25,17.88,324.38,53
CPT,83519,"HC GROWTH HORMONE BIND PROTEIN, IA ANLYT OTH TH INFC AGNT AB/AG, RIA",100.0,55.0,17.88,92.0,53
CPT,83519,"HC GROWTH HORMONE RELEASING, IA ANLYT OTH TH INFC AGNT AB/AG, RIA",440.0,242.0,17.88,380.6,53
CPT,83519,"HC HUMAN PANCREATIC POLYPEP (HPP), IA ANLYT OTH TH INFC AGNT AB/AG, RIA",99.0,54.45,17.88,92.0,53
CPT,83519,"HC IGF BINDING PROTEIN 1, IMMUNOASSAY ANALYTE QUANT RADIOIMMUNOASSAY",261.0,143.55,17.88,225.77,53
CPT,83519,"HC INTERLEUKIN 1B, IA ANLYT OTH TH INFC AGNT AB/AG, RIA",150.0,82.5,17.88,129.75,53
CPT,83519,"HC LAMBERT EATON, IA ANLYT OTH TH INFC AGNT AB/AG, RIA",252.0,138.6,17.88,217.98,53
CPT,83519,"HC MDC1 CSF, IA ANLYT OTH TH INFC AGNT AB/AG, RIA",135.0,74.25,17.88,116.78,53
CPT,83519,"HC MELANOCYTE STIMULAT HORMONE, IA ANLYT OTH TH INFC AGNT AB/AG, RIA",387.0,212.85,17.88,334.76,53
CPT,83519,"HC MUSK ANTIBODY (2), IA ANLYT OTH TH INFC AGNT AB/AG, RIA",2151.0,1183.05,17.88,1860.62,53
CPT,83519,"HC MUSK ANTIBODY (3), IA ANLYT OTH TH INFC AGNT AB/AG, RIA",1259.0,692.45,17.88,1089.04,53
CPT,83519,"HC NEURONAL (V-G)K+ CHANNEL AB (2), IA ANLYT OTH TH INFC AGNT AB/AG, RIA",492.0,270.6,17.88,425.58,53
CPT,83519,"HC NEUROTENSIN Y, IA ANLYT OTH TH INFC AGNT AB/AG, RIA",462.0,254.1,17.88,399.63,53
CPT,83519,"HC OREXIN-A/HYPOCRETIN-1 CSF, IMMUNOASSAY ANALYTE QUANT RADIOIMMUNOASSAY",1460.0,803.0,17.88,1262.9,53
CPT,83519,"HC PANCREASTATIN, IA ANLYT OTH TH INFC AGNT AB/AG, RIA",348.0,191.4,17.88,301.02,53
CPT,83519,"HC PARANEOPLAS AUTAB, NEURONAL VGKC AB, IA ANLYT OTH TH INFC AGNT AB/AG,RIA",173.0,95.15,17.88,149.65,53
CPT,83519,"HC PEPSINOGEN I, IA ANLYT OTH TH INFC AGNT AB/AG, RIA",343.0,188.65,17.88,296.7,53
CPT,83519,"HC PEPSINOGEN II, IA ANLYT OTH TH INFC AGNT AB/AG, RIA",440.0,242.0,17.88,380.6,53
CPT,83519,HC PROCOLLAGEN INTACT N TERM PROPEPTIDE TYPE 1B IMMUNOASSAY ANLYT QUANT RIA,158.0,86.9,17.88,136.67,53
CPT,83519,"HC SECRETIN, IMMNOASSAY ANALYTE OTHER THAN INFECT AGENT AB/AG, QUANT, RIA",400.0,220.0,17.88,346.0,53
CPT,83519,"HC SUBSTANCE P, IA ANLYT OTH TH INFC AGNT AB/AG, RIA",238.0,130.9,17.88,205.87,53
CPT,83519,"HC THROXINE ANTIBODY, IA ANLYT OTH TH INFC AGNT AB/AG, RIA",236.5,130.08,17.88,204.57,53
CPT,83519,"HC THYROTROPIN RELEASING HORMONE, IMMUNOASSAY ANALYTE OTH THAN INFECT AGENT",320.0,176.0,17.88,276.8,53
CPT,83519,"HC TRYPSIN, IMMNOASSAY ANALYTE OTHER THAN INFECT AGENT AB/AG, QUANT, RIA",40.0,22.0,12.0,92.0,53
CPT,83519,"HC TSH RECEPTOR ANTIBODY, IA ANLYT OTH TH INFC AGNT AB/AG, RIA",58.0,31.9,17.4,92.0,53
CPT,83519,"HC TUMOR NECROSIS FACTOR BETA, IA ANLYT OTH TH INFC AGNT AB/AG, RIA",462.0,254.1,17.88,399.63,53
CPT,83519,"HC VOLT GATE POTASSIUM CHANNEL AB, IA ANLYT OTH TH INFC AGNT AB/AG, RIA",640.0,352.0,17.88,553.6,53
CPT,83519,"HC VOLTAGE GATED CALCIUM CHANNEL, IMMUN ANALYTE QUANT",357.0,196.35,17.88,308.81,53
CPT,83520,"HC 14.3.3 ETA PROTEIN, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",340.0,187.0,16.79,294.1,53
CPT,83520,"HC ADAMTS 13 ANTIBODY, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",470.0,258.5,16.79,406.55,53
CPT,83520,"HC ADIPONECTIN, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",370.0,203.5,16.79,320.05,53
CPT,83520,"HC ALPHA SUBUNIT, IA ANALYTE OTH TH INFC AGNT AB/AG, QUANT, NOS",244.0,134.2,16.79,211.06,53
CPT,83520,"HC ALZHEIMER'S DISEASE EVAL CSF, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",860.0,473.0,16.79,743.9,53
CPT,83520,"HC ANTI MULLERIAN HORMONE, IA FOR ANLYT OTH THAN INFC AGNT AB/AG QUANT, NOS",122.0,67.1,16.79,105.53,53
CPT,83520,"HC ANTI-MULLERIAN HORMONE, IMMASSY ANALYTE OTH TH INFC AGNT AB/AG, NOS",135.0,74.25,16.79,116.78,53
CPT,83520,"HC ASIALO GM1 ANTIBODY IGG, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",41.0,22.55,12.3,86.35,53
CPT,83520,"HC ASIALO GM1 ANTIBODY IGM, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",41.0,22.55,12.3,86.35,53
CPT,83520,"HC C4 BINDING PROTEIN ANTIGEN, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",278.0,152.9,16.79,240.47,53
CPT,83520,"HC CADM-140, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",277.0,152.35,16.79,239.61,53
CPT,83520,"HC CAR AUTOANTIBODY, IMMUNOASSAY FOR ANALYTE OTH THAN INFC AGNT, NOS",777.0,427.35,16.79,672.11,53
CPT,83520,"HC CXCL9, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",736.25,404.94,16.79,743.9,106
CPT,83520,"HC CYTOKINES EACH, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",46.0,25.3,13.8,86.35,53
CPT,83520,"HC DEMYELINATING NEUROPATHY QUANT, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",144.0,79.2,16.79,124.56,53
CPT,83520,"HC EARLY SJOGRENS, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",93.0,51.15,16.79,86.35,53
CPT,83520,"HC EOSINOPHIL CATIONIC PROTEIN, IA ANLYT OTH THAN INFT AGNT AB/AG, QNT, NOS",150.0,82.5,16.79,129.75,53
CPT,83520,"HC FGFR3 ANTIBODY, IMMUNOASSAY ANALYTE QUANTITATIVE NOS",198.0,108.9,16.79,171.27,53
CPT,83520,"HC FIBROBLAST GROWTH FACTOR 23, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",553.0,304.15,16.79,478.35,53
CPT,83520,"HC FIBROSPECT HCV HA, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",271.0,149.05,16.79,234.42,53
CPT,83520,"HC FIBROSPECT HCV TIMP-1, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",271.0,149.05,16.79,234.42,53
CPT,83520,"HC FRATAXIN, IMMUNOASSAY ANLYT NON INFECT AGNT AB/AG, QUANT, NOS",1144.0,629.2,16.79,989.56,53
CPT,83520,"HC GD1A ANTIBODY IGG, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",41.0,22.55,12.3,86.35,53
CPT,83520,"HC GD1A ANTIBODY IGM, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",41.0,22.55,12.3,86.35,53
CPT,83520,"HC GD1A ANTIBODY, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",133.0,73.15,16.79,115.05,53
CPT,83520,"HC GD1A IGM ANTIBODY, IMMUNOASSAY ANALYTE QUANTITATIVE NOS",198.0,108.9,16.79,171.27,53
CPT,83520,"HC GD1B ANTIBODY IGG, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",41.0,22.55,12.3,86.35,53
CPT,83520,"HC GD1B ANTIBODY IGM, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",41.0,22.55,12.3,86.35,53
CPT,83520,"HC GD1B ANTIBODY, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",66.0,36.3,16.79,86.35,53
CPT,83520,"HC GM1 ANTIBODY CSF, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",144.0,79.2,16.79,124.56,53
CPT,83520,"HC GM1 ANTIBODY IGG, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",41.0,22.55,12.3,86.35,53
CPT,83520,"HC GM1 ANTIBODY IGM, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",41.0,22.55,12.3,86.35,53
CPT,83520,"HC GQ1B ANTBODY IGG CSF, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",103.0,56.65,16.79,89.1,53
CPT,83520,"HC GQ1B ANTIBODY IGG, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",103.0,56.65,16.79,89.1,53
CPT,83520,"HC GROWTH D-FACTOR 15, IMMUNOASSAY ANALYTE NON INFCT AGNT AB/AG, QUANT, NOS",496.0,272.8,16.79,429.04,53
CPT,83520,"HC GT1A IGG, IMMUNOASSAY ANALYTE NON INFCT AGNT AB/AG, QUANT, NOS",198.0,108.9,16.79,171.27,53
CPT,83520,"HC HISTONE H3 IGM ANTIBODY, IMMUNOASSAY ANALYTE QUANTITATIVE NOS",201.0,110.55,16.79,173.87,53
CPT,83520,"HC HUMAN ANTIMOUSE AB, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",501.0,275.55,16.79,433.37,53
CPT,83520,"HC HYALURONIC ACID (2), IA ANLYT OTH TH INFC AGNT AB/AG, NOS",439.0,241.45,16.79,379.74,53
CPT,83520,"HC IBD, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",111.0,61.05,16.79,96.02,53
CPT,83520,"HC IBM CN-1A, IMMUNOASSAY ANALYTE NON INFCT AGNT AB/AG, QUANT, NOS",470.0,258.5,16.79,406.55,53
CPT,83520,"HC IGA AB IGG, IMMNASSY ANALYTE OTH THN INFC AGNT AB/AG, QUANT, NOS",327.0,179.85,16.79,282.86,53
CPT,83520,"HC INHIBIN B, IMMUNOASSAY ANALYTE OTHER THAN INFECT AGENT AB/AG, QUANT, NOS",179.0,98.45,16.79,154.84,53
CPT,83520,"HC INSULIN LIKE GROWTH FACTOR 2 (IGF2), IMMUNOASSAY ANALYTE QUANT NOS",174.0,95.7,16.79,150.51,53
CPT,83520,"HC INTERLEUKIN 10, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",217.0,119.35,16.79,187.71,53
CPT,83520,"HC INTERLEUKIN 13, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",191.0,105.05,16.79,165.22,53
CPT,83520,"HC INTERLEUKIN 17, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",191.0,105.05,16.79,165.22,53
CPT,83520,"HC INTERLEUKIN 2 RECEPTOR A, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",382.0,210.1,16.79,330.43,53
CPT,83520,"HC INTERLEUKIN 2, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",282.0,155.1,16.79,243.93,53
CPT,83520,"HC INTERLEUKIN 5, IMMUNOASSAY ANLYT NON INFCT AGNT AB/AG, QUANT, NOS",197.0,108.35,16.79,170.41,53
CPT,83520,"HC INTERLEUKIN 6, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",197.0,108.35,16.79,170.41,53
CPT,83520,"HC INTERLEUKIN 8, IMMUNOASSAY ANALYTE NON INFCT AGNT AB/AG, QUANT, NOS",191.0,105.05,16.79,165.22,53
CPT,83520,"HC LEPTIN, IMMUNOASSAY ANALYTE OTHER THAN INFECT AGENT AB/AG, QUANT, NOS",139.0,76.45,16.79,120.24,53
CPT,83520,"HC LIPOPROTEIN A, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",81.0,44.55,16.79,86.35,53
CPT,83520,"HC MAG ANTIBODY, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",115.0,63.25,16.79,99.48,53
CPT,83520,"HC MATA ANTIBODY, IMMUNOASSAY ANALYTE QUANTITATIVE NOS",1463.0,804.65,16.79,1265.5,53
CPT,83520,"HC MATA AUTOANTIBODY,IMMUNOASSAY ANALYTE QUANT NOS",1310.0,720.5,16.79,1133.15,53
CPT,83520,"HC MMP-9, IMMUNOASSAY ANALYTE OTHER THAN INFECT AGENT AB/AG, QUANT, NOS",213.0,117.15,16.79,184.25,53
CPT,83520,HC MONITR IMMUNOASSAY ANALYTE QUANTITATIVE NOS,157.0,86.35,16.79,135.81,53
CPT,83520,"HC MSN, IMMASSY ANLYTE OTH THN INFC AGNT AB/AG, NOS",161.0,88.55,16.79,139.27,53
CPT,83520,"HC MUTAT CITRULLINATED VIMENTIN AB, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",241.0,132.55,16.79,208.47,53
CPT,83520,"HC NEUROPATHY PROFILE II CSF EACH, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",66.0,36.3,16.79,86.35,53
CPT,83520,"HC NGAL URINE, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",423.0,232.65,16.79,365.9,53
CPT,83520,"HC OXIDIZED LDL, LIPOPROTEIN, DIR MEASUREMENT, LDL CHOLESTEROL",111.0,61.05,16.79,96.02,53
CPT,83520,"HC PANCREATIC ELASTASE 1 (PE1) FE, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",437.0,240.35,16.79,378.01,53
CPT,83520,"HC PHOSPHO-TAU 217, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",792.5,435.88,16.79,685.51,53
CPT,83520,"HC PLA2 R ANTIBODY ELISA, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",150.0,82.5,16.79,129.75,53
CPT,83520,"HC PROTHROMBIN FRACTION 1+2, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",342.0,188.1,16.79,295.83,53
CPT,83520,"HC SENS NEUROPATHY QUANT IMMUNOASSAY, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",136.0,74.8,16.79,117.64,53
CPT,83520,"HC SGPG ANTIBODY, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",115.0,63.25,16.79,99.48,53
CPT,83520,"HC SMAC, IMMUNOASSAY ANALYTE QUANTITATIVE NOS",750.0,412.5,16.79,648.75,53
CPT,83520,"HC SOLUABLE CD163, IMMUNOASSAY OTHER THAN INFECT AGNT AB/AG QUANT, NOS",1615.0,888.25,16.79,1396.98,53
CPT,83520,"HC SOLUBL C5B-9 C3 GLOMERULOPATHY PNL, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",373.0,205.15,16.79,322.65,53
CPT,83520,"HC STACHYBOTRYS CHARTARUM/ATRA IGA, IMMUNOASSAY ANALYTE QUANTITATIVE NOS",156.0,85.8,16.79,134.94,53
CPT,83520,"HC STRIATIONAL ANTIBODIES, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",288.0,158.4,16.79,249.12,53
CPT,83520,"HC STRIATIONAL ANTIBODY, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",83.0,45.65,16.79,86.35,53
CPT,83520,"HC SULFATIDE ABGT1A IGG, IMMUNOASSAY ANLYT NON INFCT AGNT AB/AG, QUANT, NOS",198.0,108.9,16.79,171.27,53
CPT,83520,"HC SULFATIDE ANTIBODY EA, IA ANLY O/THAN INFECT AGENT AB/AG, QUANT, NOS",131.0,72.05,16.79,113.32,53
CPT,83520,"HC TAU ALPHA BETA TOTAL, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",1027.0,564.85,16.79,888.36,53
CPT,83520,"HC THROMBOPOIETIN, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",352.0,193.6,16.79,304.48,53
CPT,83520,"HC TRANSFORMING GROWTH FACTOR BETA, IMMUNOASSAY ANALYTE QUANTITATIVE NOS",317.0,174.35,16.79,274.21,53
CPT,83520,"HC TRYPTASE, IMMUNOASSAY ANALYTE OTHER THAN INFECT AGENT AB/AG, QUANT, NOS",44.0,24.2,13.2,86.35,53
CPT,83520,"HC TS-HDS IGM ANTIBODY, IMMUNOASSAY ANALYTE QUANTITATIVE NOS",203.0,111.65,16.79,175.6,53
CPT,83520,"HC TSH RECEPTOR ANTIBODY, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",102.0,56.1,16.79,88.23,53
CPT,83520,"HC TUMOR NECROSIS FACTOR-A, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",197.0,108.35,16.79,170.41,53
CPT,83520,"HC TYPE II COLLAGEN AB, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",327.0,179.85,16.79,282.86,53
CPT,83520,"HC VASC ENDOTHELIAL GROWTH FACTOR D, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",868.0,477.4,16.79,750.82,53
CPT,83520,"HC VASCULAR ENDOTHELIAL GROWTH FACTOR, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",366.0,201.3,16.79,316.59,53
CPT,83520,"HC VWF COLLAGEN BINDING, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",322.0,177.1,16.79,278.53,53
CPT,83520,"HC VWF PROPEPTIDE ANTIGEN, IA ANLYT OTH TH INFC AGNT AB/AG, NOS",402.0,221.1,16.79,347.73,53
CPT,83520,"HC ZIC4 AUTOANTIBODY,  IMMUNOASSAY FOR ANALYTE OTHER THAN INFC AGNT, NOS",731.0,402.05,16.79,632.32,53
CPT,83521,"HC KAPPA FREE, IMMUNOGLOBULIN LIGHT CHAINS, EACH",155.0,85.25,16.79,134.08,106
CPT,83521,"HC KAPPA LAMBA FREE, IMMUNOGLOBULIN LIGHT CHAINS URINE, EA",59.0,32.45,16.79,86.35,53
CPT,83521,"HC LAMBDA FREE, IMMUNOGLOBULIN LIGHT CHAINS, EACH",155.0,85.25,16.79,134.08,106
CPT,83525,HC INSULIN ASSAY,112.0,61.6,11.12,96.88,106
CPT,83525,HC TOTAL INSULIN ASSAY,114.0,62.7,11.12,98.61,53
CPT,83527,HC FREE INSULIN ASSAY,55.0,30.25,12.59,64.75,53
CPT,83528,ASSAY OF INTRINSIC FACTOR,,,19.26,99.1,23
CPT,83529,HC CYTOKINES IL6 ASSAY,92.0,50.6,16.79,86.35,53
CPT,83529,HC INTERLEUKIN-6 ASSAY,218.0,119.9,16.79,188.57,53
CPT,83540,HC IRON ASSAY,108.0,59.4,6.28,93.42,53
CPT,83540,HC IRON LIVER TISSUE ASSAY,1178.0,647.9,6.28,1018.97,53
CPT,83550,HC IRON BINDING TEST,134.0,73.7,8.5,115.91,53
CPT,83570,ASSAY OF IDH ENZYME,,,8.6,44.25,23
CPT,83582,ASSAY OF KETOGENIC STEROIDS,,,15.03,77.35,23
CPT,83586,ASSAY 17- KETOSTEROIDS,,,12.44,64.0,23
CPT,83593,FRACTIONATION KETOSTEROIDS,,,27.7,142.5,23
CPT,83605,"HC BLOOD, LACTIC ACID",196.0,107.8,11.24,169.54,53
CPT,83605,HC D-LACTATE ASSAY,1340.0,737.0,11.24,1159.1,53
CPT,83605,HC D-LACTATE URINE ASSAY,1340.0,737.0,11.24,1159.1,53
CPT,83605,HC LACTATE (LACTIC ACID) ASSAY,129.0,70.95,11.24,111.59,212
CPT,83605,HC LACTIC ACID ASSAY,122.0,67.1,11.24,105.53,53
CPT,83605,HC LACTIC ACID CSF ASSAY,51.0,28.05,11.24,57.85,53
CPT,83615,HC LACTATE DEHYDROGENASE BLOOD,92.0,50.6,5.88,79.58,53
CPT,83615,HC LACTATE DEHYDROGENASE MISC,80.0,44.0,5.88,69.2,53
CPT,83615,HC LACTATE DEHYDROGENASE TOTAL,65.0,35.75,5.88,56.23,53
CPT,83615,"HC LACTATE DEHYDROGENASE, TOTAL BODY FLUID",35.0,19.25,5.88,30.28,53
CPT,83625,HC LACTATE DEHYDROGENASE (LD) ISOENZYME ASSAY,69.0,37.95,12.44,63.95,53
CPT,83630,HC LACTOFERRIN FECAL QUALITATIVE,31.0,17.05,9.3,98.5,53
CPT,83630,"HC LACTOFERRIN, FECAL, QUAL",103.0,56.65,19.15,98.5,53
CPT,83631,HC LACTOFERRIN FECAL QUANT,78.0,42.9,19.08,98.15,53
CPT,83632,PLACENTAL LACTOGEN,,,19.65,101.1,23
CPT,83633,TEST URINE FOR LACTOSE,,,10.94,56.25,23
CPT,83655,HC LEAD BLOOD VENIPUNCTURE ASSAY,91.0,50.05,11.77,78.72,53
CPT,83655,"HC LEAD URINE, LEAD ASSAY",26.0,14.3,7.8,60.55,53
CPT,83655,HC LEAD WHOLE BLOOD ASSAY,91.0,50.05,11.77,78.72,53
CPT,83655,"HC LEAD WHOLE BLOOD ASSAY, CAPILLARY",91.0,50.05,11.77,78.72,106
CPT,83655,"HC LEAD WHOLE BLOOD ASSAY, VENOUS",91.0,50.05,11.77,78.72,106
CPT,83661,L/S RATIO FETAL LUNG,,,21.38,109.95,23
CPT,83662,FOAM STABILITY FETAL LUNG,,,18.38,94.55,23
CPT,83663,FLUORO POLARIZE FETAL LUNG,,,18.38,94.55,23
CPT,83664,HC LAMELLAR BDY FETAL LUNG,143.0,78.65,18.77,123.7,53
CPT,83670,ASSAY OF LAP ENZYME,,,9.53,49.05,23
CPT,83690,"HC BODY FLUID, LIPASE",141.0,77.55,6.7,121.97,53
CPT,83690,HC LIPASE ASSAY,127.0,69.85,6.7,112.45,106
CPT,83690,"HC LIPASE URINE, LIPASE ASSAY",166.0,91.3,6.7,143.59,53
CPT,83695,HC LIPOPROTEIN(A) ASSAY,41.5,22.825,11.4,71.6,106
CPT,83698,HC LIPOPROTEIN PLA2 ASSAY,142.0,78.1,42.6,231.55,53
CPT,83700,HC LIPOPROTEIN HIGH RES QUANTITATIVE NMR,123.0,67.65,10.94,106.4,53
CPT,83701,LIPOPROTEIN BLD HR FRACTION,,,32.91,169.3,23
CPT,83704,"HC LIPOPROTEIN, BLD, QUANTN LIPOPROTEIN PARTICLE NUMBR(S), INCL SUBCLS(ES)",152.0,83.6,33.24,170.95,53
CPT,83718,HC LIPOPROTEIN ASSAY DIR MEASURE HDL CHOLESTROL,80.0,44.0,7.97,69.2,53
CPT,83719,ASSAY OF BLOOD LIPOPROTEIN,,,12.39,63.75,23
CPT,83721,HC LIPOPROTEIN ASSAY DIR MEASURE LDL CHOLESTEROL,57.0,31.35,10.21,52.5,53
CPT,83721,"HC OXIDIZED, LIPOPROTEIN, DIR MEASUREMENT, LDL CHOLESTEROL",141.0,77.55,10.21,121.97,53
CPT,83722,LIPOPRTN DIR MEAS SD LDL CHL,,,33.24,170.95,23
CPT,83727,HC LRH HORMONE ASSAY,389.0,213.95,16.71,336.49,53
CPT,83735,HC MAGNESIUM ASSAY,94.0,51.7,6.52,81.31,53
CPT,83735,HC MAGNESIUM FECAL ASSAY,45.0,24.75,6.52,38.93,53
CPT,83735,HC MAGNESIUM RBC ASSAY,85.0,46.75,6.52,73.53,53
CPT,83735,HC MAGNESIUM URINE ASSAY,89.5,49.225,6.52,81.31,106
CPT,83735,HC SUPERSATURATION PANEL MAGNESIUM,21.0,11.55,6.3,33.5,53
CPT,83775,ASSAY MALATE DEHYDROGENASE,,,7.16,36.85,23
CPT,83785,HC MANGANESE BLOOD ASSAY,76.0,41.8,22.8,133.25,53
CPT,83785,HC MANGANESE URINE ASSAY,327.0,179.85,25.9,282.86,53
CPT,83789,"HC ASYMMETRIC DIMETHYLARGININE, MASS & TANDEM SPECT, NON-DRG ANLYT,EA SPCMN",255.0,140.25,23.44,220.58,53
CPT,83789,"HC BILE ACIDS FREE & T FECES, MASS & TANDEM SPECT, NON-DRG ANLYT, EA SPCMN",537.0,295.35,23.44,464.51,53
CPT,83789,"HC BUDESONIDE (ENTOCORT), MASS & TANDEM SPECT, NON-DRG ANLYT, EA SPCMN",691.0,380.05,23.44,597.72,53
CPT,83789,"HC E243W, MASS & TANDEM MASS SPECT, NON-RX ANLYT NOS, EA SPCMN",815.0,448.25,23.44,704.98,53
CPT,83789,"HC ERYTHROCYTOSIS EVALUATION, MASS & TANDEM SPECT, NON-DRG ANLYT, EA SPCMN",687.0,377.85,23.44,594.26,53
CPT,83789,"HC HEMOGLOBIN FRACT & QUANT, MASS SPECT, NON-DRG ANLYT, EA SPCMN",396.0,217.8,23.44,342.54,53
CPT,83789,"HC HEMOGLOBIN VARIANT, MASS & TANDEM MASS SPECTR, NON-DRUG ANLYT NES, EACH",713.0,392.15,23.44,616.75,53
CPT,83789,"HC HEMOGLOBIN VARIANT, MASS & TANDEM SPECT, NON-DRG ANLYT, EA SPCMN",460.0,253.0,23.44,397.9,53
CPT,83789,"HC IODINE UR (1), MASS AND TANDEM MASS SPECTR, NON-RX ANALYTE NES, EA SPEC",181.0,99.55,23.44,156.57,53
CPT,83789,"HC LYSOSOMAL PEROXISOMAL SCRN, MASS & TANDEM SPECT, NON-DRG ANLYT, EA SPCMN",388.0,213.4,23.44,335.62,53
CPT,83789,"HC MASS AND TANDEM MASS SPECTR, NON-RX ANALYTE NES QUAL/QUANT EACH SPEC",123.0,67.65,23.44,120.55,53
CPT,83789,"HC N-METHYLHISTAMINE, MASS & TANDEM SPECT, NON-DRG ANLYT, EA SPCMN",549.0,301.95,23.44,474.89,53
CPT,83789,"HC SUCCINYLACETONE, MASS & TANDEM SPECT, NON-DRG ANLYT, EA SPCMN",241.0,132.55,23.44,208.47,53
CPT,83789,"HC TIN, SERUM, MASS & TANDEM SPECT, NON-DRG ANLYT, EA SPCMN",238.5,131.18,23.44,206.3,53
CPT,83789,"HC TMA-TMA OXIDE UR, MASS AND TANDEM MASS SPECTR, NON-RX ANLYT NES, EA SPEC",685.0,376.75,23.44,592.53,53
CPT,83825,HC MERCURY BLOOD ASSAY,44.0,24.2,13.2,81.3,53
CPT,83825,"HC MERCURY URINE, MERCURY, QUANT ASSAY",46.0,25.3,13.8,81.3,53
CPT,83835,"HC METANEPHRINE FRACTIONATED URINE, METANEPHRINES ASSAY",114.0,62.7,16.47,98.61,53
CPT,83835,HC METANEPHRINES PLASMA ASSAY,106.0,58.3,16.47,91.69,53
CPT,83857,ASSAY OF METHEMALBUMIN,,,10.44,53.7,23
CPT,83861,"HC MICROFLUIDIC ANALYSIS W/ INTEGR COLLECT AND ANALYS DEV, TEAR OSMOLARITY",56.0,30.8,16.8,112.4,106
CPT,83864,"HC URINE, MUCOPOLYSACCHARIDES, ACID, QUANT",767.0,421.85,27.7,663.46,53
CPT,83872,ASSAY SYNOVIAL FLUID MUCIN,,,5.7,29.3,23
CPT,83873,HC MYELIN BASIC PROTEIN CSF ASSAY,97.0,53.35,16.72,86.0,53
CPT,83874,HC MYOGLOBIN SERUM ASSAY,44.0,24.2,12.56,64.6,53
CPT,83874,HC MYOGLOBIN URINE ASSAY,143.0,78.65,12.56,123.7,53
CPT,83876,ASSAY MYELOPEROXIDASE,,,49.44,254.3,23
CPT,83880,HC NATRIURETIC PEPTIDE N-TERMINAL PRO-B,274.0,150.7,38.16,237.01,53
CPT,83883,"HC BETA-TRACE PROTEIN, BODY FLUID, NEPHELOMETRY, EA ANALYTE NES",529.0,290.95,13.22,457.59,53
CPT,83883,"HC FIBROSPECT HCV AMG, NEPHELOMETRY, EA ANALYTE NES",250.0,137.5,13.22,216.25,53
CPT,83883,HC FREE LIGHT CHAIN EACH NEPHELOMETRY ASSAY NOS,409.0,224.95,13.22,353.79,53
CPT,83883,HC IGA HEAVY & LIGHT CHAIN PAIRS NEPHELOMETRY ASSAY NOS,196.0,107.8,13.22,169.54,53
CPT,83883,HC IGG HEAVY & LIGHT CHAIN PAIRS NEPHELOMETRY ASSAY NOS,196.0,107.8,13.22,169.54,53
CPT,83883,HC IGM HEAVY & LIGHT CHAIN PAIRS NEPHELOMETRY ASSAY NOS,196.0,107.8,13.22,169.54,53
CPT,83883,HC KAPPA FREE LIGHT CHAIN CSF NEPHELOMET ASSAY NOS,516.0,283.8,13.22,446.34,53
CPT,83883,"HC KAPPA IGA HEAVY LIGHT CHAINS, NEPHELOMETRY, EACH ANALYTE NES",164.0,90.2,13.22,141.86,106
CPT,83883,"HC KAPPA IGG HEAVY LIGHT CHAINS, NEPHELOMETRY, EACH ANALYTE NES",164.0,90.2,13.22,141.86,106
CPT,83883,"HC KAPPA IGM HEAVY LIGHT CHAINS, NEPHELOMETRY, EACH ANALYTE NES",164.0,90.2,13.22,141.86,106
CPT,83883,"HC LAMBDA IGA HEAVY LIGHT CHAINS, NEPHELOMETRY, EACH ANALYTE NES",164.0,90.2,13.22,141.86,106
CPT,83883,"HC LAMBDA IGG HEAVY LIGHT CHAINS, NEPHELOMETRY, EACH ANALYTE NES",164.0,90.2,13.22,141.86,106
CPT,83883,"HC LAMBDA IGM HEAVY LIGHT CHAINS, NEPHELOMETRY, EACH ANALYTE NES",164.0,90.2,13.22,141.86,106
CPT,83883,"HC RETINOL BINDING PROTEIN, NEPHELOMETRY EA ANALYTE NOS",76.0,41.8,13.22,68.0,53
CPT,83884,HC NEUROFILAMENT LIGHT CHAIN,1244.5,684.48,373.35,1076.49,38
CPT,83885,HC NICKEL BLOOD ASSAY,71.0,39.05,21.3,122.55,53
CPT,83885,HC NICKEL URINE ASSAY,92.0,50.6,23.82,122.55,53
CPT,83915,HC NUCLEOTIDASE ASSAY,40.0,22.0,10.84,55.75,53
CPT,83915,"HC RED BLOOD CELL , NUCLEOTIDASE 5'-",1556.0,855.8,10.84,1345.94,53
CPT,83916,HC OLIGOCLONAL BANDS,202.0,111.1,26.62,174.73,53
CPT,83916,"HC SERUM, OLIGOCOLONAL BAND",200.0,110.0,26.62,173.0,53
CPT,83918,HC ORGANIC ACIDS PLASMA QUANTITATIVE TOTAL,742.0,408.1,22.94,641.83,53
CPT,83918,HC ORGANIC ACIDS URINE QUANTITATIVE TOTAL (3),340.0,187.0,22.94,294.1,53
CPT,83919,ORGANIC ACIDS QUAL EACH,,,15.99,82.25,23
CPT,83921,"HC FORMIC ACID, ORGANIC ACID, SINGLE, QUANT",234.0,128.7,20.62,202.41,53
CPT,83921,HC METHYLMALONIC ACID (MMA) QUANTITATIVE SINGLE,144.0,79.2,20.62,124.56,53
CPT,83921,HC METHYLMALONIC ACID URINE QUANTITATIVE SINGLE,151.0,83.05,20.62,130.62,53
CPT,83921,HC OROTIC ACID QUANTITATIVE SINGLE,302.0,166.1,20.62,261.23,53
CPT,83921,"HC OROTIDINE URINE, ORGANIC ACID, SINGLE, QUANTITATIVE",302.0,166.1,20.62,261.23,53
CPT,83921,"HC PERFLUOROALKYL SUBSTANCES, ORGANIC ACID, SINGLE, QUANT",959.0,527.45,20.62,829.54,53
CPT,83921,"HC TRICHLOROETHYLENE EXPOSURE URINE, ORGANIC ACID SINGLE QUANT",1189.0,653.95,20.62,1028.49,53
CPT,83930,HC BLOOD OSMOLALITY ASSAY,105.0,57.75,6.43,90.83,106
CPT,83935,"HC OSMOLALITY, URINE",46.0,25.3,6.62,39.79,53
CPT,83935,HC SUPERSATURATION PANEL OSMOLALITY URINE,17.0,9.35,5.1,34.1,53
CPT,83935,HC URINE OSMOLALITY ASSAY,77.5,42.625,6.62,83.91,159
CPT,83937,HC OSTEOCALCIN ASSAY,107.0,58.85,29.02,149.25,53
CPT,83945,HC OXALATE SERUM ASSAY,309.0,169.95,14.05,267.29,53
CPT,83945,"HC OXALATE URINE (2), OXALATE ASSAY",49.0,26.95,14.05,72.25,53
CPT,83945,HC OXALATE URINE ASSAY,45.0,24.75,13.5,72.25,53
CPT,83945,HC SUPERSATURATION PANEL OXALATE,37.0,20.35,11.1,72.25,53
CPT,83950,HC ONCOPROTEIN HER-2 NEU ELISA ASSAY,763.0,419.65,62.6,660.0,53
CPT,83951,HC DES GAMMA CARBOSY PROTHROMBIN (DCP) ASSAY,312.0,171.6,62.6,322.05,53
CPT,83951,"HC HEPATOCELLULAR CARCINOMA ONCOPROTEIN, ONCOPROTEIN DCP",299.0,164.45,62.6,322.05,53
CPT,83970,"HC INTER-OPERATIVE PARATHYROID HORMONE ASPIRATE, PARATHORMONE",127.0,69.85,38.1,206.4,53
CPT,83970,HC PARATHORMONE FINE NDL ASPIR ASSAY,227.0,124.85,40.13,206.4,53
CPT,83970,HC PARATHORMONE SCANTIBOD CAP (1-84) ASSAY,278.0,152.9,40.13,240.47,53
CPT,83970,HC PARATHYROID HORMONE INTACT ASSAY,434.0,238.7,40.13,375.41,106
CPT,83986,HC ASSAY PH BODY FLUID NOS,42.0,23.1,3.48,36.33,53
CPT,83986,HC PH BODY FLUID FECAL ASSAY,71.0,39.05,3.48,61.42,53
CPT,83986,HC PH BODY FLUID SECRETIN ASSAY,41.0,22.55,3.48,35.47,53
CPT,83986,HC PH BODY FLUID URINE ASSAY,47.0,25.85,3.48,40.66,53
CPT,83986,HC PH GASTRIC ASSAY,41.0,22.55,3.48,35.47,106
CPT,83986,"HC PH URINE, PH, BODY FLUID, NOS",11.0,6.05,3.3,17.9,53
CPT,83986,HC SUPERSATURATION PANEL  PH,14.0,7.7,3.48,17.9,53
CPT,83987,EXHALED BREATH CONDENSATE,,,3.48,17.9,23
CPT,83992,"HC MECONIUM CONFIRMATION, PHENCYCLIDINE",278.0,152.9,35.91,240.47,38
CPT,83992,"HC MECONIUM, PHENCYCLIDINE",131.0,72.05,35.91,175.45,38
CPT,83992,HC PHENCYCLIDINE ASSAY,159.0,87.45,35.91,175.45,38
CPT,83992,"HC PHENCYCLIDINE UMBILICAL TISSUE, ASSAY",131.0,72.05,35.91,175.45,38
CPT,83992,HC PHENCYCLIDINE URINE CONFIRMATION ASSAY,159.0,87.45,35.91,175.45,38
CPT,83993,HC CALPROTECTIN FECAL ASSAY,268.0,147.4,19.08,231.82,53
CPT,83993,HC FECAL CALPROTECTIN,222.0,122.1,19.08,192.03,106
CPT,84030,HC BLOOD PKU ASSAY,28.0,15.4,5.35,27.5,53
CPT,84035,ASSAY OF PHENYLKETONES,,,3.87,19.9,23
CPT,84060,HC TARTRATE-RESISTANT ACID PHOSPHATASE TOTAL,272.0,149.6,7.43,235.28,53
CPT,84066,HC ASSAY PROSTATE PHOSPHATASE,49.0,26.95,9.39,48.3,53
CPT,84075,HC ALKALINE PHOSPHATASE CSF,44.0,24.2,5.04,38.06,53
CPT,84075,HC PHOSPHATASE ALKALINE ASSAY,68.5,37.675000000000004,5.04,102.94,106
CPT,84078,ASSAY ALKALINE PHOSPHATASE,,,8.03,41.3,23
CPT,84080,HC ALKALINE PHOSPHATASE ISOENZYMES ASSAY,125.0,68.75,14.37,108.13,53
CPT,84080,HC ALKALINE PHOSPHATASE ISOENZYMES BONE SPEC ASSY,129.0,70.95,14.37,111.59,53
CPT,84080,HC ALKALINE PHOSPHATASE ISOENZYMES CSF,155.0,85.25,14.37,134.08,53
CPT,84081,ASSAY PHOSPHATIDYLGLYCEROL,,,16.06,82.6,23
CPT,84085,ASSAY OF RBC PG6D ENZYME,,,9.18,47.2,23
CPT,84087,HC PHOSPHOHEXOSE ISOMERASE RBC ENZYME GLU ASSAY,276.0,151.8,10.43,238.74,53
CPT,84100,HC PHOSPHOROUS FECAL,134.5,73.98,4.61,116.34,53
CPT,84100,HC PHOSPHORUS ASSAY,75.0,41.25,4.61,64.88,106
CPT,84105,"HC PHOSPHORUS, URINE",40.0,22.0,5.63,34.6,53
CPT,84105,HC SUPERSATURATION PANEL PHOSPHORUS,19.0,10.45,5.63,28.9,53
CPT,84105,HC URINE PHOSPHORUS ASSAY,25.0,13.75,5.63,28.9,106
CPT,84105,"HC URINE PHOSPHORUS ASSAY, TIMED",123.0,67.65,5.63,106.4,53
CPT,84106,TEST FOR PORPHOBILINOGEN,,,5.65,29.1,23
CPT,84110,"HC PORPHOBILINOGEN, URINE, QUANT ASSAY",94.0,51.7,8.21,81.31,53
CPT,84112,EVAL AMNIOTIC FLUID PROTEIN,,,95.36,490.55,23
CPT,84119,TEST URINE FOR PORPHYRINS,,,12.99,66.8,23
CPT,84120,HC PORPHYRINS URINE QUANT & FRACTIONATION ASSAY,115.0,63.25,14.3,99.48,53
CPT,84126,HC PORPHYRINS FECES QUANTITATIVE ASSAY,405.0,222.75,38.02,350.33,53
CPT,84132,HC POTASSIUM SERUM PLASMA OR WHOLE BLOOD ASSAY,67.0,36.849999999999994,4.63,58.82,212
CPT,84132,HC WHOLE BLOOD POTASSIUM,21.0,11.55,4.63,23.8,53
CPT,84133,HC POTASSIUM URINE ASSAY,24.0,13.2,4.6,23.65,53
CPT,84133,HC POTASSIUM URINE FECES FLUID ASSAY,85.0,46.75,4.6,73.53,106
CPT,84133,HC SUPERSATURATION PANEL  POTASSIUM,16.0,8.8,4.6,23.65,53
CPT,84134,HC PREALBUMIN ASSAY,113.0,62.15,14.18,97.75,106
CPT,84135,ASSAY OF PREGNANEDIOL,,,20.67,106.35,23
CPT,84138,ASSAY OF PREGNANETRIOL,,,20.46,105.25,23
CPT,84140,HC PREGNENOLONE ASSAY,107.0,58.85,20.09,103.35,53
CPT,84143,HC 17-HYDROXYPREGNENOLONE ASSAY,108.0,59.4,22.17,114.05,53
CPT,84144,HC PROGESTERONE ASSAY,62.0,34.1,18.6,104.3,53
CPT,84145,HC PROCALCITONIN (PCT),285.0,156.75,26.45,246.53,106
CPT,84146,HC MACROPROLACTIN ASSAY,69.0,37.95,18.84,96.9,53
CPT,84146,HC PROLACTIN ASSAY,201.0,110.55,18.84,173.87,53
CPT,84150,"HC F2 ALPHA URINE, PROSTAGLANDIN, EACH",283.0,155.65,40.6,244.8,53
CPT,84150,HC PROSTAGLANDIN D2 URINE ASSAY,469.0,257.95,40.6,405.69,53
CPT,84152,ASSAY OF PSA COMPLEXED,,,17.87,91.95,23
CPT,84153,"HC PROSTATE HEALTH INDEX, PROSTATE SPECIFIC ANTIGEN, TOTAL",179.0,98.45,17.87,154.84,53
CPT,84153,HC PROSTATE SPECIFIC ANTIGEN (PSA) DX ASSAY,186.5,102.575,17.87,167.81,265
CPT,84154,"HC PROSTATE HEALTH INDEX, PROSTATE SPECIFIC ANTIGEN, FREE",182.0,100.1,17.87,157.43,53
CPT,84154,HC PSA FREE ASSAY,135.0,74.25,17.87,116.78,106
CPT,84155,HC PROTEIN BLOOD ASSAY WO REFRACTOMETRY,55.0,30.25,3.56,47.58,53
CPT,84155,HC PROTEIN WBC ASSAY WO REFRACTOMETRY,103.0,56.65,3.56,89.1,53
CPT,84156,"HC FREE LIGHT CHAINS PROTEIN URINE, TOTAL, WO REFRACTOMETRY",59.0,32.45,3.56,51.04,53
CPT,84156,HC PROTEIN URINE RANDOM ASSAY WO REFRACTOMETRY,65.0,35.75,3.56,56.23,53
CPT,84156,HC PROTEIN URINE TIMED ASSAY WO REFRACTOMETRY,96.0,52.8,3.56,83.04,53
CPT,84157,"HC ETC, PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY, OTHER SOURCE",269.0,147.95,3.89,232.69,53
CPT,84157,HC PROTEIN CSF ASSAY WO REFRACTOMETRY,78.0,42.9,3.89,67.47,53
CPT,84157,HC PROTEIN FLUID ASSAY WO REFRACTOMETRY,75.0,41.25,3.89,64.88,53
CPT,84157,"HC PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY, BODY FLUID",28.0,15.4,3.89,24.22,53
CPT,84160,ASSAY OF PROTEIN ANY SOURCE,,,5.45,28.05,23
CPT,84163,HC PREGNANCY-ASSOC PLASMA PROTEIN (PAPP-A) SEQUNTL (2),84.0,46.2,14.63,75.25,53
CPT,84165,HC PROTEIN ELECTROPHORESIS SERUM,245.0,134.75,10.44,211.93,106
CPT,84166,"HC 24 HR URINE, PROTEIN, ELP FRACT AND QUANT, OTHER FLD W/ CONCENTRATION",276.0,151.8,17.33,238.74,106
CPT,84166,HC PROTEIN ELECTROPHORESIS CSF (1),355.0,195.25,17.33,307.08,53
CPT,84166,HC PROTEIN ELECTROPHORESIS FLUID (2),355.0,195.25,17.33,307.08,53
CPT,84166,"HC RANDOM URINE, PROTEIN, ELP FRACT AND QUANT, OTHER FLD W/ CONCENTRATION",273.0,150.15,17.33,236.15,53
CPT,84181,HC 68KD ANTIBODY WESTERN BLOT,180.0,99.0,16.56,155.7,53
CPT,84182,HC 14-3-3 PROTEIN WESTERN BLOT IMMUN PROBE BAND ID,93.0,51.15,27.9,146.05,53
CPT,84182,"HC AMPHIPHYSIN ANTIBODY IGG, PROTEIN WESTERN BLOT TEST",285.0,156.75,28.4,246.53,53
CPT,84182,HC AMPHIPHYSIN WESTERN BLOT IMMUN PROBE BAND ID,334.0,183.7,28.4,288.91,53
CPT,84182,"HC ANTI-NEURONAL AB TYP 1 IB, PROTEIN, W BLOT, BLD/OTH BDY FLD, PRB BAND ID",167.0,91.85,28.4,146.05,53
CPT,84182,"HC ANTI-NEURONAL AB TYP 2 IB, PROTEIN, W BLOT, BLD/OTH BDY FLD, PRB BAND ID",167.0,91.85,28.4,146.05,53
CPT,84182,"HC AUTOIMMUNE MYOPATHY CRMPWB CSF,PROTEIN WESTERN BLOT W/INTERP RPRT",314.0,172.7,28.4,271.61,53
CPT,84182,"HC AUTOIMMUNE MYOPATHY CRMPWB, PROTEIN WESTERN BLOT W/INTERP RPRT",474.0,260.7,28.4,410.01,53
CPT,84182,"HC AXONAL, PROTEIN, W BLOT, BLD/OTH BDY FLD, PRB BAND ID",325.0,178.75,28.4,281.13,53
CPT,84182,"HC CONTACTIN ANTIBODY, PROTEIN WESTERN BLOT BLOOD/OTH FLU IMMUNOLOGICAL",75.0,41.25,22.5,146.05,53
CPT,84182,"HC CRMP-5 IGG CSF, PROTEIN WESTERN BLOT TEST",387.0,212.85,28.4,334.76,53
CPT,84182,HC CRMP-5 WESTERN BLOT IMMUN PROBE BAND ID,388.0,213.4,28.4,335.62,53
CPT,84182,HC CYSTICERCOSIS AB WESTERN BLOT IMMUN PRB BAND ID,298.0,163.9,28.4,257.77,53
CPT,84182,"HC DEMYELINATING NEUROPATHY, PROTEIN, W BLOT, BLD/OTH BDY FLD, PRB BAND ID",239.0,131.45,28.4,206.74,53
CPT,84182,"HC DERMATOMYOSITIS, PROTEIN, W BLOT, BLD/OTH BDY FLD, PRB BAND ID",85.0,46.75,25.5,146.05,53
CPT,84182,HC MATA ANTIBODY WESTERN BLOT IMMUN PROBE BAND ID,212.0,116.6,28.4,183.38,53
CPT,84182,"HC MDC1 CSF, PROTEIN, W BLOT, BLD/OTH BDY FLD, PROBE BAND ID, EA",170.0,93.5,28.4,147.05,53
CPT,84182,"HC MDS1, PROTEIN WESTERN BLOT BLOOD/OTH BODY FLUID IMMUNOLOGICAL PROBE",189.0,103.95,28.4,163.49,53
CPT,84182,"HC MELANOMA ASSOC RETINOPATHY, PROTEIN, W BLOT, BLD/OTH BDY FLD,PRB BAND ID",210.0,115.5,28.4,181.65,53
CPT,84182,HC MYOSITIS WESTERN BLOT,97.0,53.35,28.4,146.05,53
CPT,84182,"HC NEUROFASCINS ANTIBODY, PROTEIN WESTERN BLOT BLOOD/OTH FLU IMMUNOLOGICAL",75.0,41.25,22.5,146.05,53
CPT,84182,"HC NEURONAL NUCLEAR AB, PROTEIN, W BLOT, BLD/OTH BDY FLD, PRB BAND ID",105.0,57.75,28.4,146.05,53
CPT,84182,"HC NT5C1A ANTIBODY, PROTEIN WESTERN BLOT BLOOD/OTH FLU IMMUNOLOGICAL",75.0,41.25,22.5,146.05,53
CPT,84182,"HC PCA-1 IMMUNOBOLT, PROTEIN WESTRN BLOT BLOOD/OTH FLU IMMUNOLOGICAL",167.0,91.85,28.4,146.05,53
CPT,84182,"HC SENS NEUROPATHY WESTERN BLOT, OTH BDY, PRB BAND ID",152.0,83.6,28.4,146.05,53
CPT,84182,"HC W BLOT AB, PROTEIN, W BLOT, BLD/OTH BODY FLD, PROBE FOR BAND ID, EA",207.0,113.85,28.4,179.06,53
CPT,84202,HC PROTOPORPHYRINS FREE ERYTHRO ASSAY,175.0,96.25,13.95,151.38,53
CPT,84202,HC ZINC PROTOPORPHYRINS (ZPP) ASSAY,76.0,41.8,13.95,84.77,159
CPT,84202,"HC ZPP INDUSTRIAL EXPOSURE, PROTOPORPHYRIN, RBC, QUANTITATIVE",32.0,17.6,9.6,71.75,53
CPT,84202,"HC ZPP WHOLE BLOOD, PROTOPORPHYRIN, RBC, QUANTITATIVE",32.0,17.6,9.6,71.75,53
CPT,84203,TEST RBC PROTOPORPHYRIN,,,9.47,48.7,23
CPT,84206,HC PROINSULIN ASSAY,108.0,59.4,25.95,133.45,53
CPT,84207,HC VITAMIN B-6 ASSAY,126.0,69.3,27.32,140.5,53
CPT,84210,"HC BLOOD, PYRUVATE",110.0,60.5,14.08,95.15,53
CPT,84210,HC PYRUVATE ASSAY,83.0,45.65,14.08,72.4,53
CPT,84210,HC PYRUVATE CSF,93.0,51.15,14.08,80.45,53
CPT,84220,HC PYRUVATE KINASE ASSAY,219.0,120.45,9.18,189.44,53
CPT,84220,HC PYRUVATE KINASE RBC ENZYME ASSAY,456.0,250.8,9.18,394.44,53
CPT,84228,ASSAY OF QUININE,,,11.3,58.15,23
CPT,84233,ASSAY OF ESTROGEN,,,85.42,439.4,23
CPT,84234,ASSAY OF PROGESTERONE,,,63.06,324.4,23
CPT,84235,ASSAY OF ENDOCRINE HORMONE,,,69.24,356.15,23
CPT,84238,HC ASSAY NONENDOCRINE RECEPTOR,161.0,88.55,35.54,182.85,53
CPT,84238,"HC SOLUBLE TRANSFERRIN RECEPTOR, RECEPTOR ASSAY, NON-ENDOCRINE",75.0,41.25,22.5,182.85,53
CPT,84244,HC RENIN ACTIVITY ASSAY,146.0,80.3,21.38,126.29,53
CPT,84244,HC RENIN DIRECT ASSAY,400.0,220.0,21.38,346.0,53
CPT,84252,HC VITAMIN B-2 ASSAY,128.0,70.4,19.67,110.72,53
CPT,84255,HC SELENIUM ASSAY,246.0,135.3,24.82,212.79,53
CPT,84255,HC SELENIUM RBC,210.0,115.5,24.82,181.65,53
CPT,84255,HC SELENIUM URINE QUANTITATIVE,94.0,51.7,24.82,127.65,53
CPT,84260,HC SEROTONIN ASSAY,110.0,60.5,30.11,154.9,53
CPT,84270,HC SEX HORMONE BINDING GLOBULIN (SHBG),39.0,21.45,11.7,108.65,53
CPT,84270,HC SEX HORMONE GLOBULIN ASSAY,49.0,26.95,14.7,108.65,106
CPT,84275,"HC ALPHA AMINOADIPIC SEMIALDEHYDE CSF, SIALIC ACID",358.0,196.9,13.07,309.67,53
CPT,84275,"HC CSF, SIALIC ACID",358.0,196.9,13.07,309.67,53
CPT,84285,ASSAY OF SILICA,,,24.51,126.05,23
CPT,84295,HC SERUM SODIUM ASSAY,55.0,30.25,4.67,47.58,53
CPT,84295,HC SODIUM SERUM PLASMA OR WHOLE BLOOD ASSAY,52.0,28.6,4.67,44.98,159
CPT,84295,HC WHOLE BLOOD SODIUM,19.0,10.45,4.67,24.05,53
CPT,84300,"HC SODIUM, URINE",45.0,24.75,4.91,38.93,53
CPT,84300,HC SUPERSATURATION PANEL SODIUM,17.0,9.35,4.91,25.3,53
CPT,84300,HC URINE SODIUM ASSAY,45.0,24.75,4.91,56.23,106
CPT,84302,HC SODIUM FECAL ASSAY,40.0,22.0,4.73,34.6,53
CPT,84302,HC SODIUM FLUID ASSAY,90.0,49.5,4.73,77.85,53
CPT,84305,"HC INSULIN LIKE GROWTH FACTOR 1 BY LC/MS, SOMATOMEDIN",396.0,217.8,20.66,342.54,53
CPT,84305,HC SOMATOMEDIN ASSAY,77.0,42.35,20.66,106.3,106
CPT,84307,HC SOMATOSTATIN ASSAY,477.0,262.35,17.78,412.61,53
CPT,84311,HC ARYLSULFATASE A URINE SPECTROPHOTOMETRY,513.0,282.15,7.88,443.75,53
CPT,84311,"HC BODY FLUID, SPECTROPHOTOMETRY, ANALYTE NES",56.0,30.8,7.88,48.44,53
CPT,84311,"HC CHYMOTRYPSIN FECAL, SPECTROPHOTOMETRY, ANALYTE",214.0,117.7,7.88,185.11,53
CPT,84311,"HC ETC, SPECTROPHOTOMETRY, ANALYTE, NES",66.0,36.3,7.88,57.09,53
CPT,84311,HC PORPHYRINS BLOOD TOTAL SPECTROPHOTOMETRY,201.0,110.55,7.88,173.87,53
CPT,84311,"HC SYNOVIAL FLUID HEMOGLOBIN, SPECTROPHOTOMETRY ANALYTE NOS",48.0,26.4,7.88,41.52,53
CPT,84315,"HC BODY FLUID, SPECIFIC GRAVITY",55.0,30.25,3.2,47.58,53
CPT,84375,CHROMATOGRAM ASSAY SUGARS,,,37.91,195.0,23
CPT,84376,HC SUGARS SINGLE QUAL REDUCING SUBSTANCES FECES,34.0,18.7,5.35,29.41,53
CPT,84377,"HC OLIGOSACCHARIDES URINE, SUGARS, MULT QUAL, EA SPECIMEN",232.0,127.6,5.35,200.68,53
CPT,84378,"HC 1,5 ANHYDROGLUCITIOL, SUGAR, SINGLE QUANT, EA SPCMN",112.5,61.88,11.21,97.31,53
CPT,84378,HC GALACTOSE-1 PHOSPHATE RBC SUGARS SINGLE QUANT,231.5,127.33,11.21,200.25,53
CPT,84378,HC GLYCOMARK SUGARS SINGLE QUANT,134.0,73.7,11.21,115.91,53
CPT,84379,SUGARS MULTIPLE QUANT,,,11.21,57.65,23
CPT,84392,HC SULFATE URINE ASSAY,33.0,18.15,5.34,28.55,53
CPT,84392,HC SUPERSATURATION PANEL SULFATE,19.0,10.45,5.34,27.45,53
CPT,84393,"HC ALZHEIMER TAU PHOSPHORYLATED, EA",642.0,353.1,192.6,555.33,38
CPT,84393,HC PHOSPHORYLATED-TAU 217,831.5,457.33,249.45,719.25,38
CPT,84394,"HC ALZHEIMER TAU, TOTAL",642.0,353.1,192.6,555.33,38
CPT,84402,"HC LC-MS/MS , TESTOSTERONE FREE",218.0,119.9,24.75,188.57,53
CPT,84402,"HC LC-MS/MS EQUILIBRIUM DIAL, TESTOSTERONE FREE",117.0,64.35,24.75,127.35,53
CPT,84402,HC TESTOSTERONE FREE,174.0,95.7,24.75,150.51,53
CPT,84402,HC TESTOSTERONE FREE ASSAY,430.0,236.5,24.75,371.95,53
CPT,84403,"HC LC-MS/MS, TESTOSTERONE TOTAL",108.0,59.4,25.08,129.05,53
CPT,84403,HC TESTOSTERONE TOTAL ASSAY,312.0,171.60000000000002,25.08,286.32,106
CPT,84403,HC TESTOSTERONE TOTAL BY LC-MS/MS,91.0,50.05,25.08,129.05,53
CPT,84410,"HC FREE AND WEAKLY BOUND, TESTOSTERONE, BIOAVAILABLE, DIRECT MEASUREMENT",171.0,94.05,49.85,256.4,53
CPT,84425,HC VITAMIN B-1 ASSAY,157.0,86.35,20.64,135.81,53
CPT,84430,HC THIOCYANATE ASSAY,172.0,94.6,11.3,148.78,53
CPT,84431,"HC THROMBOXANE METABOLITE, INCL THROMBOXANE, URINE",316.0,173.8,34.13,273.34,53
CPT,84432,"HC CIA, THYROGLOBULIN",116.0,63.8,15.61,100.34,53
CPT,84432,HC THYROGLOBULIN ASSAY,230.0,126.5,15.61,198.95,159
CPT,84432,HC THYROGLOBULIN FINE NDL ASPIR ASSAY,456.0,250.8,15.61,394.44,53
CPT,84432,HC THYROGLOBULIN LC-MS MS ASSAY,416.0,228.8,15.61,359.84,53
CPT,84432,HC THYROGLOBULIN RIA ASSAY,293.0,161.15,15.61,253.45,53
CPT,84433,HC TPMT ACTIVITY ERYTHROCYTES ASSAY,166.0,91.3,21.55,143.59,53
CPT,84436,HC THYROXINE ASSAY TOTAL,161.0,88.55,6.68,139.27,106
CPT,84437,ASSAY OF NEONATAL THYROXINE,,,6.28,32.35,23
CPT,84439,HC THYROXINE FREE ASSAY,161.0,88.55,8.77,139.27,106
CPT,84442,HC THYROXINE BINDING GLOBULIN (TBG) ASSAY,54.0,29.7,14.37,73.9,53
CPT,84443,HC THYROID STIM HORMONE ASSAY,208.0,114.4,16.33,179.92,106
CPT,84443,HC TSH 3RD GENERATION,56.5,31.08,16.33,84.0,53
CPT,84445,HC TSI ASSAY,254.0,139.7,49.44,254.3,53
CPT,84446,HC VITAMIN E ASSAY,63.0,34.65,13.79,70.9,53
CPT,84449,HC TRANSCORTIN ASSAY,239.0,131.45,17.5,206.74,53
CPT,84450,HC TRANSFERASE (AST) (SGOT),69.0,37.95,5.04,59.69,53
CPT,84460,HC ALANINE AMINO (ALT) (SGPT),74.0,40.7,5.15,64.01,53
CPT,84466,HC TRANSFERRIN ASSAY,98.0,53.9,12.4,84.77,106
CPT,84478,HC TRIGLYCERIDES ASSAY,70.0,38.5,5.58,60.55,53
CPT,84478,HC TRIGLYCERIDES BODY FLUID ASSAY,113.0,62.15,5.58,97.75,53
CPT,84478,HC TRIGLYCERIDES FLUID ASSAY,124.0,68.2,5.58,107.26,53
CPT,84479,HC THYROID (T3 OR T4) ASSAY,80.0,44.0,6.28,69.2,106
CPT,84480,HC TOTAL TRIIODOTHYRONINE (T3) ASSAY,193.0,106.15,13.79,166.95,106
CPT,84481,HC TRIIODOTHYRONINE (T3) FREE ASSAY,103.0,56.65,16.47,89.1,53
CPT,84482,HC T3 REVERSE,74.0,40.7,15.32,78.8,53
CPT,84484,HC TROPONIN I STAT ASSAY,94.0,51.7,12.11,81.31,53
CPT,84484,HC TROPONIN T ASSAY,209.0,114.95,12.11,217.12,106
CPT,84485,ASSAY DUODENAL FLUID TRYPSIN,,,7.0,36.0,23
CPT,84488,TEST FECES FOR TRYPSIN,,,7.09,36.5,23
CPT,84490,ASSAY OF FECES FOR TRYPSIN,,,9.66,49.65,23
CPT,84510,HC TYROSINE ASSAY,100.0,55.0,10.33,86.5,53
CPT,84512,ASSAY OF TROPONIN QUAL,,,9.81,50.45,23
CPT,84520,HC BLOOD UREA NITROGEN (BUN) QUANTITATIVE ASSAY,52.0,28.6,3.84,44.98,53
CPT,84520,HC UREA NITROGEN FLUID QUANTITATIVE ASSAY,70.0,38.5,3.84,60.55,53
CPT,84525,UREA NITROGEN SEMI-QUANT,,,4.99,25.65,23
CPT,84540,HC SUPERSATURATION PANEL -UREA NITROGEN,19.0,10.45,5.4,27.8,53
CPT,84540,HC URINE UREA NITROGEN ASSAY,49.5,27.224999999999998,5.4,61.42,106
CPT,84540,"HC URINE UREA NITROGEN ASSAY, TIMED",71.0,39.05,5.4,61.42,53
CPT,84545,UREA-N CLEARANCE TEST,,,7.0,36.0,23
CPT,84550,HC BLOOD URIC ACID ASSAY,94.0,51.7,4.39,81.31,53
CPT,84560,HC SUPERSATURATION PANEL -URIC ACID,17.0,9.35,4.94,25.4,53
CPT,84560,HC URIC ACID FLUID ASSAY (2),29.0,15.95,4.94,25.4,53
CPT,84560,HC URIC ACID URINE ASSAY,85.5,47.025000000000006,4.94,123.7,106
CPT,84577,ASSAY OF FECES/UROBILINOGEN,,,16.33,84.0,23
CPT,84578,TEST URINE UROBILINOGEN,,,4.34,22.35,23
CPT,84580,ASSAY OF URINE UROBILINOGEN,,,9.28,47.75,23
CPT,84583,ASSAY OF URINE UROBILINOGEN,,,5.88,30.25,23
CPT,84585,HC VANILLYLMANDIC ACID (VMA) URINE 24 HR ASSAY,58.0,31.9,15.07,77.5,53
CPT,84586,HC VASOA INTESTINAL PEPTIDE (VIP) ASSAY,130.0,71.5,34.34,176.65,53
CPT,84588,"HC COPEPTIN PROAVP, ASSAY OF VASOPRESSIN ANTI-DIURETIC HORMONE",690.0,379.5,32.99,596.85,53
CPT,84588,HC VASOPRESSIN (ADH) PLASMA ASSAY,104.0,57.2,31.2,169.7,53
CPT,84590,HC VITAMIN A ASSAY,53.0,29.15,11.29,58.05,53
CPT,84591,HC BIOTIN VITAMIN B7 ASSAY,234.0,128.7,16.58,202.41,53
CPT,84591,"HC CYP24A1, VITAMIN NOS",31.0,17.05,9.3,85.3,53
CPT,84591,HC VITAMIN B3 ASSAY,173.0,95.15,16.58,149.65,53
CPT,84591,HC VITAMIN B5 (PANTOTHENIC ACID) ASSAY,168.0,92.4,16.58,145.32,53
CPT,84597,HC VITAMIN K ASSAY,126.0,69.3,13.33,108.99,53
CPT,84600,"HC PROPYLENE GLYCOL, VOLATILES",382.0,210.1,16.63,330.43,53
CPT,84600,HC TOLUENE VOLATILE ASSAY,269.0,147.95,16.63,232.69,53
CPT,84600,HC VOLATILE HYDROCARBON OXYGENATED ASSAY,242.0,133.1,16.63,209.33,53
CPT,84620,XYLOSE TOLERANCE TEST,,,12.55,64.55,23
CPT,84630,HC ZINC (EDTA DRAW) ASSAY,97.0,53.35,11.07,83.91,53
CPT,84630,HC ZINC RBC ASSAY,312.0,171.6,11.07,269.88,53
CPT,84630,HC ZINC URINE RANDOM ASSAY,81.0,44.55,11.07,70.07,53
CPT,84681,HC C-PEPTIDE ASSAY,102.0,56.1,20.22,104.05,106
CPT,84702,HC GONADOTROPIN CHORIONIC (HCG) BETA CSF QUAN ASSY,53.0,29.15,14.63,75.25,53
CPT,84702,HC GONADOTROPIN CHORIONIC (HCG) BETA QUANT ASSAY,64.0,35.2,14.63,75.25,53
CPT,84702,HC GONADOTROPIN CHORIONIC (HCG) BETA TUMR QUAN ASY,64.0,35.2,14.63,75.25,53
CPT,84702,HC GONADOTROPIN CHORIONIC (HCG) PREGNCY QUANT ASSY,199.0,109.45,14.63,172.14,53
CPT,84702,HC GONADOTROPIN CHORIONIC (HCG) TOTAL QUANT ASSAY,72.0,39.6,14.63,75.25,53
CPT,84702,HC GONADOTROPIN CHORIONIC (HCG) TUMOR QUANT ASSAY,78.0,42.9,14.63,75.25,159
CPT,84703,HC CHORIONIC GONADOTROPIN ASSAY,90.0,49.5,7.31,77.85,53
CPT,84704,HCG FREE BETACHAIN TEST,,,14.87,76.45,23
CPT,84830,OVULATION TESTS,,,12.35,63.5,23
CPT,84999,"HC OSMOLALITY FECAL, UNLISTED CHEMISTRY PROCEDURE",88.0,48.4,26.4,76.12,38
CPT,84999,"HC POTASSIUM FECAL, UNLISTED CHEMISTRY PROCEDURE",75.0,41.25,22.5,64.88,38
CPT,84999,"HC POTASSIUM FLUID, UNLISTED CHEMISTRY PROCEDURE",58.0,31.9,17.4,50.17,38
CPT,84999,"HC PREDICTRPK IFX, UNLISTED CHEMISTRY PROCEDURE",882.0,485.1,264.6,762.93,38
CPT,85002,BLEEDING TIME TEST,,,4.68,24.1,23
CPT,85004,HC AUTOMATED DIFF WBC COUNT,74.0,40.7,6.28,64.01,53
CPT,85007,HC BLOOD SMEAR W MANUAL DIFFERENTIAL,40.5,22.275,3.69,39.79,159
CPT,85008,BL SMEAR W/O DIFF WBC COUNT,,,3.34,17.15,23
CPT,85009,MANUAL DIFF WBC COUNT B-COAT,,,4.92,25.35,23
CPT,85013,HC SPUN MICROHEMATOCRIT,19.0,10.45,5.7,35.0,53
CPT,85014,HC HEMATOCRIT,57.0,31.35,2.3,77.85,212
CPT,85014,"HC POC, HEMATOCRIT",40.0,22.0,2.3,34.6,159
CPT,85018,HC BLOOD COUNT HEMOGLOBIN,49.5,27.225,2.3,49.31,371
CPT,85025,HC COMPL CBC W AUTO DIFF WBC,129.5,71.225,7.55,119.37,159
CPT,85027,HC COMPL CBC AUTOMATED,111.5,61.325,6.28,119.37,159
CPT,85032,MANUAL CELL COUNT EACH,,,4.19,21.55,23
CPT,85041,HC AUTOMATED RBC COUNT,27.0,14.85,2.93,23.36,53
CPT,85044,MANUAL RETICULOCYTE COUNT,,,4.19,21.55,23
CPT,85045,HC RETICULOCYTE COUNT AUTOMATED,88.5,48.675,3.88,95.15,159
CPT,85046,RETICYTE/HGB CONCENTRATE,,,5.41,27.85,23
CPT,85048,HC LEUKOCYTE (WBC) AUTOMATED COUNT,35.0,19.25,2.48,30.28,53
CPT,85049,HC AUTOMATED PLATELET COUNT,61.0,33.55,4.36,52.77,53
CPT,85055,"HC IMMATURE PLATELET FRACTION, RETICULATED PLATELET ASSAY",121.0,66.55,34.74,178.7,53
CPT,85060,"HC BOOD SMEAR REVIEW, BLOOD SMEAR PERIPHERAL INTERP PHYS W/WRIT REPORT",448.0,246.4,21.69,387.52,53
CPT,85097,HC BONE MARROW DIFFERENTIAL INTERP,935.0,514.25,280.5,931.81,53
CPT,85097,HC BONE MARROW SLIDE INTERP,909.0,499.95,272.7,931.81,53
CPT,85130,"HC APIXABAN ANTI-XA, CHROMOGENIC SUBSTRATE ASSAY",284.0,156.2,11.56,245.66,53
CPT,85130,HC ARIXTRA ASSAY,152.0,83.6,11.56,131.48,53
CPT,85130,"HC FACTOR ACTIVITY, CHROMOGENIC SUBSTRATE ASSAY",594.0,326.7,11.56,513.81,53
CPT,85130,HC FACTOR VIII ACTIVITY CHROMOGENIC,150.0,82.5,11.56,129.75,53
CPT,85130,"HC HEPARIN COFACTOR II, CHROMOGENIC SUBSTRATE ASSAY",202.0,111.1,11.56,174.73,53
CPT,85170,BLOOD CLOT RETRACTION,,,15.84,81.5,23
CPT,85175,BLOOD CLOT LYSIS TIME,,,19.8,101.85,23
CPT,85210,HC BLOOD CLOT FACTOR II TEST,144.0,79.2,12.62,124.56,53
CPT,85210,"HC CLOTTING FACTOR II, PROTHROMBIN SPECIFIC",50.0,27.5,12.62,64.9,53
CPT,85220,"HC CLOTTING FACTOR V, ACG OR PROACCELERIN LABILE FACTOR",88.0,48.4,17.15,88.25,53
CPT,85220,"HC CLOTTING, FACTOR V, LABILE FACTOR",341.0,187.55,17.15,294.97,53
CPT,85220,"HC CLOTTING, FACTOR V, LABILE FACTOR (2)",294.0,161.7,17.15,254.31,53
CPT,85220,HC FACTOR V ACTIVITY TEST,102.0,56.1,17.15,88.25,53
CPT,85230,HC BLOOD CLOT FACTOR VII TEST,90.0,49.5,17.4,89.5,53
CPT,85230,HC CLOT FACTOR VII ANTIGEN,381.0,209.55,17.4,329.57,53
CPT,85230,"HC CLOTTING FACTOR VII, PROCONVERTIN STABLE",77.0,42.35,17.4,89.5,53
CPT,85240,"HC ARUP, BLOOD CLOT FACTOR VIII (AHG) 1-STAGE",106.0,58.3,17.4,91.69,53
CPT,85240,HC BLOOD CLOT FACTOR VIII (AHG) 1-STAGE,446.0,245.3,17.4,385.79,159
CPT,85244,CLOT FACTOR VIII RELTD ANTGN,,,19.85,102.1,23
CPT,85245,HC BLD CLOT FACTR VIII VW FCTR RISTOCETIN COFACTOR,111.0,61.05,22.3,114.7,106
CPT,85246,"HC CLOTTING, FACTOR VIII, VW FACTOR ANTIGEN",98.0,53.9,22.3,114.7,106
CPT,85246,"HC COLLAGEN, CLOTTING, FACTOR VIII, VW FACTOR ANTIGEN",579.0,318.45,22.3,500.84,53
CPT,85247,HC BLOOD CLOT FACTOR VIII VW FACTOR MULTIMETRIC,199.0,109.45,22.3,172.14,53
CPT,85250,HC FACTOR IX (PTC OR CHRISTMAS) ACTIVITY TEST,155.0,85.25,18.51,134.08,106
CPT,85250,"HC FACTOR IX HEPZYME TREATED (VERSITI), CLOTTING, FACTOR IX",228.0,125.4,18.51,197.22,53
CPT,85260,"HC CLOTTING FACTOR X, STUART PROWER",92.0,50.6,17.4,89.5,53
CPT,85260,HC FACTOR X (STUART-PROWER) ACTIVITY TEST,101.0,55.55,17.4,89.5,53
CPT,85260,HC FACTOR X (STUART-PROWER) ANTIGEN TEST (2),399.0,219.45,17.4,345.14,53
CPT,85260,HC FACTOR XA CHROMOGENIC CLOTTING FACTOR TEST,365.0,200.75,17.4,315.73,53
CPT,85260,"HC VERSITI, CLOTTING, FACTOR X",228.0,125.4,17.4,197.22,53
CPT,85270,HC BLOOD CLOT FACTOR XI TEST,349.0,191.95,17.4,301.89,53
CPT,85270,"HC CLOTTING FACTOR XI, PTA",81.0,44.55,17.4,89.5,53
CPT,85280,HC BLOOD CLOT FACTOR XII TEST,722.0,397.1,18.81,624.53,53
CPT,85280,"HC CLOTTING FACTOR XII, HAGEMAN",81.0,44.55,18.81,96.75,106
CPT,85280,"HC CLOTTING, FACTOR XII ACTIVITY",349.0,191.95,18.81,301.89,53
CPT,85290,HC BLOOD CLOT FACTOR XIII (FIBRIN STABILIZING) TEST,317.0,174.35,15.89,274.21,53
CPT,85290,"HC CLOTTING FACTOR XIII, FIBRIN STABILIZING",123.0,67.65,15.89,106.4,53
CPT,85290,"HC FACTOR XIII ACTIVITY(FIBRIN STABLIZING), CLOTTING",238.0,130.9,15.89,205.87,53
CPT,85291,"HC MIX, CLOTTING, FACTOR XIII, SCREEN SOLUBILITY",95.0,52.25,8.86,82.18,53
CPT,85291,"HC QUALITATIVE, CLOTTING, FACTOR XIII, SCREEN SOLUBILITY",95.0,52.25,8.86,82.18,53
CPT,85292,"HC CLOTTING, PREKALLIKREIN ASSAY (FLETCHER FACTOR)",243.0,133.65,18.41,210.2,53
CPT,85293,"HC CLOTTING, HIGH MOLECULAR WT KININOGEN ASSAY (FITZGERALD FACTOR)",342.0,188.1,18.41,295.83,53
CPT,85300,HC ANTITHROMBIN III ACTIVITY TEST,211.0,116.05,11.52,182.52,106
CPT,85301,HC ANTITHROMBIN III TEST,67.0,36.85,10.5,57.96,53
CPT,85302,HC BLOOD CLOT INHIBITOR ANTIGEN,74.0,40.7,11.67,64.01,53
CPT,85303,HC BLOOD CLOT INHIBITOR TEST,122.0,67.1,13.46,105.53,53
CPT,85303,HC CLOTTING INHIBITORS OR ANTICOAG PROTEIN C ACTIVITY,64.0,35.2,13.46,69.2,53
CPT,85305,HC BLOOD CLOT INHIBITOR ASSAY,191.0,105.05,11.29,165.22,53
CPT,85306,HC CLOTTING INHIBITORS OR ANTICOAG PROTEIN S FREE,68.0,37.4,14.89,76.6,53
CPT,85306,HC PROTEIN S ACTIVITY TEST,157.0,86.35,14.89,135.81,53
CPT,85306,HC PROTEIN S ANTIGEN FREE CLOTTING INHIBITOR TEST,251.0,138.05,14.89,217.12,106
CPT,85307,HC ASSAY ACTIVATED PROTEIN C,307.0,168.85,14.89,265.56,53
CPT,85335,HC ADAMTS13 INHIBITOR TEST,350.0,192.5,12.51,302.75,53
CPT,85335,HC FACTOR IX INHIBITOR TEST,358.0,196.9,12.51,309.67,53
CPT,85335,HC FACTOR V INHIBITOR,373.0,205.15,12.51,322.65,53
CPT,85335,HC FACTOR VIII INHIBITOR TEST,294.0,161.7,12.51,316.59,106
CPT,85335,"HC FACTOR X, FACTOR INHIBITOR TEST",366.0,201.3,12.51,316.59,53
CPT,85335,HC FACTOR XIIII INHIBITOR TEST,196.0,107.8,12.51,169.54,53
CPT,85335,"HC PORCINE, FACTOR VIII INHIBITOR TEST",366.0,201.3,12.51,316.59,53
CPT,85337,THROMBOMODULIN,,,16.79,86.35,23
CPT,85345,COAGULATION TIME LEE & WHITE,,,4.56,23.45,23
CPT,85347,HC COAGULATION TIME ACTIVATED,65.5,36.025,4.17,57.09,106
CPT,85347,"HC COAGULATION TIME, ACTIVATED",66.0,36.3,4.17,57.09,212
CPT,85347,"HC TEG R, COAGULATION TIME, ACTIVATED",81.0,44.55,4.17,70.07,159
CPT,85348,COAGULATION TIME OTR METHOD,,,4.37,22.45,23
CPT,85360,HC EUGLOBULIN LYSIS,216.0,118.8,8.17,186.84,53
CPT,85362,FIBRIN DEGRADATION PRODUCTS,,,6.7,34.45,23
CPT,85366,FIBRINOGEN TEST,,,78.21,402.3,23
CPT,85370,FIBRINOGEN TEST,,,12.09,62.15,23
CPT,85378,FIBRIN DEGRADE SEMIQUANT,,,9.44,48.6,23
CPT,85379,HC FIBRIN DEGRADATION D-DIMER QUANT,126.0,69.3,9.9,108.99,159
CPT,85380,FIBRIN DEGRADJ D-DIMER,,,9.9,50.9,23
CPT,85384,HC FIBRINOGEN ACTIVITY,91.0,50.05,9.44,78.72,159
CPT,85384,"HC TEG K, FIBRINOGEN, ACTIVITY",129.0,70.95,9.44,111.59,265
CPT,85385,HC FIBRINOGEN ANTIGEN,78.0,42.9,14.06,72.3,53
CPT,85390,"HC TEG LY30, FIBRINOLYSINS OR COAGULOPATHY SCREEN",90.0,49.5,15.05,77.85,106
CPT,85396,CLOTTING ASSAY WHOLE BLOOD,,,17.75,92.73,23
CPT,85397,HC CLOTTING FUNCT ACTIVITY,428.0,235.4,30.0,370.22,53
CPT,85397,"HC COAG FIBRINOLYSIS, FUNCTIONAL ACTIVITY, NOS, ADAMTS-13, EA",157.0,86.35,30.0,154.3,106
CPT,85397,"HC VWF GP1BM ACTIVITY, COAG & FIBRINOLYSIS FUNCT ACTIVITY, NOS, EA ANALYTE",304.0,167.2,30.0,262.96,53
CPT,85400,FIBRINOLYTIC PLASMIN,,,7.5,38.55,23
CPT,85410,HC ALPHA-2 ANTIPLASMIN ACTIVITY (2),93.0,51.15,7.5,80.45,53
CPT,85415,HC PLASMINOGEN ACTIVATOR INHIBITOR ACTIVITY,491.0,270.05,16.71,424.72,53
CPT,85415,HC PLASMINOGEN ACTIVATOR INHIBITOR ANTIGEN,384.0,211.2,16.71,332.16,53
CPT,85415,HC TISSUE PLASMINOGEN ACTIVATOR ANTIGEN,331.0,182.05,16.71,286.32,53
CPT,85420,HC FBRNLYTC FACTR INHIB PLASMINOGN EXCEPT ANTG ASY,60.0,33.0,6.35,51.9,53
CPT,85421,HC FIBRINLYTC FACTR & INHIB PLASMINOGEN ANTG ASSAY,209.0,114.95,9.9,180.79,53
CPT,85441,HC HEINZ BODIES DIRECT,130.0,71.5,4.09,112.45,53
CPT,85445,HC HEINZ BODIES INDUCED,403.0,221.65,6.62,348.6,53
CPT,85460,"HC FETAL CELL, HEMOGLOBIN OR RBCS, FETAL FETOMATERNAL HEMORRHAGE,DIFF LYSIS",21.0,11.55,6.3,38.65,106
CPT,85461,HC HGB-RBCS FETAL FETOMATERNAL HEMRRG ROSETTE,28.0,15.4,8.4,46.8,53
CPT,85475,HEMOLYSIN ACID,,,8.62,44.35,23
CPT,85520,HC HEPARIN ASSAY,277.0,152.35,12.73,239.61,53
CPT,85520,HC HEPARIN UNFRACTIONATED ASSAY,242.0,133.1,12.73,209.33,106
CPT,85520,HC LOW MOLECULAR WEIGHT HEPARIN (ANTI-XA) ASSAY,553.0,304.15,12.73,478.35,106
CPT,85525,"HC FACTOR IX HEPZYME TREATED (VERSITI), HEPARIN NEUTRAILIZATION",268.0,147.4,11.51,231.82,53
CPT,85525,"HC LA HEP, HEPARIN NEUTRALIZATION (WDL)",40.0,22.0,11.51,59.2,53
CPT,85525,"HC PTT-D HEPARIN REFLEX PLT NEUTRALIZATION, HEPARIN NEUTRALIZATION",94.0,51.7,11.51,81.31,53
CPT,85530,HEPARIN-PROTAMINE TOLERANCE,,,12.73,65.45,23
CPT,85536,IRON STAIN PERIPHERAL BLOOD,,,6.69,34.4,23
CPT,85540,HC WBC ALKALINE PHOSPHATASE,39.0,21.45,8.36,43.0,53
CPT,85547,RBC MECHANICAL FRAGILITY,,,8.36,43.0,23
CPT,85549,HC LYSOZYME PLASMA,50.0,27.5,15.0,93.75,53
CPT,85555,HC OSMOTIC FRAGILITY RBC UNINCUBATED,122.0,67.1,7.25,105.53,53
CPT,85557,"HC OSMOTIC FRAGILITY, OSMOTIC FRAGILITY RBC INCUBATED",317.0,174.35,12.99,274.21,53
CPT,85557,"HC OSMOTIC FRAGILITY, RBC INCUBATED",317.0,174.35,12.99,274.21,53
CPT,85576,HC PLATELET AGGREGATION,425.0,233.75,24.21,367.63,53
CPT,85576,HC PLATELET AGGREGATION TEG,133.0,73.15,24.21,124.55,159
CPT,85576,HC PLATELET FUNCTION SCREEN COL ADP,177.0,97.35,24.21,153.11,106
CPT,85576,HC PLATELET FUNCTION SCREEN COL EPI,183.0,100.65,24.21,158.3,106
CPT,85576,"HC PLATELET, AGGREGATION (IN VITRO), EACH AGENT",421.0,231.55,24.21,364.17,53
CPT,85576,"HC TEG MA, PLATELET, AGGREGATION (IN VITRO), EA AGENT",277.0,152.35,24.21,239.61,159
CPT,85576,"HC VERIFY NOW P2Y12 (PLAVIX), PLATELET, AGGREGATION (IN VITRO), EA AGENT",299.0,164.45,24.21,258.64,53
CPT,85576,"HC VERIFYNOW ASPRIRIN, PLATELET, AGGREGATION (IN VITRO), EA AGENT",214.0,117.7,24.21,185.11,106
CPT,85597,"HC LA DRVVT RATIO, PHOSPHOLIPID PLTLT NEUTRALIZ (WDL)",61.0,33.55,17.48,89.9,53
CPT,85597,"HC PLATELET NEUTRALZ REFLEX, PHOSPHOLIPID NEUTRALIZATION, PLATELET",129.0,70.95,17.48,111.59,53
CPT,85598,"HC HEXAGONAL PHOSPHO REFLEX, PHOSPHOLIPID NEUTRALZ, HEXAGONAL PHOSPHOLIPID",193.0,106.15,17.48,166.95,53
CPT,85598,"HC LA PTT HEXPL, HEXAGNAL PHOSPH PLTLT NEUTRL (WDL)",62.0,34.1,17.48,89.9,53
CPT,85598,"HC LUPUS, PTT HEXAGONAL PHOSPHOLIPID NEUTRALIZATION",126.0,69.3,17.48,108.99,53
CPT,85610,"HC LA PT, PROTHROMBIN TIME (WDL)",15.0,8.25,4.18,21.45,53
CPT,85610,"HC LUPUS, PROTHROMBIN TIME",32.0,17.6,4.18,27.68,106
CPT,85610,HC PROTHROMBIN TIME,89.0,48.95,4.18,95.15,212
CPT,85611,HC PROTHROMBIN TEST,74.0,40.7,3.83,64.01,106
CPT,85612,VIPER VENOM PROTHROMBIN TIME,,,17.0,87.45,23
CPT,85613,"HC DRVVT CONFIRMATION, RUSSELL VIPER VENOM TIME (INCLUDES VENOM), DILUTED",134.0,73.7,9.32,115.91,106
CPT,85613,"HC DRVVT MIX REFLEX, RUSSELL VIPER VENOM TIME (INCLUDES VENOM), DILUTED",74.0,40.7,9.32,64.01,53
CPT,85613,"HC LA DRVVT MIX, RUSSELL VIPER VENOM DILUTED (WDL)",36.0,19.8,9.32,47.9,53
CPT,85613,"HC LUPUS, RUSSELL VIPER VENOM DILUTED CONFIRMATION",240.0,132.0,9.32,207.6,53
CPT,85613,"HC LUPUS, RUSSELL VIPER VENOM DILUTED MIX",168.0,92.4,9.32,145.32,53
CPT,85613,"HC LUPUS, RUSSELL VIPER VENOM TIME (INCLUDES VENOM), DILUTED",94.0,51.7,9.32,81.31,106
CPT,85635,HC REPTILASE TEST,61.0,33.55,9.58,52.77,53
CPT,85635,"HC REPTILASE TIME REFLEX, REPTILASE TEST",62.0,34.1,9.58,53.63,53
CPT,85651,HC RBC SED RATE NONAUTOMATED,76.0,41.8,4.15,65.74,53
CPT,85652,"HC SEDIMENTATION RATE RBC,AUTOMATED",42.0,23.1,2.63,36.33,53
CPT,85660,HC RBC SICKLE CELL TEST,142.0,78.1,5.36,122.83,53
CPT,85660,HC RBC SICKLE CELL TEST - DONOR BLOOD,23.0,12.65,5.36,27.55,53
CPT,85660,HC RBC SICKLE CELL TEST SCREEN,236.0,129.8,5.36,204.14,53
CPT,85670,HC THROMBIN TIME PLASMA,53.0,29.15,5.61,45.85,106
CPT,85670,"HC THROMBIN TIME REFLEX, THROMBIN TIME, PLASMA",68.0,37.4,5.61,58.82,53
CPT,85675,THROMBIN TIME TITER,,,6.66,34.25,23
CPT,85705,THROMBOPLASTIN INHIBITION,,,9.36,48.15,23
CPT,85730,"HC LA PTT, THROMBOPLASTIN TIME PARTIAL (WDL)",13.0,7.15,3.9,30.05,53
CPT,85730,HC PARTIAL THROMBOPLASTIN TIME (PTT),83.0,45.65,5.84,71.8,159
CPT,85730,"HC PTT-D HEPARIN REFLEX, PTT, PLASMA OR WHOLE BLOOD",37.0,20.35,5.84,32.01,53
CPT,85732,"HC LA PTT MIX, THROMBOPLASTIN TIME PARTIAL (WDL)",35.0,19.25,6.28,32.35,53
CPT,85732,"HC LUPUS, PTT, SUBSTITUTION, PLASMA FRACT, EA",106.0,58.3,6.28,91.69,106
CPT,85732,"HC LUPUS, THROMBOPLASTIN TIME PARTIAL INCUBATION MIX",371.0,204.05,6.28,320.92,53
CPT,85732,"HC LUPUS, THROMBOPLASTIN TIME PARTIAL MIX",97.0,53.35,6.28,83.91,53
CPT,85732,"HC PTT-D MIX REFLEX, PTT, SUBSTITUTION, PLASMA FRACTIONS, EACH",59.0,32.45,6.28,51.04,53
CPT,85732,HC THROMBOPLASTIN TIME PARTIAL,174.0,95.7,6.28,150.51,106
CPT,85810,HC SERUM VISCOSITY EXAMINATION,57.0,31.35,11.34,58.35,53
CPT,86000,AGGLUTININS FEBRILE ANTIGEN,,,6.79,34.9,23
CPT,86001,HC ALLERGEN SPECIFIC IGG,36.0,19.8,7.6,39.1,53
CPT,86001,"HC STACHYBOTRYS CHARTARUM/ATRA IGG, ALLERGEN SPECIFIC IGG QUAN/SEMIQUAN EA",36.0,19.8,7.6,39.1,53
CPT,86003,HC ALLERGEN SPECIFIC IGE,30.0,16.5,5.07,26.1,53
CPT,86003,"HC BIRD, ALLERG SPECIFC IGE, QUANT/SEMIQUANT, CRUDE ALLERG EXTRACT, EA",59.0,32.45,5.07,51.04,53
CPT,86003,"HC GALACTOSE A 1-3, ALLERG SPECIFIC IGE, QNT/SEMI-QNT, CRUDE ALLG EXTRCT,EA",309.0,169.95,5.07,267.29,53
CPT,86003,"HC HYPERSEN, ALLERGY IGE, QUANTITATIVE/SEMIQUANTITATIVE CRUDE EXTRACT EA",97.0,53.35,5.07,83.91,53
CPT,86003,"HC RAST LATEX, ALLERG SPECIFIC IGE, QNT/SEMI-QNT, CRUDE ALLG EXTRCT, EA",218.0,119.9,5.07,188.57,53
CPT,86003,"HC RAST VENOM, ALLERG SPECIFIC IGE, QNT/SEMI-QNT, CRUDE ALLG EXTRCT, EA",227.0,124.85,5.07,196.36,53
CPT,86003,"HC RAST, ALLERG SPECIFIC IGE, QNT/SEMI-QNT, CRUDE ALLG EXTRCT, EA",121.0,66.55,5.07,104.67,53
CPT,86003,"HC RTRI A 19 OMEGA 5 GLIADIN WHEAT IGE, ALLERGEN SPEC IGE CRUDE EXTRACT EA",164.0,90.2,5.07,141.86,53
CPT,86003,HC STACHYBOTRYS CHARTARUM/ATRA IGE ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT,191.0,105.05,5.07,165.22,53
CPT,86005,"HC ALLERGY MULTIALLERGEN SCREEN, ALLERGEN SPEC IGE QUAL MULTIALLG SCREEN",53.0,29.15,7.74,45.85,53
CPT,86005,"HC HYPERSEN, MULTI ALLERGY IGE, QUALITATIVE SCREEN",31.0,17.05,7.74,39.85,53
CPT,86008,HC ALLERGEN SPECIFIC IGE PEANUT COMPONENT EA,120.0,66.0,17.43,103.8,53
CPT,86008,"HC ALLERGEN SPECIFIC IGE, QUANT OR SEMIQUANT, RECOMB OR PURIFIED COMP, EA",30.0,16.5,9.0,89.65,53
CPT,86008,"HC HAZELNUT, ALLERG SPECIFIC IGE, QUANT/SEMIQUANT, RECOMB/PURIFIED COMP, EA",159.0,87.45,17.43,137.54,53
CPT,86008,"HC VIRACOR, ALLERG SPECIFIC IGE, RECOMBINANT/PURIFIED COMPONENT, EA",151.0,83.05,17.43,130.62,53
CPT,86015,"HC F-ACTIN IGG, ACTIN SMOOTH MUSCLE AB, EA",60.0,33.0,11.71,60.25,53
CPT,86021,"HC DRUG DEPEND NEUT AB ADDL, ANTIBODY IDENTIFICATION, LEUKOCYTE ANTIBODIES",149.0,81.95,14.63,128.89,53
CPT,86021,HC LEUKOCYTE ANTIBD IDENTIF NEUTROPHIL DRUG EA,664.0,365.2,14.63,574.36,53
CPT,86021,HC LEUKOCYTE ANTIBD IDENTIFICATION NEUTROPHIL,691.0,380.05,14.63,597.72,53
CPT,86021,HC LEUKOCYTE ANTIBD IDENTIFICATN NEUTROPHIL LVL 1,608.0,334.4,14.63,525.92,53
CPT,86021,HC LEUKOCYTE ANTIBODY IDENTIFICATION GRANULOCYTE,196.0,107.8,14.63,169.54,53
CPT,86021,"HC WEST NILE IGM CSF, ANTIBODY IDENTIFICATION, LEUKOCYTE ANTIBODIES",58.0,31.9,14.63,75.25,53
CPT,86022,"HC HEPARIN-INDUCED THROMBOCYTOPENIA EVAL, ANTIBODY ID; PLATELET ANTIBODIES",464.0,255.2,17.86,401.36,53
CPT,86022,"HC P SELECTIN EXPRESSION ASSAY, IDENTIFICATION PLATELET ANTIBODIES",732.0,402.6,17.86,633.18,53
CPT,86022,"HC PLATELET AB ID IN PRT, ANTIBODY IDENTIFICATION PLATELET ANTIBODIES",361.0,198.55,17.86,312.27,53
CPT,86022,HC PLATELET ANTIBODY (HEPARIN DEPENDENT) IGG PF4,297.0,163.35,17.86,256.91,53
CPT,86022,HC PLATELET ANTIBODY IDENTIFICATION,355.0,195.25,17.86,307.08,53
CPT,86022,HC PLATELET ANTIBODY IDENTIFICATION DRUG EA ADDL,165.0,90.75,17.86,142.73,53
CPT,86022,HC PLATELET ANTIBODY IDENTIFICATION FACTOR 4 IGA,591.0,325.05,17.86,511.22,53
CPT,86022,HC PLATELET ANTIBODY IDENTIFICATION FACTOR 4 IGG,464.0,255.2,17.86,401.36,53
CPT,86022,HC PLATELET ANTIBODY IDENTIFICATION FACTOR 4 IGM,591.0,325.05,17.86,511.22,53
CPT,86022,HC PLATELET ANTIBODY IDENTIFICATION HEPARIN SRA UNFRACTIONATED,761.0,418.55,17.86,658.27,53
CPT,86022,HC PLATELET ANTIBODY IDENTIFICATION NATP EACH,187.0,102.85,17.86,161.76,53
CPT,86022,HC PLATELET ANTIBODY IDENTIFICATION PANEL,551.0,303.05,17.86,476.62,53
CPT,86022,HC PLATELET ANTIBODY IDENTIFICATION SCREEN,455.0,250.25,17.86,393.58,53
CPT,86022,HC PLATELET ANTIBODY IDENTIFICATION TO DRUG (2),551.0,303.05,17.86,476.62,53
CPT,86023,HC PLATELET ASSOCIATED IMMUNOGLOBULIN ASSAY,241.0,132.55,12.11,208.47,53
CPT,86036,"HC ANTINEUTROPHIL CYTOPLASMIC ANTIBODY (ANCA), SCREEN, EA AB",97.0,53.35,11.71,83.91,53
CPT,86036,"HC CYTOPLASMIC NEUTROPHIL ANTIBODY, SCREEN, EA AB",63.0,34.65,11.71,60.25,53
CPT,86037,ANCA TITER EACH ANTIBODY,,,11.71,60.25,23
CPT,86038,HC ANTINUCLEAR ANTIBODIES,194.0,106.7,11.75,167.81,53
CPT,86039,HC ANTINUCLEAR ANTIBODIES (ANA) TITER,137.0,75.35,10.85,141.0,159
CPT,86041,"HC ACETYLCHOLINE RECEPTOR, BINDING ANTIBODY",64.0,35.2,17.88,92.0,53
CPT,86042,"HC ACETYLCHOLINE RECEPTOR, BLOCKING ANTIBODY",90.0,49.5,17.88,92.0,53
CPT,86043,"HC ACETYLCHOLINE RECEPTOR, MODULATING ANTIBODY",101.0,55.55,11.71,87.37,53
CPT,86051,AQUAPORIN-4 ANTB ELISA,,,11.21,57.65,23
CPT,86052,AQUAPORIN-4 ANTB CBA EACH,,,11.71,60.25,23
CPT,86053,"HC AUTOIMMUNE MYELOPATHY, AQUAPORIN-4 (NMO) AB, FLOW CYTOMETRY, EA",196.0,107.8,36.68,188.65,53
CPT,86053,"HC IGG, AQUAPORIN-4 (NMO) AB, FLOW CYTOMETRY, EA",765.0,420.75,36.68,661.73,53
CPT,86053,"HC TITER, AQUAPORIN-4 (NMO) AB, FLOW CYTOMETRY, EA",161.0,88.55,36.68,188.65,53
CPT,86060,HC ANTISTREPTOLYSIN O TITER,88.0,48.4,7.09,76.12,53
CPT,86063,ANTISTREPTOLYSIN O SCREEN,,,5.61,28.85,23
CPT,86077,PHYS BLOOD BANK SERV XMATCH,,,24.26,256.37,23
CPT,86078,PHYS BLOOD BANK SERV REACTJ,,,152.85,256.37,23
CPT,86079,PHYS BLOOD BANK SERV AUTHRJ,,,48.74,257.98,23
CPT,86140,HC C-REA PROTEIN,98.0,53.9,5.04,84.77,106
CPT,86140,"HC IBD, C-REA PROTEIN",100.0,55.0,5.04,86.5,53
CPT,86140,"HC SYNOVIAL FLUID CRP, C-REA PROTEIN",119.0,65.45,5.04,102.94,53
CPT,86141,HC C-REA PROTEIN HS,169.0,92.95,12.59,146.19,53
CPT,86141,HC MONITR C-REA PROTEIN HIGH SENSITIVITY,208.0,114.4,12.59,179.92,53
CPT,86146,HC GLYCOPROTEIN ANTIBODY,97.0,53.35,24.74,127.25,53
CPT,86147,HC CARDIOLIPIN IGA ANTIBODY (1),63.0,34.65,18.9,127.25,53
CPT,86147,HC CARDIOLIPIN IGG ANTIBODY (1),63.0,34.65,18.9,127.25,53
CPT,86147,HC CARDIOLIPIN IGM ANTIBODY (1),221.0,121.55,24.74,191.17,53
CPT,86148,HC ANTI-PHOSPHATIDYLSERINE ANTIBODY,142.0,78.1,15.62,122.83,53
CPT,86152,HC CIRCULATING TUMOR CELLS,661.0,363.55,198.3,1253.9,53
CPT,86153,CELL ENUMERATION PHYS INTERP,,,161.44,161.44,2
CPT,86155,CHEMOTAXIS ASSAY,,,15.54,79.95,23
CPT,86156,HC COLD AGGLUTININ SCREEN_BC,191.0,105.05,7.84,165.22,53
CPT,86157,"HC COLD AGGLUTININS, SOMATOMEDIN",57.0,31.35,7.83,49.31,53
CPT,86160,HC ANTIGEN COMPLEMENT AHUS C3,136.0,74.8,11.66,117.64,53
CPT,86160,HC ANTIGEN COMPLEMENT AHUS C4,136.0,74.8,11.66,117.64,53
CPT,86160,HC ANTIGEN COMPLEMENT AHUS FACTOR B,177.0,97.35,11.66,153.11,53
CPT,86160,HC ANTIGEN COMPLEMENT AHUS FACTOR H,254.0,139.7,11.66,219.71,53
CPT,86160,HC ANTIGEN COMPLEMENT AHUS FACTOR I,254.0,139.7,11.66,219.71,53
CPT,86160,HC ANTIGEN COMPLEMENT C1 ESTERASE INHIBITOR,89.0,48.95,11.66,76.99,53
CPT,86160,HC ANTIGEN COMPLEMENT C1Q COMPONENT,342.0,188.1,11.66,295.83,53
CPT,86160,HC ANTIGEN COMPLEMENT C2 BODY FLUID,126.0,69.3,11.66,108.99,53
CPT,86160,HC ANTIGEN COMPLEMENT C3 BODY FLUID,144.0,79.2,11.66,147.05,159
CPT,86160,HC ANTIGEN COMPLEMENT C3A,346.0,190.3,11.66,299.29,53
CPT,86160,HC ANTIGEN COMPLEMENT C4 BODY FLUID,149.0,81.95,11.66,155.7,159
CPT,86160,HC ANTIGEN COMPLEMENT C4A,346.0,190.3,11.66,299.29,53
CPT,86160,HC ANTIGEN COMPLEMENT C5 LEVEL,242.0,133.1,11.66,209.33,53
CPT,86160,HC ANTIGEN COMPLEMENT C8 LEVEL COMPONENT,104.0,57.2,11.66,89.96,53
CPT,86160,HC ANTIGEN COMPLEMENT C9 LEVEL COMPONENT,104.0,57.2,11.66,89.96,53
CPT,86160,HC ANTIGEN COMPLEMENT FACTOR H LEVEL,209.0,114.95,11.66,180.79,53
CPT,86160,HC ANTIGEN COMPLEMENT FACTOR I LEVEL,209.0,114.95,11.66,180.79,53
CPT,86160,HC ANTIGEN COMPLEMENT MANNAN BINDING LECTIN,330.0,181.5,11.66,285.45,53
CPT,86160,HC ANTIGEN COMPLEMENT SC5B-9 LEVEL,285.0,156.75,11.66,246.53,53
CPT,86160,"HC BA LEVEL, COMPLEMENT; ANTIGEN, EACH COMPONENT",990.0,544.5,11.66,856.35,53
CPT,86160,"HC BB FRAGMENT LEVEL, COMPLEMENT; ANTIGEN, EACH COMPONENT",926.0,509.3,11.66,800.99,53
CPT,86160,"HC BB LEVEL C3 GLOMERULOPATHY PNL, COMPLEMENT, ANTIGEN, EA COMPONENT",278.0,152.9,11.66,240.47,53
CPT,86160,"HC C3 LEVEL C3 GLOMERULOPATHY PNL, COMPLEMENT, ANTIGEN, EA COMPONENT",278.0,152.9,11.66,240.47,53
CPT,86160,"HC C3 LEVEL, COMPLEMENT; ANTIGEN, EACH COMPONENT",371.0,204.05,11.66,320.92,53
CPT,86160,"HC C3C LEVEL, COMPLEMENT; ANTIGEN, EACH COMPONENT",1285.0,706.75,11.66,1111.53,53
CPT,86160,"HC C4 LEVEL C3 GLOMERULOPATHY PNL, COMPLEMENT, ANTIGEN, EA COMPONENT",278.0,152.9,11.66,240.47,53
CPT,86160,"HC C4 LEVEL, COMPLEMENT; ANTIGEN, EACH COMPONENT",371.0,204.05,11.66,320.92,53
CPT,86160,"HC C5 LEVEL, COMPLEMENT; ANTIGEN, EACH COMPONENT",1078.0,592.9,11.66,932.47,53
CPT,86160,"HC C9, COMPLEMENT, ANTIGEN, EA COMPONENT",263.0,144.65,11.66,227.5,53
CPT,86160,"HC COMPLEMENT C6, COMPLEMENT, ANTIGEN, EACH COMPONENT",236.0,129.8,11.66,204.14,53
CPT,86160,"HC FACTOR H LEVEL C3 GLOMERULOPATHY PNL, COMPLEMENT, ANTIGEN, EA COMPONENT",278.0,152.9,11.66,240.47,53
CPT,86160,"HC FACTOR I LEVEL C3 GLOMERULOPATHY PNL, COMPLEMENT, ANTIGEN, EA COMPONENT",278.0,152.9,11.66,240.47,53
CPT,86160,"HC FB LEVEL C3 GLOMERULOPATHY PNL, COMPLEMENT, ANTIGEN, EA COMPONENT",278.0,152.9,11.66,240.47,53
CPT,86160,"HC FB LEVEL, COMPLEMENT; ANTIGEN, EACH COMPONENT",555.0,305.25,11.66,480.08,53
CPT,86160,"HC FD LEVEL C3 GLOMERULOPATHY PNL, COMPLEMENT, ANTIGEN, EA COMPONENT",278.0,152.9,11.66,240.47,53
CPT,86160,"HC FH LEVEL, COMPLEMENT; ANTIGEN, EACH COMPONENT",555.0,305.25,11.66,480.08,53
CPT,86160,"HC FI LEVEL, COMPLEMENT; ANTIGEN, EACH COMPONENT",555.0,305.25,11.66,480.08,53
CPT,86160,"HC PROPERDIN FACTOR B, COMPLEMENT, ANTIGEN, EACH COMPONENT",300.0,165.0,11.66,259.5,53
CPT,86160,"HC PROPERDIN LEVEL C3 GLOMERULOPATHY PNL, COMPLEMENT, ANTIGEN, EA COMPONENT",278.0,152.9,11.66,240.47,53
CPT,86161,HC AH50 COMPLEMENT ACTIVITY ALTERNATE,169.0,92.95,11.66,146.19,53
CPT,86161,"HC APFA C3 GLOMERULOPATHY PNL, COMPLEMENT, FUNCT ACTV, EA COMPONENT",294.0,161.7,11.66,254.31,53
CPT,86161,"HC APFA, COMPLEMENT; FUNCTIONAL ACTIVITY, EACH COMPONENT",430.0,236.5,11.66,371.95,53
CPT,86161,"HC C3NEF LEVEL C3 GLOMERULOPATHY PNL, COMPLEMENT, FUNCT ACTV, EA COMPONENT",294.0,161.7,11.66,254.31,53
CPT,86161,"HC C4NEF LEVEL C3 GLOMERULOPATHY PNL, COMPLEMENT, FUNCT ACTV, EA COMPONENT",294.0,161.7,11.66,254.31,53
CPT,86161,"HC C5NEF LEVEL C3 GLOMERULOPATHY PNL, COMPLEMENT, FUNCT ACTV, EA COMPONENT",294.0,161.7,11.66,254.31,53
CPT,86161,"HC CH50 LEVEL C3 GLOMERULOPATHY PNL, COMPLEMENT, FUNCT ACTV, EA COMPONENT",294.0,161.7,11.66,254.31,53
CPT,86161,"HC CH50EQ, COMPLEMENT; FUNCTIONAL ACTIVITY, EACH COMPONENT",233.0,128.15,11.66,201.55,53
CPT,86161,HC COMPLEMENT FUNCT ACTIVITY C1 ESTERASE INHIBITOR,58.0,31.9,11.66,60.0,53
CPT,86161,HC COMPLEMENT FUNCT ACTIVITY C3 NEPHRITIC FACTOR,264.0,145.2,11.66,228.36,53
CPT,86161,"HC HEMOLYTIC ASSAY, COMPLEMENT; FUNCTIONAL ACTIVITY, EACH COMPONENT",688.0,378.4,11.66,595.12,53
CPT,86162,"HC C3B LEVEL C3 GLOMERULOPATHY PNL, COMPLEMENT, TOTAL HEMOLYTIC (CH50)",699.0,384.45,19.75,604.64,53
CPT,86162,HC COMPLEMENT TOTAL HEMOLYTIC (CH50),63.0,34.65,18.9,101.6,53
CPT,86171,COMPLEMENT FIXATION EACH,,,9.73,50.05,23
CPT,86200,HC CYCLIC CITRULLINATED PEPTIDE (CCP) ANTIBODY,53.0,29.15,12.59,64.75,106
CPT,86200,"HC IGG, CYCLIC CITRULLINATED PEPTIDE(CCP) ANTIBODY",58.0,31.9,12.59,64.75,53
CPT,86215,HC DEOXYRIBONUCLEASE ANTIBODY,44.0,24.2,12.88,66.25,53
CPT,86225,HC DNA ANTIBODY DOUBLE STRANDED,168.0,92.4,13.36,145.32,106
CPT,86226,HC DNA ANTIBODY SINGLE STRAND,254.0,139.7,11.77,219.71,53
CPT,86231,EMA EACH IG CLASS,,,11.75,60.45,23
CPT,86235,HC ANTI-CHROMATIN NUCLEAR ANTIGEN IGG ANTIBODY,102.0,56.1,17.43,89.65,53
CPT,86235,HC ANTI-HISTONE NUCLEAR ANTIGEN ANTIBODY,530.0,291.5,17.43,458.45,53
CPT,86235,HC CENTROMERE B NUCLEAR ANTIGEN ANTIBODY,102.0,56.1,17.43,89.65,53
CPT,86235,HC EXTRACTABLE NUCLEAR ANTIGEN ANTIBODY EACH,140.0,77.0,17.43,121.1,53
CPT,86235,"HC FIBRILLARIN (U3 RNP) AB, EXTRACTABLE NUCLEAR ANTIGEN ANTIBODY ANY METHOD",216.0,118.8,17.43,186.84,53
CPT,86235,HC J01 NUCLEAR ANTIGEN ANTIBODY,102.0,56.1,17.43,89.65,53
CPT,86235,"HC MYOMARKER JO AB, EXTRACTABLE NUCLEAR ANTIGEN, ANTIBODY, EACH",97.0,53.35,17.43,89.65,53
CPT,86235,"HC MYOMARKER MDA-5 AB, EXTRACTABLE NUCLEAR ANTIGEN ANTIBODY ANY METHOD",71.0,39.05,17.43,89.65,53
CPT,86235,"HC MYOMARKER NXP-2 AB, EXTRACTABLE NUCLEAR ANTIGEN ANTIBODY ANY METHOD",71.0,39.05,17.43,89.65,53
CPT,86235,"HC MYOMARKER PSCL AB, EXTRACTABLE NUCLEAR ANTIGEN, ANTIBODY, EACH",97.0,53.35,17.43,89.65,53
CPT,86235,"HC MYOMARKER QUAL IA, EXTRACTABLE NUCLEAR AG, AB TO, ANY METHOD, EA AB",81.0,44.55,17.43,89.65,53
CPT,86235,"HC MYOMARKER SSA 52KD AB, EXTRACTABLE NUCLEAR ANTIGEN, ANTIBODY, EACH",97.0,53.35,17.43,89.65,53
CPT,86235,"HC MYOMARKER TIF1 AB, EXTRACTABLE NUCLEAR ANTIGEN ANTIBODY ANY METHOD",71.0,39.05,17.43,89.65,53
CPT,86235,"HC MYOMARKER U1RNP AB, EXTRACTABLE NUCLEAR ANTIGEN, ANTIBODY, EACH",97.0,53.35,17.43,89.65,53
CPT,86235,"HC MYOSITIS NUCLEAR ANTIGEN ANTIBODY, EXTRACTABLE ANY METHOD",149.0,81.95,17.43,128.89,53
CPT,86235,"HC PM SCL AB, EXTRACTABLE NUCLEAR AG, AB TO, ANY METHOD, EA AB",155.0,85.25,17.43,134.08,53
CPT,86235,HC RNP NUCLEAR ANTIGEN ANTIBODY,102.0,56.1,17.43,89.65,53
CPT,86235,HC SCL-70 NUCLEAR ANTIGEN ANTIBODY,102.0,56.1,17.43,89.65,53
CPT,86235,HC SMITH NUCLEAR ANTIGEN ANTIBODY,102.0,56.1,17.43,89.65,53
CPT,86235,HC SMITH RNP NUCLEAR ANTIGEN ANTIBODY,102.0,56.1,17.43,89.65,53
CPT,86235,HC SS-A NUCLEAR ANTIGEN ANTIBODY,102.0,56.1,17.43,89.65,53
CPT,86235,HC SS-B NUCLEAR ANTIGEN ANTIBODY,102.0,56.1,17.43,89.65,53
CPT,86235,"HC SSA 52 & 60 (ENA) IGG, EXTRACTABLE NUCLEAR AG, AB TO, ANY METHOD, EA AB",57.0,31.35,17.1,89.65,53
CPT,86255,"HC ACHR MODULATING AB, FLUORES NONINFC AGNT AB, SCREEN, EA AB",474.0,260.7,11.71,410.01,53
CPT,86255,"HC ADRENAL, FLUORESCENT NONINFECTIOUS AGENT ANTIBODY, SCREEN, EACH ANTIBODY",222.0,122.1,11.71,192.03,53
CPT,86255,"HC AMPA RECEPTOR ANTIBODY, FLUORESCENT NONINFECTIOUS AGENT",557.0,306.35,11.71,481.81,53
CPT,86255,"HC AMPA RECEPTOR CFS, FLUORES NONNFCT AGNT AB, SCREEN, EA AB",501.0,275.55,11.71,433.37,53
CPT,86255,"HC AMPHIPHYSIN CSF, FLUORES NONINFC AGNT AB, SCREEN, EA AB",295.0,162.25,11.71,255.18,53
CPT,86255,"HC ANCA IGG, FLUORESCENT NONNFCT AGT ANTB SCREEN EA ANTIBODY",47.0,25.85,11.71,60.25,53
CPT,86255,"HC ANTI-GLIAL NUCLEAR B TYPE 1 CSF, FLUORES NONINFC AGNT AB, SCREEN, EA AB",295.0,162.25,11.71,255.18,53
CPT,86255,"HC ANTI-MYELIN, FLUORES NONINFC AGNT AB, SCREEN, EA AB",75.0,41.25,11.71,64.88,53
CPT,86255,"HC ANTIGLOMERULAR BASEMENT MEMBRANE AB, FLUORESCENT NONNFCT AGT ANTB SCREEN",197.0,108.35,11.71,170.41,53
CPT,86255,"HC ANTINEUTROPHIL CYTOPLASMIC AB, FLUORESCENT NONNFCT AGT AB, SCREEN, EA AB",122.0,67.1,11.71,105.53,53
CPT,86255,"HC AUTOIMMUNE MYOPATHY FA CSF, FLURO NONINFC AGNT ANTIBODY SCRN EA ANTIBODY",362.0,199.1,11.71,313.13,53
CPT,86255,"HC AUTOIMMUNE MYOPATHY FA, FLURO NONINFC AGNT ANTIBODY SCRN, EA ANTIBODY",344.0,189.2,11.71,297.56,53
CPT,86255,"HC AXONAL, FLUORES NONINFC AGNT AB, SCREEN, EA AB",177.0,97.35,11.71,153.11,53
CPT,86255,"HC CASPR2 IGG CBA, FLUORESCENT NONINFECTIOUS AGENT ANTIBODY, SCREEN, EA AB",878.0,482.9,11.71,759.47,53
CPT,86255,"HC CASPR2 IGG WITH REFLEX, FLUORESCENT NONINFECTIOUS AGENT ANTIBODY",336.0,184.8,11.71,290.64,53
CPT,86255,"HC CIDP EVAL, FLUORES NONINFC AGNT AB, SCREEN, EA AB",527.0,289.85,11.71,455.86,53
CPT,86255,"HC CNS DEMYELINATING, FLUORESCENT NONINFECT AGENT ANTIBODY, SCREEN, EA AB",1286.0,707.3,11.71,1112.39,53
CPT,86255,"HC CRMP-5 IGG CSF, FLUORES NONINFC AGNT AB, SCREEN, EA AB",295.0,162.25,11.71,255.18,53
CPT,86255,"HC DEMENTIA EVAL, FLUORESCENT NONINFECTIOUS AGENT ANTIBODY, SCREEN, EA AB",181.0,99.55,11.71,156.57,53
CPT,86255,"HC DEMENTIA, FLUORESCENT NONINFECT AGNT ANTIBODY SCREEN EA AB",249.0,136.95,11.71,215.39,53
CPT,86255,"HC DPPX AB, FLUORES NONINFC AGNT AB, SCREEN, EA AB",571.0,314.05,11.71,493.92,53
CPT,86255,"HC DYSAUTONOMIA ANTIBODIES IF, FLUORESCENT NONINFECT AGENT ANTIBODY; SCREEN",387.0,212.85,11.71,334.76,53
CPT,86255,"HC ENCEPHALOPATHY AB CSF, FLUORES NONINFC AGNT AB, SCREEN, EA AB",227.0,124.85,11.71,196.36,53
CPT,86255,"HC ENCEPHALOPATHY, FLUORES NONINFC AGNT AB, SCREEN, EA AB",240.0,132.0,11.71,207.6,53
CPT,86255,"HC EPILEPSY AUTOIMMUNE CSF, FLUORES NONINFC AGNT AB, SCREEN, EA AB",222.0,122.1,11.71,192.03,53
CPT,86255,"HC EPILEPSY AUTOIMMUNE, FLUORES NONINFC AGNT AB, SCREEN, EA AB",271.0,149.05,11.71,234.42,53
CPT,86255,"HC GABA B RECEPTOR AB CSF, FLUORES NONNFCT AGT ANTB SCREEN EA ANTIBODY",501.0,275.55,11.71,433.37,53
CPT,86255,"HC GABA-B RECEPTOR AB, FLUORESCENT NONNFCT AGT ANTB SCREEN EA ANTIBODY",1409.0,774.95,11.71,1218.79,53
CPT,86255,"HC GFAP CBA CSF, FLUORESCENT NONNFCT AGT ANTB SCREEN EA ANTIBODY",1647.0,905.85,11.71,1424.66,53
CPT,86255,"HC GLYCINE ALPHA 1 IGG, FLUORESCENT NONNFCT AGT ANTB SCREEN EA ANTIBODY",1558.0,856.9,11.71,1347.67,53
CPT,86255,"HC HU, FLUORESCENT NONINFECTIOUS AGENT ANTIBODY, SCREEN, EACH ANTIBODY",75.0,41.25,11.71,64.88,53
CPT,86255,"HC LEUCINE RICH GLIOMA AB (LGI1G), FLUORESCENTIOUS NONINFECT AGENT ANTIBODY",388.0,213.4,11.71,335.62,53
CPT,86255,"HC LEUCINE RICH GLIOMA AB CFS, FLUORES NONNFCT AGT ANTB SCREEN EA ANTIBODY",423.0,232.65,11.71,365.9,53
CPT,86255,"HC LEUCINE RICH GLIOMA INACT, FLUORES NONINFC AGNT AB, SCREEN, EA AB",462.0,254.1,11.71,399.63,53
CPT,86255,"HC LGI1 AUTOANTIBODY CSF, FLUORES NONINFC AGNT AB, SCREEN, EA AB",1606.0,883.3,11.71,1389.19,53
CPT,86255,"HC LGI1 IGG CBA, FLUORESCENT NONINFECTIOUS AGENT ANTIBODY, SCREEN, EA AB",878.0,482.9,11.71,759.47,53
CPT,86255,"HC LRP4 AUTOANTIBODY, FLUORESCENT NONNFCT AGT ANTB SCREEN EA ANTIBODY",2401.0,1320.55,11.71,2076.87,53
CPT,86255,"HC MDC1 CSF, FLUORES NONINFC AGNT AB, SCREEN, EA AB",215.0,118.25,11.71,185.98,53
CPT,86255,"HC MDS1, FLUORESCENT NONINFECT AGNT ANTIBODY SCREEN EA AB",219.0,120.45,11.71,189.44,53
CPT,86255,"HC MOG (MYELIN OLIGODENDROCYTE GLYCOPROTEIN CSF, FLUORESCENT ANTIBDY SCREEN",1943.0,1068.65,11.71,1680.7,53
CPT,86255,"HC MOG IGG1 FSCS, FLUORESCENT NONINFECTIOUS AGENT ANTIBODY, SCREEN, EA AB",1608.0,884.4,11.71,1390.92,53
CPT,86255,"HC MOTOR AND SENSORY NEUROPATHY, FLUORESCENT ANTIBODY SCREEN",170.0,93.5,11.71,147.05,53
CPT,86255,"HC MSN, FLUORES NONINFC AGNT AB, SCREEN, EA AB",210.0,115.5,11.71,181.65,53
CPT,86255,"HC MYELIN IGG, FLUORES NONINFC AGNT AB, SCREEN, EA AB",340.0,187.0,11.71,294.1,53
CPT,86255,"HC MYOCARDIAL, FLUORESCENT NONINFECTIOUS AGENT ANTIBODY, TITER, EA ANTIBODY",64.0,35.2,11.71,60.25,53
CPT,86255,"HC N-METHYL-D-ASPARTATE RECEP, FLUORES NONINFC AGNT AB, SCREEN, EA AB",458.0,251.9,11.71,396.17,53
CPT,86255,"HC NECROTIZING MYOPATHY SRP, FLUORES NONINFC AGNT AB, SCREEN, EA AB",122.0,67.1,11.71,105.53,53
CPT,86255,"HC NEUROMYELITIS OPTICA IGG, FLUORES NONINFC AGNT AB, SCREEN, EA AB",1742.0,958.1,11.71,1506.83,53
CPT,86255,"HC NEURONAL NUCLEAR (1), FLUORES NONINFC AGNT AB, SCREEN, EA AB",799.0,439.45,11.71,691.14,53
CPT,86255,"HC NEURONAL NUCLEAR CSF, FLUORES NONINFC AGNT AB, SCREEN, EA AB",295.0,162.25,11.71,255.18,53
CPT,86255,"HC NEURONAL NUCLEAR TYPE 3 CSF, FLUORES NONINFC AGNT AB, SCREEN, EA AB",295.0,162.25,11.71,255.18,53
CPT,86255,"HC NMDA AB CSF, FLUORESCENT NONINFECTIOUS AGENT ANTIBODY, SCREEN, EA AB",336.0,184.8,11.71,290.64,53
CPT,86255,"HC NMDA-R AB CBA FLUORESCENT NONINFECTIOUS AGT ANTIBDY, SCREEN, EA ANTIBODY",1473.0,810.15,11.71,1274.15,53
CPT,86255,"HC OVARIAN, FLUORESCENT NONINFECTIOUS AGENT ANTIBODY, SCREEN, EACH ANTIBODY",289.0,158.95,11.71,249.99,53
CPT,86255,"HC P-CELL CYTOPLASMIC CSF, FLUORES NONINFC AGNT AB, SCREEN, EA AB",295.0,162.25,11.71,255.18,53
CPT,86255,"HC P-CELL CYTOPLASMIC TR CSF, FLUORES NONINFC AGNT AB, SCREEN, EA AB",295.0,162.25,11.71,255.18,53
CPT,86255,"HC P-CELL CYTOPLASMIC TYPE 2 CSF, FLUORES NONINFC AGNT AB, SCREEN, EA AB",295.0,162.25,11.71,255.18,53
CPT,86255,"HC P-CELL, FLUORES NONINFC AGNT AB, SCREEN, EA AB",162.0,89.1,11.71,140.13,53
CPT,86255,"HC PARANEOPLAS AUTAB, AGNA TYPE 1, FLUORES NONINFC AGNT AB, SCREEN, EA AB",227.0,124.85,11.71,196.36,53
CPT,86255,"HC PARANEOPLAS AUTAB, AMPHIPHYSIN, FLUORES NONINFC AGNT AB, SCREEN, EA AB",227.0,124.85,11.71,196.36,53
CPT,86255,"HC PARANEOPLAS AUTAB, ANNA TYPE 1&2, FLUORES NONINFC AGNT AB, SCREEN, EA AB",227.0,124.85,11.71,196.36,53
CPT,86255,"HC PARANEOPLAS AUTAB, ANNA TYPE 3, FLUORES NONINFC AGNT AB, SCREEN, EA AB",227.0,124.85,11.71,196.36,53
CPT,86255,"HC PARANEOPLAS AUTAB, CRMP-5-IGG, FLUORES NONINFC AGNT AB, SCREEN, EA AB",227.0,124.85,11.71,196.36,53
CPT,86255,"HC PARANEOPLAS AUTAB, PCA TYPE 1, FLUORES NONINFC AGNT AB, SCREEN, EA AB",227.0,124.85,11.71,196.36,53
CPT,86255,"HC PARANEOPLAS AUTAB, PCA TYPE 2, FLUORES NONINFC AGNT AB, SCREEN, EA AB",227.0,124.85,11.71,196.36,53
CPT,86255,"HC PARANEOPLAS AUTAB, PCA TYPE TR, FLUORES NONINFC AGNT AB, SCREEN, EA AB",227.0,124.85,11.71,196.36,53
CPT,86255,"HC PLA2 R IFA, FLUORES NONINFC AGNT AB, SCREEN, EA AB",456.0,250.8,11.71,394.44,53
CPT,86255,"HC RARE SUBEPI BLISTERING VARIANTS, FLUORESCENT ANTIBODY SCREEN",694.5,381.98,11.71,600.74,53
CPT,86255,"HC RETICULIN, FLUORES NONINFC AGNT AB, SCREEN, EA AB",166.0,91.3,11.71,143.59,53
CPT,86255,"HC RI, FLUORESCENT NONINFECTIOUS AGENT ANTIBODY, SCREEN, EACH ANTIBODY",75.0,41.25,11.71,64.88,53
CPT,86255,"HC STIFF PERSON ANTIBODY SCREEN, FLUORESCENT NONNFCT AGT ANTB SCREEN EA ATB",327.0,179.85,11.71,282.86,53
CPT,86255,"HC STRIATIONAL, FLUORES NONINFC AGNT AB, SCREEN, EA AB",303.0,166.65,11.71,262.1,53
CPT,86255,"HC THSD7A AB, FLUORES NONINFC AGNT AB, SCREEN, EA AB",1049.0,576.95,11.71,907.39,53
CPT,86255,"HC YO AB, FLUORES NONINFC AGNT AB, SCREEN, EA AB",747.0,410.85,11.71,646.16,53
CPT,86256,"HC ANCA TITER, FLUORESCENT NONNFCT AGT ANTB EA ANTIBODY",77.0,42.35,11.71,66.61,53
CPT,86256,"HC ANCA-CYTOPLASMIC, FLUORES NONINFC AGNT AB, TITER, EA AB",80.0,44.0,11.71,69.2,53
CPT,86256,"HC ANCA-PERINUCLEAR, FLUORES NONINFC AGNT AB, TITER, EA AB",80.0,44.0,11.71,69.2,53
CPT,86256,"HC ANTI-GLIAL NUCLEAR CSF, FLUORES NONINFC AGNT AB, TITER, EA AB",159.0,87.45,11.71,137.54,53
CPT,86256,"HC ANTINEUTROPHIL CYTOPLASMIC AB TITER, FLUORESCENT NONNFCT AGT ANTB, EA AB",97.0,53.35,11.71,83.91,53
CPT,86256,"HC CASPR2 IGG TITER, FLUORESCENT NONINFECTIOUS AGENT ANTIBODY",368.0,202.4,11.71,318.32,53
CPT,86256,"HC ENDOMYSIAL IGA, FLUORES NONINFC AGNT AB, TITER, EA, AB",30.0,16.5,9.0,60.25,53
CPT,86256,"HC EPILEPSY AUTOIMMUNE CSF, FLUORES NONINFC AGNT AB, TITER, EA AB",193.0,106.15,11.71,166.95,53
CPT,86256,"HC EPILEPSY AUTOIMMUNE, FLUORES NONINFC AGNT AB, TITER, EA AB",225.0,123.75,11.71,194.63,53
CPT,86256,"HC GFAP IFA TITER CSF, FLUORESCENT NONNFCT AGT ANTB TITER EA ANTIBODY",130.0,71.5,11.71,112.45,53
CPT,86256,"HC LEUCINE RICH GLIOMA AB (LGI1G) TITER, FLUORESCENT NONINFECT AGENT ANTIBD",374.0,205.7,11.71,323.51,53
CPT,86256,"HC LEUCINE RICH GLIOMA INACT, FLUORES NONINFC AGNT AB, TITER, EA AB",546.0,300.3,11.71,472.29,53
CPT,86256,"HC MOG FACS TITER, FLUORESCENT NONINFCT AGNT ANTBD, TITER, EA ANTIBODY",142.0,78.1,11.71,122.83,53
CPT,86256,HC MYOCARDIAL AB TITER,108.0,59.4,11.71,93.42,53
CPT,86256,"HC NMDA, FLUORESCENT NONINFECTIOUS AGENT ANTIBODY, TITER, EACH ANTIBODY",253.0,139.15,11.71,218.85,53
CPT,86256,"HC NMDA-R AB CBA TITER, FLUORESCENT NONINFCT AGNT ANTBD, TITER, EA ANTIBODY",171.0,94.05,11.71,147.92,53
CPT,86256,"HC NMO AQP4 FACS CSF, FLUORES NONINFC AGNT AB, TITER, EA AB",159.0,87.45,11.71,137.54,53
CPT,86256,"HC NMO AQP4 FACS, FLUORES NONINFC AGNT AB, TITER, EA AB",159.0,87.45,11.71,137.54,53
CPT,86256,"HC OVARY, FLUORESCENT NONNFCT AGT ANTB TITER EA ANTIBODY",170.0,93.5,11.71,147.05,53
CPT,86256,"HC PLA2 R, FLUORESCENT NONINFECTIOUS AGENT ANTIBODY, TITER, EACH ANTIBODY",414.0,227.7,11.71,358.11,53
CPT,86256,"HC SMOOTH MUSCLE AB TITER, FLUORES NONINFC AGNT AB, TITER, EA AB",71.0,39.05,11.71,61.42,53
CPT,86256,"HC STRIATED MUSCLE AB TITER, FLUORES NONINFC AGNT AB, TITER, EACH AB",88.0,48.4,11.71,76.12,53
CPT,86258,DGP ANTIBODY EACH IG CLASS,,,11.71,60.25,23
CPT,86277,GROWTH HORMONE ANTIBODY,,,15.3,78.7,23
CPT,86280,HEMAGGLUTINATION INHIBITION,,,7.97,40.95,23
CPT,86294,IMMUNOASSAY TUMOR QUAL,,,24.85,127.85,23
CPT,86300,HC CANCER ANTIGEN 15-3 IMMUNOASSAY,202.0,111.1,20.22,174.73,106
CPT,86301,HC CANCER ANTIGEN 19-9 FLUID IMMUNOASSAY,130.0,71.5,20.22,112.45,53
CPT,86301,HC CANCER ANTIGEN 19-9 IMMUNOASSAY,186.0,102.3,20.22,160.89,53
CPT,86304,HC IMMUNOASSAY TUMOR CA 125,409.5,225.225,20.22,445.48,106
CPT,86304,"HC ROMA CANCER ANTIGEN 125, IA TUMOR AG, QUANT",147.0,80.85,20.22,127.16,53
CPT,86305,HC HUMAN EPIDIDYMIS PROTEIN 4,364.0,200.2,20.22,314.86,53
CPT,86305,HC ROMA HUMAN EPIDIDYMIS PROTEIN 4,147.0,80.85,20.22,127.16,53
CPT,86308,HC HETEROPHILE ANTIBODIES,110.0,60.5,5.04,95.15,106
CPT,86308,"HC HETEROPHILE ANTIBODIES, SCREENING",32.0,17.6,5.04,27.68,53
CPT,86309,HETEROPHILE ANTIBODY TITER,,,6.28,32.35,23
CPT,86310,HETEROPHILE ANTIBODY ABSRBJ,,,7.16,36.85,23
CPT,86316,HC ALPHA FETOPROTEIN CSF TUMOR ANTIGEN IMMUNOASSAY,187.0,102.85,20.22,161.76,53
CPT,86316,"HC ALPHA-FETOPROTEIN TUMOR FLUID, IMMUNOASSAY FOR TUMOR ANTIGEN",197.0,108.35,20.22,170.41,53
CPT,86316,"HC ANTI-ANGIOTENSIN TYPE 1 RECEPTORS, IA TUMOR AG, OTHER AG, QUANT, EA",432.0,237.6,20.22,373.68,53
CPT,86316,HC CHOROMOGRANIN TUMOR ANTIGEN IMMUNOASSAY,157.0,86.35,20.22,135.81,53
CPT,86316,HC NEURON SPECIF ENOLASE CSF TUMOR ANTIG IMMUNASSY,164.0,90.2,20.22,141.86,53
CPT,86316,HC NEURON SPECIFIC ENOLASE TUMOR ANTIGEN IMMUNASSY,130.0,71.5,20.22,112.45,53
CPT,86316,"HC PROSTATE HEALTH INDEX, IMMUNO FOR TUMOR ANTIGEN, OTH ANTIGEN, QUANT, EA",241.0,132.55,20.22,208.47,53
CPT,86316,HC S-100B PROTEIN TUMOR ANTIGEN IMMUNOASSAY,840.0,462.0,20.22,726.6,53
CPT,86316,"HC SOLUBLE MESOTHELIAL PEPTIDES, IMMUNOASSAY TUMOR OTHER",240.0,132.0,20.22,207.6,53
CPT,86316,HC SQUAMOUS CELL CARCINOMA ANTIGEN IMMUNOASSAY,176.5,97.08,20.22,152.67,53
CPT,86317,HC 14-3-3 PROTEIN INFECT AGENT ANTIBD IMMUNASSY,78.0,42.9,14.57,74.95,53
CPT,86317,"HC ASPERGILLUS FUMIGATUS AB IGG, IA INFC AGNT, QUANT, NOS",132.0,72.6,14.57,114.18,53
CPT,86317,HC DIPHTHERIA TOXOID ANTIBODY IMMUNOASSAY,67.0,36.85,14.57,74.95,53
CPT,86317,"HC H INFLUENZA TYPE B ANTIBODY IGG, IMMUNOASSAY INFECTIOUS AGENT ANTIBODY",157.0,86.35,14.57,135.81,53
CPT,86317,"HC PNEUMOCOCCAL IGG AB (23) EA, IMMUNOASSAY INFC AGNT AB, QUANT, NOS",24.0,13.2,7.2,74.95,53
CPT,86317,"HC STREP PNEUMONIAE IGG AB (14) EA, IMMUNOASSAY INFC AGNT AB, QUANT, NOS",45.0,24.75,13.5,74.95,53
CPT,86317,HC STREPTOCOCCUS PNEUMONIAE ANTIBODY IMMUNOASSAY,24.0,13.2,7.2,74.95,53
CPT,86317,"HC TETANUS, IA INFC AGNT AB, QUANT, NOS",60.0,33.0,14.57,74.95,53
CPT,86318,HC IMMUNOASSAY INFECTIOUS AGENT,213.0,117.15,17.59,184.25,53
CPT,86320,SERUM IMMUNOELECTROPHORESIS,,,29.08,149.6,23
CPT,86325,OTHER IMMUNOELECTROPHORESIS,,,22.48,115.65,23
CPT,86327,APC,,,29.92,30.82,15
CPT,86327,Lab/Pathology,,,149.6,149.6,1
CPT,86327,Laboratory,,,149.6,149.6,1
CPT,86328,IA NFCT AB SARSCOV2 COVID19,,,44.02,226.4,23
CPT,86329,HC IMMUNODIFFUSION TEICHOIC ACID,56.0,30.8,13.65,70.25,53
CPT,86331,"HC ASPERGILLUS ANTIGEN, IMMUNODIFFUSN, GEL DIFFUSN, OUCHTERLONY, EA AG/AB",146.0,80.3,11.65,126.29,53
CPT,86331,"HC ASPERGILLUS FUMIGATUS, IMMUNODIFFUSN, GEL DIFFUSN, OUCHTERLONY, EA AG/AB",64.0,35.2,11.65,59.9,53
CPT,86331,"HC BIRD PRECIPITIN TEST, IMMUNODIFFUSN, GEL DIFFUSN, OUCHTERLONY, EA AG/AB",64.0,35.2,11.65,59.9,53
CPT,86331,"HC BIRD PRECIPITIN, IMMUNODIFFUSN, GEL DIFFUSN, OUCHTERLONY, EA AG/AB",45.0,24.75,11.65,59.9,53
CPT,86331,"HC HY PIGEON SERUM AB, IMMUNODIFFUSN, GEL DIFFUSN, OUCHTERLONY, EA AG/AB",53.0,29.15,11.65,59.9,53
CPT,86331,"HC HYPERSEN, IMMUNODIFFUSION, QUALITATIVE EA AG/ANTBDY",45.0,24.75,11.65,59.9,53
CPT,86332,HC C1Q BINDING IMMUNE COMPLEX ASSAY,263.0,144.65,23.69,227.5,53
CPT,86332,HC CIRCULATING IMMUNE COMPLEX ASSAY,199.0,109.45,23.69,172.14,53
CPT,86334,"HC CRYOGLOBULIN IMMUNOFIX EP, IMMUNOFIXATION ELECTROPHORESIS, SERUM",122.0,67.1,21.72,111.7,53
CPT,86334,"HC DELTA & EPSILON, IFIX ELP, SERUM",456.0,250.8,21.72,394.44,53
CPT,86334,"HC FLUID PHASE ACTIVITY ASSAY C3 GLOMERULOPATHY PNL, IFIX ELP, SERUM",362.0,199.1,21.72,313.13,53
CPT,86334,HC IMMUNOFIXATION ELECTROPHORESIS SERUM,444.0,244.2,21.72,384.06,106
CPT,86334,"HC IMMUNOFIXATON ELECTROPHORESIS SERUM , DARATUMUAB-SPECIFIC IFE",593.0,326.15,21.72,512.95,53
CPT,86335,HC IMMNFIXTN ELCTRPH BETA-2 TRANSFERIN BOD FLD,675.0,371.25,28.53,583.88,53
CPT,86335,HC IMMUNOFIXATION ELECTROPHORESIS UB,284.0,156.2,28.53,245.66,53
CPT,86335,HC IMMUNOFIXATN ELECTROPHORESIS CSF,261.0,143.55,28.53,225.77,53
CPT,86336,HC INHIBIN,308.0,169.4,15.16,266.42,53
CPT,86336,HC INHIBIN A,187.0,102.85,15.16,161.76,53
CPT,86337,HC INSULIN ANTIBODIES,126.0,69.3,20.81,108.99,53
CPT,86340,HC INTRINSIC FACTOR ANTIBODY,114.0,62.7,14.66,98.61,53
CPT,86341,"HC AUTOIMMUNE MYOPATHY GAD CSF, ISLET CELL ANTIBODY",361.0,198.55,22.91,312.27,53
CPT,86341,"HC AUTOIMMUNE MYOPATHY GAD, ISLET CELL ANTIBODY",425.0,233.75,22.91,367.63,53
CPT,86341,"HC CYTOPLASMIC, ISLET CELL ANTIBODY",141.0,77.55,22.91,121.97,53
CPT,86341,"HC DEMENTIA EVAL, ISLET CELL ANTIBODY",216.0,118.8,22.91,186.84,53
CPT,86341,"HC DEMENTIA, ISLET CELL ANTIBODY",291.0,160.05,22.91,251.72,53
CPT,86341,"HC ENCEPHALOPATHY GAD AB CSF, ISLET CELL ANTIBODY",220.0,121.0,22.91,190.3,53
CPT,86341,"HC ENCEPHALOPATHY GAD AB, ISLET CELL ANTIBODY",280.0,154.0,22.91,242.2,53
CPT,86341,"HC EPILEPSY AUTOIMMUNE GAD CSF, ISLET CELL ANTIBODY",268.0,147.4,22.91,231.82,53
CPT,86341,"HC EPILEPSY AUTOIMMUNE GAD, ISLET CELL ANTIBODY",319.0,175.45,22.91,275.94,53
CPT,86341,"HC GAD 65, ISLET CELL ANTIBODY",617.0,339.35,22.91,533.71,53
CPT,86341,"HC GAD65 ANTIBODY CSF, ISLET CELL ANTIBODY",162.0,89.1,22.91,140.13,53
CPT,86341,"HC GLUTAMIC ACID DECARBOXY, ISLET CELL ANTIBODY",629.0,345.95,22.91,544.09,53
CPT,86341,"HC IA2 (ICA), ISLET CELL ANTIBODY",270.0,148.5,22.91,233.55,53
CPT,86341,HC ISLET CELL ANTIBODY,71.0,39.05,21.3,117.85,53
CPT,86341,"HC MDC1 CSF, ISLET CELL AB",220.0,121.0,22.91,190.3,53
CPT,86341,"HC MDS1, ISLET CELL ANTIBODY",251.0,138.05,22.91,217.12,53
CPT,86341,HC STIFF PERSON ISLET CELL ANTIBODY,603.0,331.65,22.91,521.6,53
CPT,86341,"HC ZINC TRANSPORTER 8, ISLET CELL ANTIBODY",455.0,250.25,22.91,393.58,53
CPT,86343,HC LEUKOCYTE HISTAMINE RELEASE TEST BASOFUNCTN HRT,219.0,120.45,12.11,189.44,53
CPT,86344,LEUKOCYTE PHAGOCYTOSIS,,,10.1,51.95,23
CPT,86352,HC CELLULAR FUNCTION ASSAY W STIMULATION,968.0,532.4,132.06,837.32,53
CPT,86352,"HC CHRONIC URICARIA INDEX, CELLULAR FUNCT ASSAY W STIM & DETECT BIOMARKER",317.0,174.35,95.1,679.3,53
CPT,86352,"HC CMV CD4, CELLULAR FUNCTION ASSAY W/ STIM AND DETECTION OF BIOMARKER",1026.0,564.3,132.06,887.49,53
CPT,86352,"HC CMV CD8, CELLULAR FUNCTION ASSAY W/ STIM AND DETECTION OF BIOMARKER",1026.0,564.3,132.06,887.49,53
CPT,86353,HC LYMPHOCYTE TRANSFORMATION ANTIGEN & MITOGEN PAN,162.5,89.38,47.66,245.15,53
CPT,86353,HC LYMPHOCYTE TRANSFORMATION BERYLLIUM PROLIFERA,643.0,353.65,47.66,556.2,53
CPT,86355,HC B CELLS TOTAL COUNT,358.0,196.9,36.68,309.67,53
CPT,86355,HC B CELLS TOTAL COUNT CD20+ FOR RITUXIMAB MONITORING,264.0,145.2,36.68,228.36,53
CPT,86355,"HC CVID, B CELLS, TOTAL COUNT",324.0,178.2,36.68,280.26,53
CPT,86355,"HC LYMPHOCYTE, B CELLS, TOTAL COUNT",186.0,102.3,36.68,188.65,53
CPT,86355,"HC PID2, B CELLS, TOTAL COUNT",357.0,196.35,36.68,308.81,53
CPT,86356,"HC CD57 BY FLOW CYTOMETRY, MONONUCLEAR CELL AG, QUANT, NOS, EA AG",162.0,89.1,26.04,140.13,53
CPT,86356,"HC LYMPHOCYTE, MONONUCLEAR CELL ANTIGEN, QUANTITATIVE, NOS, EA ANTIGEN",88.0,48.4,26.04,133.9,53
CPT,86356,HC MONONUCL CELL ANTG QUANT % TOTAL CD20 (B-CELLS),208.0,114.4,26.04,179.92,53
CPT,86356,HC MONONUCLEAR CELL ANTIG QUANT T-REG CD3+CD4+CD25+CD127-,192.0,105.6,26.04,166.08,53
CPT,86356,HC MONONUCLEAR CELL ANTIGEN QUANT % TOTAL CD25+,208.0,114.4,26.04,179.92,53
CPT,86356,HC MONONUCLEAR CELL ANTIGEN QUANT % TOTAL CD45RA,208.0,114.4,26.04,179.92,53
CPT,86356,HC MONONUCLEAR CELL ANTIGEN QUANT % TOTAL HLA-DR+,208.0,114.4,26.04,179.92,53
CPT,86356,"HC REGULATORY T-CELLS FOX P3, MONONUCLEAR CELL AG, QUANT, NOS, EA AG",140.5,77.28,26.04,133.9,53
CPT,86357,"HC CVID, NATURAL KILLER (NK) CELLS TOTAL COUNT",324.0,178.2,36.68,280.26,53
CPT,86357,"HC LYMPHOCYTE, NATURAL KILLER (NK) CELLS TOTAL COUNT",186.0,102.3,36.68,188.65,53
CPT,86357,HC NATURAL KILLER (NK) CELLS TOTAL COUNT,369.0,202.95,36.68,319.19,53
CPT,86357,"HC PID2, NATURAL KILLER (NK) CELLS, TOTAL COUNT",357.0,196.35,36.68,308.81,53
CPT,86359,"HC LYMPHOCYTE SUB, T CELLS, TOTAL COUNT",108.0,59.4,32.4,188.65,53
CPT,86359,HC T CELLS TOTAL COUNT,273.0,150.15,36.68,236.15,106
CPT,86360,"HC LYMPHOCYTE, T CELL CD4 & CD8 ABSOLUTE COUNT INCL RATIO",119.0,65.45,35.7,234.9,53
CPT,86360,HC T CELL (%T-HELPER CD4) CD3+CD4+ ABSOLUTE COUNT,380.0,209.0,45.67,328.7,53
CPT,86361,HC T CELL ABSOLUTE COUNT,234.0,128.7,26.04,202.41,53
CPT,86362,MOG-IGG1 ANTB CBA EACH,,,11.71,60.25,23
CPT,86363,"HC AUTOIMMUNE MYELOPATHY, MOG-IGG1 AB, FLOW CYTOMETRY, EA",258.0,141.9,36.68,223.17,53
CPT,86363,"HC MOG-IGG1 AB, FLOW CYTOMETRY, EA",1166.0,641.3,36.68,1008.59,53
CPT,86363,"HC TITER, MOG-IGG1 AB, FLOW CYTOMETRY, EA",211.0,116.05,36.68,188.65,53
CPT,86364,TISS TRNSGLTMNASE EA IG CLAS,,,11.21,57.65,23
CPT,86366,MUSCLE-SPECIFIC KINASE ANTB,,,17.88,92.0,23
CPT,86367,HC ABSOLUTE CD34 STEM CELL COUNT,142.0,78.1,42.6,388.9,106
CPT,86367,HC STEM CELLS TOTAL COUNT,438.0,240.9,75.61,388.9,53
CPT,86376,HC LIVER CYTOSOL (LC-1) MICROSOMAL ANTIBODIES,493.0,271.15,14.14,426.45,53
CPT,86376,HC LIVER KIDNEY MICROSOMAL ANTIBODIES,64.0,35.2,14.14,72.75,53
CPT,86376,HC THYROID PEROXIDASE (TPO) MICROSOMAL ANTIBODIES,182.0,100.1,14.14,157.43,106
CPT,86381,"HC MITOCHONDRIAL AB IGG, EA",68.0,37.4,20.4,127.25,53
CPT,86382,NEUTRALIZATION TEST VIRAL,,,16.43,84.55,23
CPT,86384,NITROBLUE TETRAZOLIUM DYE,,,13.23,68.05,23
CPT,86386,NUCLEAR MATRIX PROTEIN 22,,,21.18,108.9,23
CPT,86403,HC CRYOTICICCAL PARTICLE AGGLUTINATION SCREEN,85.0,46.75,11.22,73.53,53
CPT,86406,HC PARTICLE AGGLUTINATION TEST,198.0,108.9,10.34,171.27,53
CPT,86408,NEUTRLZG ANTB SARSCOV2 SCR,,,40.95,210.65,23
CPT,86409,NEUTRLZG ANTB SARSCOV2 TITER,,,79.61,398.05,23
CPT,86413,SARS-COV-2 ANTB QUANTITATIVE,,,40.84,257.15,23
CPT,86430,"HC RHEUMATOID FACTOR FLUID QUAL, RHEUMATOID FACTOR QUALITATIVE",128.0,70.4,5.97,110.72,53
CPT,86431,HC RHEUMATOID FACTOR CSF QUANT,63.0,34.65,5.51,54.5,53
CPT,86431,HC RHEUMATOID FACTOR QUANT,55.5,30.525,5.51,60.55,159
CPT,86480,"HC QUANTIFERON TB GOLD PLUS, TB TEST CELL MEDIATED ANTIGN RESPNSE MEASURE",259.0,142.45,60.25,309.9,106
CPT,86481,HC TB TEST ENUMERATN GAMMA INTERFERON-PROD T-CELLS,335.0,184.25,97.2,500.0,53
CPT,86485,SKIN TEST CANDIDA,,,24.26,91.75,23
CPT,86486,SKIN TEST UNLISTED ANTIGN EA,,,24.26,29.95,23
CPT,86490,Lab/Pathology,,,373.97,373.97,1
CPT,86490,Laboratory,,,373.97,373.97,1
CPT,86510,HISTOPLASMOSIS SKIN TEST,,,34.33,68.98,23
CPT,86580,tuberculin PPD skin test 5 UNIT/0.1ML Solution 1 mL Vial,610.24,335.64,24.26,527.86,53
CPT,86581,"HC STREPTOCOCCUS PNEUMONIAE 14 SEROTYPES, MULTPLX IA, QUANT",85.5,47.03,25.65,73.96,38
CPT,86581,"HC STREPTOCOCCUS PNEUMONIAE 23 SEROTYPES, MULTPLX IA, QUANT",134.5,73.98,40.35,116.34,38
CPT,86581,"HC STREPTOCOCCUS PNEUMONIAE 9 SEROTYPES, MULTPLX IA, QUANT",84.5,46.48,25.35,73.09,38
CPT,86590,STREPTOKINASE ANTIBODY,,,12.3,63.3,23
CPT,86592,HC SYPHILIS TEST NON-TREPONEMAL QUAL RPR,80.0,44.0,4.15,69.2,106
CPT,86592,"HC VDRL CSF, SYPHILIS TEST, NON-TREPONEMAL AB, QUAL",24.0,13.2,4.15,21.35,53
CPT,86593,HC SYPHILIS TEST NON-TREP QUANT,39.0,21.45,4.28,33.74,106
CPT,86593,"HC VDRL TITER CSF, SYPHILIS TEST, NON-TREPONEMAL ANTIBODY, QUANT",28.0,15.4,4.28,24.22,53
CPT,86596,"HC MDS1, VOLTAGE-GATED CALCIUM CHANNEL AB, EA",128.0,70.4,11.71,110.72,53
CPT,86596,"HC PARANEOPLAS AUTAB, P/Q TYPE, VOLTAGE-GATED CALCIUM CHANNEL AB, EA",251.0,138.05,11.71,217.12,53
CPT,86596,"HC VOLTAGE GATED CALCIUM CHANNEL AB, EA",407.0,223.85,11.71,352.06,53
CPT,86602,ANTINOMYCES ANTIBODY,,,9.9,50.9,23
CPT,86603,"HC ANTIBODY, ADENOVIRUS",228.0,125.4,12.51,197.22,53
CPT,86606,HC ASPERGILLUS ANTIBODY,135.0,74.25,14.63,116.78,53
CPT,86606,HC ASPERGILLUS CSF ANTIBODY,45.0,24.75,13.5,75.25,53
CPT,86606,HC ASPERGILLUS FUMIGATUS IGE ANTIBODY,104.0,57.2,14.63,89.96,53
CPT,86606,HC ASPERGILLUS FUMIGATUS IGG ANTIBODY,104.0,57.2,14.63,89.96,53
CPT,86606,"HC ASPERGILLUS FUMIGATUS PRECIPITINS, ANTIBODY",70.0,38.5,14.63,75.25,53
CPT,86606,"HC FUNGAL ANTIBODIES, ASPERGILLUS",35.0,19.25,10.5,75.25,53
CPT,86606,"HC HYPERSEN, ASPERGILLUS ANTIBODY",44.0,24.2,13.2,75.25,53
CPT,86609,HC LISTERIA BACTERIUM ANTIBODY,215.0,118.25,12.52,185.98,53
CPT,86609,HC LISTERIA BACTERIUM CSF ANTIBODY,249.0,136.95,12.52,215.39,53
CPT,86609,HC MICROPOLY FAENI BACTERIUM ANTIBODY,54.0,29.7,12.52,64.4,53
CPT,86611,HC BARTONELLA ANTIBODY,57.0,31.35,9.9,50.9,53
CPT,86612,HC BLASTOMYCES ANTIBODY,55.0,30.25,12.54,64.5,53
CPT,86612,"HC FUNGAL ANTIBODIES, BLASOMYCES",35.0,19.25,10.5,64.5,53
CPT,86615,HC BORDETELLA PERTUSSIS AB IGM,119.0,65.45,12.83,102.94,53
CPT,86615,HC BORDETELLA PERTUSSIS IGG ANTIBODY,53.0,29.15,12.83,65.95,53
CPT,86615,"HC BORDETELLA PERTUSSIS IGG IMMUNOBLOT, ANTIBODY",113.0,62.15,12.83,97.75,53
CPT,86615,HC PERTUSSIS BORDETELLA ANTIBODY,80.0,44.0,12.83,69.2,53
CPT,86617,"HC BORRELIA BURGDORFERI CONFIRMATORY TEST  ANTIBODY, IGG BY IMMUNOBLOT CSF",97.0,53.35,15.06,83.91,53
CPT,86617,"HC BORRELIA BURGDORFERI CONFIRMATORY TEST ANTIBODY, IGM BY IMMUNOBLOT CSF",97.0,53.35,15.06,83.91,53
CPT,86617,"HC CONFIRMATORY B. BURGDORFERI TEST SYS ANTIBODIES, IGG",88.0,48.4,15.06,77.45,53
CPT,86617,"HC CONFIRMATORY B. BURGDORFERI TEST SYS ANTIBODIES, IGM",88.0,48.4,15.06,77.45,53
CPT,86617,"HC IGG ANTIBODY, LYME DISEASE, CONFIRM TEST, IMMUNOBLOT",50.0,27.5,15.0,77.45,53
CPT,86617,"HC IGM ANTIBODY, LYME DISEASE, CONFIRM TEST, IMMUNOBLOT",50.0,27.5,15.0,77.45,53
CPT,86617,HC LYME DISEASE ANTIBODY CONFIRM TEST WESTERN BLOT,156.0,85.8,15.06,134.94,53
CPT,86618,HC C6 PEPTIDE ANTIBODY TOTAL,506.0,278.3,16.56,437.69,53
CPT,86618,"HC C6 PEPTIDE CSF, ANTIBODY, LYME DISEASE",625.0,343.75,16.56,540.63,53
CPT,86618,"HC IGG, ANTIBODY, BORRELIA BURGDORFERI (LYME DISEASE)",74.0,40.7,16.56,85.15,53
CPT,86618,"HC IGM, ANTIBODY, BORRELIA BURGDORFERI (LYME DISEASE)",75.0,41.25,16.56,85.15,53
CPT,86618,"HC LYME ANTIBODY REFLECTIVE PANEL, CSF",205.0,112.75,16.56,177.33,53
CPT,86618,HC LYME DISEASE (BORRELIA BURGDORFERI) ANTIBODIES,86.5,47.58,16.56,85.15,53
CPT,86618,"HC SEROLOGY, AB, BORRELIA BURGDORFERI (LYME DISEASE)",474.0,260.7,16.56,410.01,53
CPT,86619,BORRELIA ANTIBODY,,,13.01,66.9,23
CPT,86622,HC BRUCELLA ABORTUS IGG ANTIBODY (1),173.0,95.15,8.69,149.65,53
CPT,86622,HC BRUCELLA ABORTUS IGM ANTIBODY (1),173.0,95.15,8.69,149.65,53
CPT,86622,HC BRUCELLA ANTIBODY,40.0,22.0,8.69,44.65,53
CPT,86622,HC BRUCELLA ANTIBODY (STATE),273.0,150.15,8.69,236.15,53
CPT,86625,HC CAMPYLOBACTER ANTIBODY,222.0,122.1,12.75,192.03,53
CPT,86628,HC CANDIDA ANTIBODY,31.0,17.05,9.3,60.05,53
CPT,86628,HC CANDIDA ANTIBODY EACH,41.0,22.55,11.67,60.05,53
CPT,86631,HC CHLAMYDIA ANTIBODY (2),68.0,37.4,11.48,59.1,53
CPT,86631,HC CHLAMYDIA PNEUMONIAE IGG ANTIBODY (1),66.0,36.3,11.48,59.1,53
CPT,86631,HC CHLAMYDIA PNEUMONIAE IGG ANTIBODY (2),161.0,88.55,11.48,139.27,53
CPT,86631,HC CHLAMYDIA PSITTACI IGG ANTIBODY,215.0,118.25,11.48,185.98,53
CPT,86631,HC CHLAMYDIA TRACHOMATIS IGG ANTIBODY,212.0,116.6,11.48,183.38,53
CPT,86632,HC CHLAMYDIA IGM ANTIBODY (1),55.0,30.25,12.33,63.4,53
CPT,86632,HC CHLAMYDIA PSITTACI IGM ANTIBODY (2),148.0,81.4,12.33,128.02,53
CPT,86632,HC CHLAMYDIA TRACHOMATIS IGM ANTIBODY,43.0,23.65,12.33,63.4,53
CPT,86635,HC COCCIDIOIDES ANTIBODY,66.0,36.3,11.14,57.35,53
CPT,86635,HC COCCIDIOIDES ANTIBODY EACH,66.0,36.3,11.14,57.35,53
CPT,86635,HC COCCIDIOIDES ANTIBODY PANEL,111.0,61.05,11.14,96.02,53
CPT,86635,HC COCCIDIOIDES CF CSF ANTIBODY,66.0,36.3,11.14,57.35,53
CPT,86635,HC COCCIDIOIDES ID CSF ANTIBODY,66.0,36.3,11.14,57.35,53
CPT,86635,"HC FUNGAL ANTIBODIES, COCCIDIOIDES",35.0,19.25,10.5,57.35,53
CPT,86635,HC PARACOCCIDIOIDES BRASILIENSIS ANTIBODY,581.0,319.55,11.14,502.57,53
CPT,86638,HC COXIELLA BURNETTI (Q FEVER) ANTIBODY,75.0,41.25,11.78,64.88,53
CPT,86638,HC COXIELLA BURNETTI (Q FEVER) IGG ANTIBODY,549.0,301.95,11.78,474.89,53
CPT,86638,HC COXIELLA BURNETTI (Q FEVER) IGM ANTIBODY (2),549.0,301.95,11.78,474.89,53
CPT,86638,"HC IGG PHASE I TITER, ANTIBODY, COXIELLA BURNETII (Q FEVER)",161.0,88.55,11.78,139.27,53
CPT,86638,"HC IGG PHASE II TITER, ANTIBODY, COXIELLA BURNETII (Q FEVER)",161.0,88.55,11.78,139.27,53
CPT,86641,HC CRYPTOCOCCUS ANTIBODY,87.0,47.85,14.0,75.26,53
CPT,86644,HC ADULT CYTOMEGALOVIRUS (CMV) ANTIBODY,254.0,139.7,13.99,219.71,53
CPT,86644,HC CYTOMEGALOVIRUS (CMV) IGG ANTIBODY,157.5,86.625,13.99,141.86,159
CPT,86644,HC CYTOMEGALOVIRUS (CMV) IGG AVIDITY ANTIBODY,619.0,340.45,13.99,535.44,53
CPT,86644,HC CYTOMEGALOVIRUS (CMV) IGG CSF ANTIBODY,411.0,226.05,13.99,355.52,53
CPT,86644,"HC DONOR CMV AB, CYTOMEGALOVIRUS",177.0,97.35,13.99,153.11,53
CPT,86645,HC CYTOMEGALOVIRUS (CMV) IGM CSF ANTIBODY,452.0,248.6,16.38,390.98,53
CPT,86645,HC CYTOMEGALOVIRUS (CMV) IGM-IFA ANTIBODY,99.0,54.45,16.38,85.64,53
CPT,86648,DIPHTHERIA ANTIBODY,,,14.79,76.05,23
CPT,86651,"HC ANTIBODY, ENCEPHALITIS, CALIFORNIA (LA CROSSE), EACH",179.0,98.45,12.83,154.84,53
CPT,86651,HC CALIFORNIA (LA CROSSE) ENCEPHALITIS ANTIBODY (2),63.0,34.65,12.83,65.95,53
CPT,86651,"HC CSF, CALIFORNIA (LA CROSSE) ENCEPHALITIS ANTIBODY",67.0,36.85,12.83,65.95,53
CPT,86652,"HC ANTIBODY, ENCEPHALITIS, EASTERN EQUINE, EACH",181.0,99.55,12.83,156.57,53
CPT,86652,"HC CSF, EASTERN EQUINE ENCEPHALITIS ANTIBODY",67.0,36.85,12.83,65.95,53
CPT,86652,HC EASTERN EQUINE ENCEPHALITIS ANTIBODY (2),63.0,34.65,12.83,65.95,53
CPT,86653,"HC ANTIBODY, ENCEPHALITIS, ST. LOUIS, EACH",137.0,75.35,12.83,118.51,53
CPT,86653,"HC CSF, ST LOUIS ENCEPHALITIS ANTIBODY",67.0,36.85,12.83,65.95,53
CPT,86653,HC ST LOUIS ENCEPHALITIS ANTIBODY (2),63.0,34.65,12.83,65.95,53
CPT,86654,"HC CSF, WESTERN EQUINE ENCEPHALITIS ANTIBODY",67.0,36.85,12.83,65.95,53
CPT,86654,HC WESTERN EQUINE ENCEPHALITIS ANTIBODY (2),63.0,34.65,12.83,65.95,53
CPT,86658,"HC COXSACKIE A (1), ANTIBODY, ENTEROVIRUS",48.0,26.4,12.67,65.15,53
CPT,86658,"HC COXSACKIE A (2), ENTEROVIRUS ANTIBODY",52.0,28.6,12.67,65.15,53
CPT,86658,"HC COXSACKIE A CSF, ENTEROVIRUS ANTIBODY",90.0,49.5,12.67,77.85,53
CPT,86658,"HC COXSACKIE, ENTEROVIRUS ANTIBODY",66.0,36.3,12.67,65.15,53
CPT,86658,"HC ECHOVIRUS (1), ENTEROVIRUS ANTIBODY",137.0,75.35,12.67,118.51,53
CPT,86658,"HC POLIO 1, ENTEROVIRUS ANTIBODY",147.0,80.85,12.67,127.16,53
CPT,86658,"HC POLIO 3, ENTEROVIRUS ANTIBODY",147.0,80.85,12.67,127.16,53
CPT,86663,HC EPSTEIN-BARR VIRUS ANTIBODY EARLY ANTIGEN,68.0,37.4,12.75,65.6,53
CPT,86664,HC EPSTEIN-BARR VIRUS ANTIBD NUCLEAR ANTIG (EBNA),87.0,47.85,14.87,76.45,106
CPT,86665,"HC ANTIBODY ,EPSTEIN BARR VIRUS, IGG (DONOR)",112.0,61.6,17.63,96.88,53
CPT,86665,"HC ANTIBODY ,EPSTEIN BARR VIRUS, IGM (DONOR)",112.0,61.6,17.63,96.88,53
CPT,86665,HC EPSTEIN-BARR VIRAL CAPSID (VCA) IGA ANTIBODY,136.0,74.8,17.63,117.64,53
CPT,86665,HC EPSTEIN-BARR VIRAL CAPSID (VCA) IGG ANTIBODY,95.0,52.25,17.63,90.7,53
CPT,86665,HC EPSTEIN-BARR VIRAL CAPSID (VCA) IGM ANTIBODY,194.0,106.7,17.63,167.81,106
CPT,86666,HC CHAFEENIS HME EHRLICHIA ANTIBODY,136.0,74.8,9.9,117.64,53
CPT,86666,HC EQUI HE EHRLICHIA ANTIBODY,96.0,52.8,9.9,83.04,53
CPT,86668,HC FRANCISELLA TULARENSIS,42.0,23.1,12.6,70.8,53
CPT,86671,HC AUREOBASIDIUM PULLULANS FUNGUS ANTIBODY,82.0,45.1,11.91,70.93,53
CPT,86671,HC IBD SACCHAROMYCES FUNGUS ANTIBODY,110.0,60.5,11.91,95.15,53
CPT,86671,"HC S.CEREVISIAE ANTIBODY EACH, ANTIBODY FUNGUS NES",42.0,23.1,11.91,61.25,53
CPT,86671,HC SACCHAROMYCES CERVISIAE FUNGUS ANTIBODY,109.0,59.95,11.91,94.29,53
CPT,86674,GIARDIA LAMBLIA ANTIBODY,,,14.3,73.6,23
CPT,86677,HC HELICOBACTER PYLORI IGA ANTIBODY,202.0,111.1,16.38,174.73,53
CPT,86677,HC HELICOBACTER PYLORI IGG ANTIBODY,328.0,180.4,16.38,283.72,106
CPT,86677,HC HELICOBACTER PYLORI IGM ANTIBODY,336.0,184.8,16.38,290.64,53
CPT,86682,HC CYSTICERCOSIS HELMINTH CSF ANTIBD,196.0,107.8,12.65,169.54,53
CPT,86682,HC ECHINOCOCCUS HELMINTH ANTIBODY,68.0,37.4,12.65,65.05,53
CPT,86682,HC FILARIA HELMINTH IGG4 ANTIBODY,269.0,147.95,12.65,232.69,53
CPT,86682,HC SCHISTOSOMA HELMINTH IGG ANTIBODY,373.0,205.15,12.65,322.65,53
CPT,86682,HC STRONGYLOIDES HELMINTH ANTIBODY,102.0,56.1,12.65,88.23,53
CPT,86682,HC TOXOCARA HELMINTH IGG ANTIBODY,294.0,161.7,12.65,254.31,53
CPT,86682,HC TOXOCARA SPECIES HELMINTH ANTIBODY,354.0,194.7,12.65,306.21,53
CPT,86684,HEMOPHILUS INFLUENZA ANTIBDY,,,15.4,79.2,23
CPT,86687,HTLV-I ANTIBODY,,,8.84,45.45,23
CPT,86688,HTLV-II ANTIBODY,,,13.61,70.0,23
CPT,86689,"HC HTLV I/II AB CONFIRMATION, AB, HTLV OR HIV AB, CONFIRMATORY TEST",171.0,94.05,18.81,147.92,53
CPT,86689,"HC WESTERN BLOT, AB, HTLV/HIV AB, CONF TEST",171.0,94.05,18.81,147.92,53
CPT,86692,HC HEPATITIS DELTA VIRUS ANTIBODY,36.0,19.8,10.8,85.8,53
CPT,86692,HC HEPATITIS DELTA VIRUS IGM ANTIBODY,319.0,175.45,16.68,275.94,53
CPT,86694,HC HERPES TYPE NOS ANTIBODY SIMPLEX TEST,39.0,21.45,11.7,71.95,53
CPT,86694,HC HERPES TYPE NOS FLUID IGG ANTIBODY SIMPLEX TEST,68.0,37.4,13.99,71.95,53
CPT,86695,HC HERPES TYPE 1 GLYCO ANTIBODY SIMPLEX TEST,73.0,40.15,12.83,65.95,53
CPT,86695,HC HERPES TYPE 1 IGG ANTIBODY SIMPLEX TEST,100.0,55.0,12.83,86.5,53
CPT,86696,HC HERPES TYPE 2 GLYCOPROTEIN IGG ANTIBD SIMPLEX,73.0,40.15,18.81,96.75,53
CPT,86696,HC HERPES TYPE 2 IGG ANTIBODY SIMPLEX TEST,102.0,56.1,18.81,96.75,53
CPT,86698,"HC FUNGAL ANTIBODIES, HISTOPLASMA",35.0,19.25,10.5,68.95,53
CPT,86698,HC HISTOPLASMA ANTIBODY,74.0,40.7,13.41,68.95,53
CPT,86698,HC HISTOPLASMA CF ANTIBODY,74.0,40.7,13.41,68.95,53
CPT,86698,HC MYCELIAL HISTOPLASMA ANTIBODY,114.0,62.7,13.41,98.61,53
CPT,86701,HC HIV-1 ANTIBODY DIFFERENTIATION (MULTISPOT),36.0,19.8,8.64,44.45,53
CPT,86702,HC HIV-2 ANTIBODY DIFFERENTIATION (MULTISPOT),54.0,29.7,13.14,67.6,53
CPT,86703,HC HIV-1 & HIV-2 SINGLE ASSAY,27.0,14.85,8.1,68.55,53
CPT,86703,"HC HIV-1 /HIV-2 ANTIBODY, SINGLE RESULT(DONOR)",44.0,24.2,13.2,68.55,53
CPT,86704,HC HEPATITIS B CORE ANTIBODY TOTAL,211.0,116.05,11.71,182.52,53
CPT,86704,HC HEPATITIS CORE ANTIBODY (DONOR),225.0,123.75,11.71,194.63,53
CPT,86705,HC HEP B CORE ANTIBODY IGM,155.0,85.25,11.44,134.08,106
CPT,86706,HC HEPATITIS B SURFACE ANTIBODY,163.0,89.65,10.44,141.0,106
CPT,86707,HC HEP BE ANTIBODY,77.0,42.35,11.24,66.61,53
CPT,86708,HC HEPATITIS A ANTIBODY (HAAB),153.0,84.15,12.04,132.35,106
CPT,86709,"HC HEPATITIS A ANTIBODY (HAAB), IGM ANTIBODY",157.0,86.35,10.94,135.81,53
CPT,86710,HC INFLUENZA A VIRUS CF ANTIBODY,96.0,52.8,13.17,83.04,53
CPT,86710,HC INFLUENZA B VIRUS ANTIBODY,96.0,52.8,13.17,83.04,53
CPT,86711,HC JC VIRUS ANTIBODY WITH REFLEX,3266.0,1796.3,16.42,2825.09,53
CPT,86711,"HC JC VIRUS ANTIBODY, INHIBITION WITH REFLEX",1446.0,795.3,16.42,1250.79,53
CPT,86713,HC LEGIONELLA PNEUMOPHILIA AB 1-6 IGM,88.0,48.4,14.87,76.5,53
CPT,86717,HC LEISHMANIA ANTIBODY,128.0,70.4,11.91,110.72,53
CPT,86720,HC LEPTOSPIRA ANTIBODY (2),211.0,116.05,15.75,182.52,53
CPT,86720,HC LEPTOSPIRA ANTIBODY IGM,151.0,83.05,15.75,130.62,53
CPT,86723,LISTERIA MONOCYTOGENES,,,12.83,65.95,23
CPT,86727,HC LYMPHOCYTIC CHORIOMENINGITIS IGG ANTIBODY,97.0,53.35,12.51,83.91,53
CPT,86727,HC LYMPHOCYTIC CHORIOMENINGITIS IGM ANTIBODY,103.0,56.65,12.51,89.1,53
CPT,86732,MUCORMYCOSIS ANTIBODY,,,14.58,75.0,23
CPT,86735,HC MUMPS ANTIBODY,96.0,52.8,12.68,83.04,53
CPT,86735,HC MUMPS IGM ANTIBODY,20.0,11.0,6.0,65.25,53
CPT,86738,HC MYCOPLASMA ANTIBODY,64.0,35.2,12.87,66.2,53
CPT,86738,HC MYCOPLASMA IGG ANTIBODY,74.0,40.7,12.87,66.2,53
CPT,86738,HC MYCOPLASMA PNEUMONIAE CSF ANTIBD,161.0,88.55,12.87,139.27,53
CPT,86741,NEISSERIA MENINGITIDIS,,,12.83,65.95,23
CPT,86744,NOCARDIA ANTIBODY,,,15.54,79.95,23
CPT,86747,HC PARVOVIRUS IGG ANTIBODY,46.0,25.3,13.8,75.15,53
CPT,86747,HC PARVOVIRUS IGM ANTIBODY,46.0,25.3,13.8,75.15,53
CPT,86750,MALARIA ANTIBODY,,,12.83,65.95,23
CPT,86753,HC BABESIA MICROTI PROTOZOA ANTIBODY,68.0,37.4,12.04,61.95,53
CPT,86753,"HC DONOR T. CRUZI AB, PROTOZOA, NES",191.0,105.05,12.04,165.22,53
CPT,86753,HC E HISTOLYTICA PROTOZOA ANTIBODY NOS,54.0,29.7,12.04,61.95,53
CPT,86753,HC TYRPANOSOMA CRUZI PROTOZOA ANTIBODY BCW,191.0,105.05,12.04,165.22,53
CPT,86753,HC TYRPANOSOMA CRUZI PROTOZOA IGG ANTIBODY,98.0,53.9,12.04,84.77,53
CPT,86753,HC TYRPANOSOMA CRUZI PROTOZOA IGM ANTIBODY,156.0,85.8,12.04,134.94,53
CPT,86756,HC RESPIRATORY VIRUS ANTIBODY,211.0,116.05,15.44,182.52,53
CPT,86757,HC RICKETTSIA AB IGG EACH,204.0,112.2,18.81,176.46,53
CPT,86757,HC RICKETTSIA ANTIBODY (1),64.0,35.2,18.81,96.75,53
CPT,86759,ROTAVIRUS ANTIBODY,,,17.72,91.15,23
CPT,86762,HC RUBELLA ANTIBODY,92.0,50.6,13.99,79.58,53
CPT,86762,HC RUBELLA IGG ANTIBODY QUANTITATIVE,79.0,43.45,13.99,71.95,53
CPT,86762,HC RUBELLA IGM ANTIBODY (2),107.0,58.85,13.99,92.56,53
CPT,86765,HC RUBEOLA (MEASLES) ANTIBODY,92.0,50.6,12.52,79.58,53
CPT,86765,HC RUBEOLA (MEASLES) IGM ANTIBODY (1),39.0,21.45,11.7,64.4,53
CPT,86768,"HC SALMONELLA TYPHI AND PARATYPHI, ANTIBODY",105.0,57.75,12.83,90.83,53
CPT,86769,HC SARS-COV-2 IGG ANTIBODY,122.0,67.1,36.6,210.65,53
CPT,86769,"HC TOTAL QUANT SPIKE, ANTIBODY, SARS-COV-2",122.0,67.1,36.6,210.65,106
CPT,86771,SHIGELLA ANTIBODY,,,23.8,122.4,23
CPT,86774,HC TETANUS ANTIBODY,69.0,37.95,14.38,74.0,53
CPT,86777,HC TOXOPLASMA ANTIBODY,114.0,62.7,13.99,98.61,53
CPT,86777,HC TOXOPLASMA GONDII IGG ANTIBODY,54.0,29.7,13.99,71.95,53
CPT,86777,HC TOXOPLASMA IGG ANTIBODY,114.0,62.7,13.99,98.61,53
CPT,86777,HC TOXOPLASMA IGG ANTIBODY DYE TEST,554.0,304.7,13.99,479.21,53
CPT,86778,HC TOXOPLASMA CSF IGM ANTIBODY,156.0,85.8,14.0,134.94,53
CPT,86778,HC TOXOPLASMA IGM ANTIBODY (1),67.0,36.85,14.0,72.05,53
CPT,86778,HC TOXOPLASMA IGM ELISA ANTIBODY,656.0,360.8,14.0,567.44,53
CPT,86780,"HC AB, TREPONEMA PALLIDUM ANTIBODY",140.0,77.0,12.87,121.1,53
CPT,86780,"HC DONOR RPR SYPHILIS, TREPONEMA PALLIDUM",185.0,101.75,12.87,160.03,53
CPT,86780,HC FTA TREPONEMA PALLIDUM ANTIBODY,155.0,85.25,12.87,134.08,53
CPT,86780,HC FTA TREPONEMA PALLIDUM CSF ANTIBD,227.0,124.85,12.87,196.36,53
CPT,86780,"HC TREPONEMA PALLIDUM AB IGG, ANTIBODY, TREPONEMA PALLIDUM",59.0,32.45,12.87,66.2,53
CPT,86780,HC TREPONEMA PALLIDUM IGG+IGM ANTIBODY,99.0,54.45,12.87,85.64,106
CPT,86784,HC TRICHINELLA ANTIBODY,210.0,115.5,12.2,181.65,53
CPT,86787,HC VARICELLA-ZOSTER ANTIBODY,95.0,52.25,12.52,82.18,53
CPT,86787,HC VARICELLA-ZOSTER CSF IGG ANTIBODY,130.0,71.5,12.52,112.45,53
CPT,86787,HC VARICELLA-ZOSTER CSF IGM ANTIBODY,130.0,71.5,12.52,112.45,53
CPT,86787,HC VARICELLA-ZOSTER IGM ANTIBODY,47.0,25.85,12.52,64.4,53
CPT,86788,HC W NILE VIRUS CSF IGM ANTIBD (1),32.0,17.6,9.6,84.25,53
CPT,86788,HC W NILE VIRUS CSF IGM ANTIBD (2),84.0,46.2,16.38,84.25,53
CPT,86788,HC WEST NILE VIRUS IGM ANTIBODY,108.0,59.4,16.38,93.42,53
CPT,86788,HC WEST NILE VIRUS IGM ANTIBODY (2),55.0,30.25,16.38,84.25,53
CPT,86788,"HC WEST NILE VIRUS, IGM CSF ANTIBODY",157.0,86.35,16.38,135.81,53
CPT,86788,"HC WEST NILE VIRUS, IGM CSF ANTIBODY (2)",61.0,33.55,16.38,84.25,53
CPT,86789,"HC ANTIBODY, WEST NILE VIRUS, EACH",108.0,59.4,13.99,93.42,53
CPT,86789,"HC ANTIBODY, WEST NILE VIRUS, EACH (2)",54.0,29.7,13.99,71.95,53
CPT,86789,HC W NILE VIRUS CSF IGG ANTIBD (2),149.0,81.95,13.99,128.89,53
CPT,86789,HC WEST NILE VIRUS IGG ANTIBODY,95.0,52.25,13.99,82.18,53
CPT,86789,HC WEST NILE VIRUS IGG ANTIBODY (2),49.0,26.95,13.99,71.95,53
CPT,86790,"HC CHIKUNGUNYA IGG, ANTIBODY, VIRUS, NES",140.0,77.0,12.52,121.1,53
CPT,86790,"HC CHIKUNGUNYA IGM, ANTIBODY, VIRUS, NES",145.0,79.75,12.52,125.43,53
CPT,86790,"HC DENGUE FEVER EACH, ANTIBODY, VIRUS, NES",66.0,36.3,12.52,64.4,53
CPT,86790,"HC DENGUE FEVER NS1 ANTIGEN, ANTIBODY, VIRUS, NES",364.0,200.2,12.52,314.86,53
CPT,86790,"HC DONOR HTLV AB, VIRUS, NES",111.0,61.05,12.52,96.02,53
CPT,86790,"HC HANTA IGG, ANTIBODY, VIRUS, NES",213.0,117.15,12.52,184.25,53
CPT,86790,"HC HANTA IGM, ANTIBODY, VIRUS, NES (2)",215.0,118.25,12.52,185.98,53
CPT,86790,"HC HEPATITIS E (HEV) EACH, ANTIBODY, VIRUS, NES",113.0,62.15,12.52,97.75,53
CPT,86790,"HC HEPATITIS E (HEV) IGG, ANTIBODY, VIRUS, NES (2)",237.0,130.35,12.52,205.01,53
CPT,86790,"HC HERPES VIRUS 6 AB IGM TITER, AB, VIRUS, NES",279.0,153.45,12.52,241.34,53
CPT,86790,"HC HTLV I/II ANTIBODIES, AB, VIRUS, NES",42.0,23.1,12.52,64.4,53
CPT,86790,"HC HTLV-I AND HTLV-II CSF, ANTIBODY, VIRUS, NES",125.0,68.75,12.52,108.13,53
CPT,86790,"HC HUMAN HERPES 6 (HHV6) IGG, ANTIBODY, VIRUS, NES",541.0,297.55,12.52,467.97,53
CPT,86790,"HC HUMAN HERPES 6 AB IGM, AB, VIRUS, NES",541.0,297.55,12.52,467.97,53
CPT,86790,"HC HUMAN HERPES 7 (HHV7) IGG, ANTIBODY, VIRUS, NES",538.0,295.9,12.52,465.37,53
CPT,86790,"HC HUMAN HERPES 7 (HHV7) IGM, ANTIBODY, VIRUS, NES",538.0,295.9,12.52,465.37,53
CPT,86790,"HC JAMESTOWN CANYON, ANTIBODY, VIRUS, NOS, EACH",423.0,232.65,12.52,365.9,53
CPT,86790,"HC POWASSAN, ANTIBODY, VIRUS, NOS, EACH",423.0,232.65,12.52,365.9,53
CPT,86790,"HC RABIES, ANTIBODY, VIRUS, NES",317.0,174.35,12.52,274.21,53
CPT,86793,HC YERSINIA IGM ANTIBODY,118.0,64.9,12.83,102.07,53
CPT,86794,"HC ANTIBODY, ZIKA VIRUS, IGM",231.0,127.05,16.38,199.82,53
CPT,86800,HC THYROGLOBULIN ANTIBODY,327.0,179.85,15.46,282.86,159
CPT,86800,HC THYROGLOBULIN ANTIBODY (2),211.0,116.05,15.46,182.52,53
CPT,86800,HC THYROGLOBULIN ANTIBODY (3),55.0,30.25,15.46,79.55,53
CPT,86800,HC THYROGLOBULIN ANTIBODY FINE NDL ASPIR,211.0,116.05,15.46,182.52,53
CPT,86803,HC HEPATITIS C (HCV) ANTIBODY,306.0,168.3,13.87,264.69,53
CPT,86803,HC HEPATITIS C ANTIBODY (DONOR),306.0,168.3,13.87,264.69,53
CPT,86804,HEP C AB TEST CONFIRM,,,15.06,77.45,23
CPT,86805,LYMPHOCYTOTOXICITY ASSAY,,,184.2,947.55,23
CPT,86806,LYMPHOCYTOTOXICITY ASSAY,,,46.26,237.95,23
CPT,86807,CYTOTOXIC ANTIBODY SCREENING,,,76.45,393.25,23
CPT,86808,"HC HLA DETECT (1), SERUM SCREEN CYTOTOXIC PERCENT REA AB (PRA), QUICK",80.0,44.0,24.0,148.4,53
CPT,86812,"HC HLA B27, TYPING A/B/C SINGLE ANTIGEN",214.0,117.7,25.08,185.11,53
CPT,86813,HLA TYPING A B OR C,,,56.38,290.0,23
CPT,86816,HLA TYPING DR/DQ,,,29.32,150.85,23
CPT,86817,HLA TYPING DR/DQ,,,103.17,530.7,23
CPT,86821,LYMPHOCYTE CULTURE MIXED,,,35.53,182.8,23
CPT,86825,HC HLA CROSSMATCH NON-CYTOTOXIC 1ST SERUM OR DILUT,1021.0,561.55,106.43,883.17,53
CPT,86826,HC HLA CROSSMATCH NON-CYTOTOX EA AD SERUM OR DILUT,233.0,128.15,35.51,201.55,53
CPT,86828,HC HLA ANTBD ASSAY CLASS I & II ANTIGENS QUAL SCRN,302.0,166.1,62.4,320.95,53
CPT,86828,HC HLA ANTIBODY ASSAY CLASS I & II ANTIGENS NEUT,482.0,265.1,62.4,416.93,53
CPT,86828,HC HLA ANTIBODY ASSAY CLASS I & II ANTIGENS QUAL,245.0,134.75,62.4,320.95,53
CPT,86829,HLA CLASS I/II ANTIBODY QUAL,,,62.4,320.95,23
CPT,86830,HLA CLASS I PHENOTYPE QUAL,,,92.84,477.6,23
CPT,86831,HLA CLASS II PHENOTYPE QUAL,,,79.59,409.4,23
CPT,86832,HC HLA ANTIBODY ASSAY CLASS I HI DEF QUAL PANEL,848.5,466.675,243.3,1618.75,106
CPT,86833,HC HLA ANTIBODY ASSAY CLASS II HI DEF QUAL PANEL,752.0,413.6,207.0,1629.0,106
CPT,86834,HLA CLASS I SEMIQUANT PANEL,,,347.54,1787.8,23
CPT,86835,HLA CLASS II SEMIQUANT PANEL,,,313.92,1614.8,23
CPT,86850,HC RBC ANTIBODY SCREEN,138.0,75.9,9.5,119.37,53
CPT,86850,HC RBC ANTIBODY SCREEN ALLO ADSORB INTERP,429.0,235.95,9.5,371.09,53
CPT,86850,HC RBC ANTIBODY SCREEN BCW CASE 1 AHG,207.0,113.85,9.5,179.06,53
CPT,86850,HC RBC ANTIBODY SCREEN BCW CASE 2 AHG,217.0,119.35,9.5,187.71,53
CPT,86850,HC RBC ANTIBODY SCREEN BCW DAT NEG HA EVAL (1),138.0,75.9,9.5,119.37,53
CPT,86850,HC RBC ANTIBODY SCREEN BCW DAT NEG HA EVAL (2),138.0,75.9,9.5,119.37,53
CPT,86850,HC RBC ANTIBODY SCREEN BCW DAT NEG HA EVAL (3),138.0,75.9,9.5,119.37,53
CPT,86850,HC RBC ANTIBODY SCREEN BCW REF LAB 2ME,179.0,98.45,9.5,154.84,53
CPT,86860,"HC BCW, ANTIBODY ELUTION (RBC), EACH ELUTION",213.0,117.15,63.9,188.7,53
CPT,86860,HC RBC ANTIBODY ELUTION,267.0,146.85,80.1,230.96,53
CPT,86860,HC RBC ANTIBODY ELUTION BCSEW DAT EVAL,191.0,105.05,57.3,188.7,53
CPT,86870,HC RBC ANTIBD IDENTIFICATION BCSEW DAT NEG HA EVAL,380.0,209.0,114.0,388.93,53
CPT,86870,HC RBC ANTIBODY IDENTIFICATION BCW,380.0,209.0,114.0,388.93,53
CPT,86870,HC RBC ANTIBODY IDENTIFICATION BCW CASE 1,380.0,209.0,114.0,388.93,53
CPT,86870,HC RBC ANTIBODY IDENTIFICATION COMPLEX,380.0,209.0,114.0,388.93,53
CPT,86880,HC ANTIHUMAN GLOBLN (COOMBS) TST DIR BCSEW MONOSOP,119.0,65.45,5.24,102.94,53
CPT,86880,HC ANTIHUMAN GLOBULIN (COOMBS) TEST DIRECT,122.0,67.1,5.24,105.53,53
CPT,86880,HC ANTIHUMAN GLOBULIN (COOMBS) TEST DIRECT C3,122.0,67.1,5.24,105.53,53
CPT,86880,HC ANTIHUMAN GLOBULIN (COOMBS) TEST DIRECT IGG,122.0,67.1,5.24,105.53,53
CPT,86880,HC ANTIHUMAN GLOBULN (COOMBS) DIR BCSEW DAT NEG HA,119.0,65.45,5.24,102.94,53
CPT,86880,HC ANTIHUMAN GLOBULN (COOMBS) DIRECT BCSEW REF LAB,119.0,65.45,5.24,102.94,53
CPT,86885,COOMBS TEST INDIRECT QUAL,,,5.55,179.36,23
CPT,86886,HC ANTIHUMAN GLOBLN (COOMBS) INDIR TITER BCSEW REF,191.5,105.33,5.04,179.36,53
CPT,86886,HC ANTIHUMAN GLOBULIN (COOMBS) TEST INDIRECT TITER,185.0,101.75,5.04,179.36,53
CPT,86886,HC ANTIHUMAN GLOBULN (COOMBS) TEST INDIR TITER,285.0,156.75,5.04,246.53,53
CPT,86886,"HC ISOAGGLUTININ TITER, ANTI-A, ANTIHUMAN GLOBULIN TEST (COOMBS), INDIR, EA AB TITER",654.5,359.98,5.04,566.14,53
CPT,86886,"HC ISOHEMMAGLUTININ, ANTIHUMAN GLOBULIN TEST (COOMBS), INDIR, EA AB TITER",185.0,101.75,5.04,179.36,53
CPT,86890,AUTOLOGOUS BLOOD PROCESS,,,152.85,460.36,23
CPT,86891,HC AUTOLOG BLD PROCESS INTRA-POST OP SALV COMPL,2589.0,1423.95,650.3,2239.49,53
CPT,86891,HC AUTOLOG BLD PROCESS INTRA-POST OP SALV LTD,1088.0,598.4,326.4,941.12,53
CPT,86900,HC ABO BLOOD TYPING SEROLOGIC,134.5,73.98,2.91,134.92,53
CPT,86900,HC ABO BLOOD TYPING SEROLOGIC ABO & RH TRANSPLANT,134.5,73.98,2.91,134.92,53
CPT,86900,HC ABO BLOOD TYPING SEROLOGIC BCW,134.5,73.98,2.91,134.92,53
CPT,86900,HC ABO BLOOD TYPING SEROLOGIC BCW DAT NEG HA EVAL,134.5,73.98,2.91,134.92,53
CPT,86900,HC ABO BLOOD TYPING SEROLOGIC CASE WORKUP,134.5,73.98,2.91,134.92,53
CPT,86900,HC ABO BLOOD TYPING SEROLOGIC GROUP & SUBTYPE,134.5,73.98,2.91,134.92,53
CPT,86900,HC ABO BLOOD TYPING SEROLOGIC RH,134.5,73.98,2.91,134.92,53
CPT,86900,"HC ISOHEMMAGLUTININ TITER IGG AND IGM, ABO BLOOD TYPING SEROLOGIC",134.5,73.98,2.91,134.92,53
CPT,86900,"HC TRANSPLANT RECONFIRMATION, BLOOD TYPING, SEROLOGIC, ABO",134.5,73.98,2.91,134.92,53
CPT,86901,HC RH (D) BLOOD TYPING SEROLOGIC,53.5,29.425,2.91,47.58,106
CPT,86901,HC RH (D) BLOOD TYPING SEROLOGIC ABO & RH TRANSPLANT,52.0,28.6,2.91,44.98,53
CPT,86901,HC RH (D) BLOOD TYPING SEROLOGIC BCW,52.0,28.6,2.91,44.98,53
CPT,86901,HC RH (D) BLOOD TYPING SEROLOGIC BCW DAT NEG HA EVAL,52.0,28.6,2.91,44.98,53
CPT,86901,HC RH (D) BLOOD TYPING SEROLOGIC CASE WORKUP,52.0,28.6,2.91,44.98,53
CPT,86902,HC BLOOD TYP SEROLOGIC ANTIGEN TEST DONOR BLOOD BCW SCREEN RARE,380.0,209.0,6.17,376.51,53
CPT,86902,HC BLOOD TYPING SEROLOGIC 1 ANTIGEN TEST DONOR BLOOD BCW,380.0,209.0,6.17,376.51,53
CPT,86902,"HC IN-HOUSE, BLOOD TYP, SEROLOGIC, AG TEST DONOR BLOOD, EA AG",380.0,209.0,6.17,376.51,53
CPT,86902,"HC VERSITI, BLOOD TYP, SEROLOGIC, AG TEST DONOR BLOOD, EA AG",380.0,209.0,6.17,376.51,53
CPT,86904,BLOOD TYPING PATIENT SERUM,,,15.89,81.7,23
CPT,86905,HC BLOOD TYPING SEROLOGIC RBC PHENOTYPE ANTIGEN BCW,380.0,209.0,3.73,376.51,53
CPT,86905,HC BLOOD TYPING SEROLOGIC RBC PHENOTYPE BIG S ANTIGEN,380.0,209.0,3.73,376.51,53
CPT,86905,HC BLOOD TYPING SEROLOGIC RBC PHENOTYPE FYA ANTIGEN,380.0,209.0,3.73,376.51,53
CPT,86905,HC BLOOD TYPING SEROLOGIC RBC PHENOTYPE FYB ANTIGEN,380.0,209.0,3.73,376.51,53
CPT,86905,HC BLOOD TYPING SEROLOGIC RBC PHENOTYPE JKA ANTIGEN,380.0,209.0,3.73,376.51,53
CPT,86905,HC BLOOD TYPING SEROLOGIC RBC PHENOTYPE JKB ANTIGEN,380.0,209.0,3.73,376.51,53
CPT,86905,HC BLOOD TYPING SEROLOGIC RBC PHENOTYPE KELL ANTIGEN,389.0,213.95,3.73,376.51,53
CPT,86905,HC BLOOD TYPING SEROLOGIC RBC PHENOTYPE LITTLE S ANTIGEN,380.0,209.0,3.73,376.51,53
CPT,86905,HC BLOOD TYPING SEROLOGIC RBC PHENOTYPE M ANTIGEN,380.0,209.0,3.73,376.51,53
CPT,86905,HC BLOOD TYPING SEROLOGIC RBC PHENOTYPE N ANTIGEN,380.0,209.0,3.73,376.51,53
CPT,86905,"HC CW AG, BLOOD TYPING, SEROLOGIC, RBC AG, OTHER THAN ABO/RH (D), EACH",380.0,209.0,3.73,376.51,53
CPT,86905,"HC LITTLE K, BLOOD TYP, SEROLOGIC, RBC AG, OTH THAN ABO/RH (D), EA",376.0,206.8,3.73,376.51,53
CPT,86905,"HC VERSITI, BLOOD TYP, SEROLOGIC, RBC AG, OTH THAN ABO/RH (D), EA",376.0,206.8,3.73,376.51,53
CPT,86906,HC BLOOD TYPING SEROLOGIC RH PHENOTYPE BIG C ANTIGEN COMPLETE,146.0,80.3,7.53,126.29,53
CPT,86906,HC BLOOD TYPING SEROLOGIC RH PHENOTYPE BIG E ANTIGEN COMPLETE,146.0,80.3,7.53,126.29,53
CPT,86906,HC BLOOD TYPING SEROLOGIC RH PHENOTYPE COMPLETE BCW,210.0,115.5,7.53,181.65,53
CPT,86906,HC BLOOD TYPING SEROLOGIC RH PHENOTYPE LITTLE C ANTIGEN COMPLETE,152.0,83.6,7.53,131.48,53
CPT,86906,HC BLOOD TYPING SEROLOGIC RH PHENOTYPE LITTLE E ANTIGEN COMPLETE,152.0,83.6,7.53,131.48,53
CPT,86910,BLOOD TYPING PATERNITY TEST,,,24.38,119.11,8
CPT,86911,BLOOD TYPING ANTIGEN SYSTEM,,,21.09,103.02,8
CPT,86920,HC COMPATIBILITY TEST SPIN,215.0,118.25,64.5,188.7,53
CPT,86921,COMPATIBILITY TEST INCUBATE,,,146.48,188.7,23
CPT,86922,HC COMPAT TST ANTIGLOBULN TECHNQ BCW XMATCH ADSORB,343.0,188.65,102.9,296.7,53
CPT,86922,HC COMPATIBILITY TEST ANTIGLOBULIN TECHNIQUE,211.0,116.05,63.3,188.7,53
CPT,86922,HC COMPATIBILITY TEST ANTIGLOBULIN TECHNIQUE BCW,344.0,189.2,103.2,297.56,53
CPT,86923,HC COMPATIBILITY TEST EA UNIT ELECTRONIC,179.0,98.45,53.7,188.7,53
CPT,86927,HC THAW FRESH FROZEN PLASMA,446.0,245.3,91.75,385.79,53
CPT,86930,FROZEN BLOOD PREP,,,174.14,542.45,23
CPT,86931,FROZEN BLOOD THAW,,,174.14,407.24,23
CPT,86932,FROZEN BLOOD FREEZE/THAW,,,33.01,460.36,23
CPT,86940,HC HEMOLYSINS & AGGLUTININS AUTO SCREEN THERMAL,111.5,61.325,8.52,100.34,106
CPT,86941,HC HEMOLYSINS & AGGLUTININS INCUBATION ISOHEMMAGLUTINATION TITER EA,66.0,36.3,11.77,60.55,53
CPT,86941,HC HEMOLYSINS & AGGLUTININS INCUBATION THERMAL,158.0,86.9,11.77,136.67,53
CPT,86941,"HC ISOHEMMAGLUTININ, HEMOLYSINS & AGGLUTININS INCUBATION",230.0,126.5,11.77,198.95,53
CPT,86945,HC BLOOD PRODUCT IRRADIATION,186.0,102.3,33.01,160.89,53
CPT,86950,LEUKACYTE TRANSFUSION,,,152.85,352.51,23
CPT,86960,HC VOL REDUCTION OF BLOOD PROD,304.0,167.2,91.2,262.96,53
CPT,86965,POOLING BLOOD PLATELETS,,,151.31,188.7,23
CPT,86970,RBC PRETX INCUBATJ W/CHEMICL,,,33.01,135.21,23
CPT,86971,HC PRETREATMENT RBC INCUBATION W ENZYMES EA,303.0,166.65,90.9,388.93,53
CPT,86972,HC RBC PRE-TREAT RBC ANTBD ID DENSITY GRAD SEPARTN,423.0,232.65,126.9,365.9,53
CPT,86975,RBC SERUM PRETX INCUBJ DRUGS,,,146.48,453.08,23
CPT,86976,RBC SERUM PRETX ID DILUTION,,,24.26,162.57,23
CPT,86977,HC SERUM PRE-TRT ANTBD ID INCUBT W INHB BCW NEUTRL,267.0,146.85,80.1,230.96,53
CPT,86977,HC SERUM PRE-TRT ANTBD ID INCUBT W INHIB BCSEW 2ME,236.0,129.8,70.8,204.14,53
CPT,86978,HC SERUM PRE-TREAT ANTIBD ID DIFFERENTIAL ALLO,247.0,135.85,33.01,213.66,53
CPT,86978,HC SERUM PRE-TRT ANTIBD ID DIFFRNTL BCSEW AFTER HR,909.0,499.95,33.01,786.29,53
CPT,86985,SPLIT BLOOD OR PRODUCTS,,,119.11,188.7,23
CPT,86999,HC BCW ANTIGEN TYPING MOLECULAR,445.0,244.75,24.26,384.93,53
CPT,87003,SMALL ANIMAL INOCULATION,,,16.37,84.2,23
CPT,87015,"HC BLOOD PARASITE SMEAR, CONCENTRATION, FOR INFC AGENTS",19.0,10.45,5.7,33.4,53
CPT,87015,"HC MICROSPORIDIUM CONCENTRATION, FOR INFECTIOUS AGENTS",53.0,29.15,6.5,45.85,53
CPT,87015,"HC PC DFA BILL ONLY, CONCENTRATION, FOR INFECTIOUS AGENTS",113.0,62.15,6.5,97.75,106
CPT,87015,"HC SPECIMEN CONCENTRATION, FOR INFECTIOUS AGENTS",68.0,37.4,6.5,58.82,53
CPT,87015,"HC TB SPECIMEN CONCENTRATION, FOR INFECTIOUS AGENTS",54.0,29.7,6.5,46.71,53
CPT,87040,HC BLOOD CULTURE FOR BACTERIA,144.0,79.2,10.03,124.56,53
CPT,87045,HC FECES CULTURE BACTERIA,184.0,101.2,9.18,159.16,106
CPT,87046,HC STOOL CULTR BACTERIA EACH,33.0,18.15,9.18,47.2,106
CPT,87070,HC GENITOURINARY BACTERIA CULTURE AEROBIC,98.0,53.9,8.38,84.77,53
CPT,87070,"HC HELICOBACTER PYLORI CULTURE (C HPYLORI), OTHER SPECIMN AEROBIC ISOL",20.0,11.0,6.0,43.1,53
CPT,87070,HC NOS BACTERIA CULTURE AEROBIC,164.0,90.2,8.38,141.86,53
CPT,87070,HC QC BACTERIA CULTURE AEROBIC,61.0,33.55,8.38,52.77,53
CPT,87070,HC RESPIRATORY BACTERIA CULTURE AEROBIC,98.0,53.9,8.38,84.77,53
CPT,87070,HC RESPIRATORY CF BACTERIA CULTURE AEROBIC,84.0,46.2,8.38,72.66,53
CPT,87070,HC ROUTINE BACTERIA CULTURE AEROBIC,98.0,53.9,8.38,84.77,106
CPT,87070,HC THROAT BACTERIA CULTURE AEROBIC,98.0,53.9,8.38,84.77,53
CPT,87071,HC DUODENAL ASP BACTERIA CULTURE QUANT AEROBIC,161.0,88.55,9.61,139.27,53
CPT,87073,HC CULTURE BACTERIA ANAEROBIC,63.0,34.65,9.39,54.5,53
CPT,87075,HC BACTERIA CULTURE ANAEROBIC EXCEPT BLD_BILL ONLY,124.0,68.2,9.2,107.26,53
CPT,87076,HC BACTERIA CULTURE ANAEROBIC ADDL METHOD ID MALDI,105.0,57.75,7.86,90.83,53
CPT,87077,"HC AP120E, CULT, BACT, AROB, ADL METHODS, DEFTV ID, EA ISOLATE",111.0,61.05,7.86,96.02,53
CPT,87077,"HC HAEMOPHILUS, CULT, BACT, AROB, ADL METHODS, DEFTV ID, EA ISOLATE",190.0,104.5,7.86,164.35,106
CPT,87077,"HC MALDI, CULT, BACT, AROB, ADL METHODS, DEFTV ID, EA ISOLATE",79.0,43.45,7.86,68.34,53
CPT,87081,"HC ACANTHAMMOEBA, PRESUMPTIVE CULTURE, PATHOGENIC ORGANISMS, SCREENING ONLY",22.0,12.1,6.44,33.15,53
CPT,87081,"HC BETA STREP GRP A, CULT, PRESUM, PATHOGENIC ORG SCRN ONLY",85.0,46.75,6.44,73.53,53
CPT,87081,"HC BETA STREP GRP, CULT, PRESUM, PATHOGENIC ORG SCRN ONLY",85.0,46.75,6.44,73.53,53
CPT,87081,"HC BILL C CF RESP, CULT, PRESUM, PATHOGENIC ORG SCRN ONLY",33.0,18.15,6.44,33.15,53
CPT,87081,"HC DIPTHERIAE, PRESUMPTIVE CULTURE, PATHOGENIC ORGANISMS, SCREENING ONLY",85.0,46.75,6.44,73.53,53
CPT,87081,"HC FLUOROQUINOLONE RESISTANT, CULT, PRESUM, PATHOGENIC ORG SCRN ONLY",78.0,42.9,6.44,67.47,53
CPT,87081,"HC GC, PRESUMPTIVE CULTURE, PATHOGENIC ORGANISMS, SCREENING ONLY",85.0,46.75,6.44,73.53,53
CPT,87081,"HC LEGIONELLA CULT, PRESUM, PATHOGENIC ORG SCRN ONLY",173.0,95.15,6.44,149.65,53
CPT,87081,"HC LEGIONELLA, PRESUMPTIVE CULTURE, PATHOGENIC ORGANISMS, SCREENING ONLY",87.0,47.85,6.44,75.26,53
CPT,87081,"HC MRSA, PRESUMPTIVE CULTURE, PATHOGENIC ORGANISMS, SCREENING ONLY",35.0,19.25,6.44,33.15,53
CPT,87081,"HC VANCO RESIST ENTEROCOCCUS, CULT, PRESUM, PATHOGENIC ORG SCRN ONLY",35.0,19.25,6.44,33.15,53
CPT,87084,CULTURE OF SPECIMEN BY KIT,,,26.31,135.35,23
CPT,87086,"HC PRE-PROCEDURAL URINE CULTURE, BACT, QUANT COLONY COUNT",15.5,8.53,4.65,40.35,53
CPT,87086,HC URINE CULTURE COLONY COUNT,109.0,59.95,7.84,94.29,53
CPT,87088,HC URINE BACTERIA CULTR ISOLATN & PRESUMPTIVE ID,97.0,53.35,7.87,83.91,53
CPT,87101,HC SKIN FUNGI CULTURE,106.0,58.3,7.5,91.69,53
CPT,87102,HC FUNGUS CULTR ISOLATN & PRESUMPTIVE ID DUODENAL,91.0,50.05,8.17,78.72,53
CPT,87102,HC FUNGUS CULTURE ISOLATION & PRESUMPTIVE ID,104.0,57.2,8.17,89.96,53
CPT,87103,HC BLOOD FUNGUS CULTURE,94.0,51.7,19.89,102.3,53
CPT,87106,HC FUNGUS CULTURE DEFINITIVE ID YEAST,188.0,103.4,10.03,162.62,53
CPT,87106,HC FUNGUS CULTURE DEFINITIVE ID YEAST MALDI,102.0,56.1,10.03,88.23,53
CPT,87107,HC FUNGUS CULTURE DEFINITIVE ID MOLD,110.0,60.5,10.03,95.15,53
CPT,87107,HC FUNGUS CULTURE DEFINITIVE ID MOLD REF LAB,589.0,323.95,10.03,509.49,53
CPT,87109,HC MYCOPLASMA CULTURE_BILL ONLY,254.0,139.7,14.96,219.71,53
CPT,87109,HC MYCOPLASMA UREAPLASMA CULTURE,143.0,78.65,14.96,123.7,53
CPT,87110,HC CHLAMYDIA CULTURE TRACHOMATIS,116.0,63.8,19.05,100.34,53
CPT,87116,HC ACID-FAST BACILLI CULTR ISOLATN & PRESUMPTVE ID,247.0,135.85,10.49,213.66,53
CPT,87116,HC MYCOBACTERIAL CULTURE ISOLATN & PRESUMPTIVE ID,130.0,71.5,10.49,112.45,53
CPT,87118,HC MYCOBACTERIC ID_MALDI FOR ACID FAST BACILLI,84.0,46.2,14.2,73.05,53
CPT,87140,CULTURE TYPE IMMUNOFLUORESC,,,5.41,27.85,23
CPT,87143,CULTURE TYPING GLC/HPLC,,,12.17,62.6,23
CPT,87147,"HC BETA STREP LATEX, CULT, TYP, OTH THAN IMMUNFLUORES, PER ANTISERUM",56.0,30.8,5.04,48.44,53
CPT,87147,HC CULTR TYPING IMMUNOLOGIC METHOD E COLI 0157 H7,59.0,32.45,5.04,51.04,53
CPT,87147,HC CULTR TYPING IMMUNOLOGIC METHOD STAPH LATEX ID,49.0,26.95,5.04,42.39,106
CPT,87149,"HC BLASTOMYCES DERMATIDIS IDENTIFICATION BY PROBE, CULTURE, TYPING, NUCLEIC",443.0,243.65,19.49,383.2,53
CPT,87149,"HC COCCIDIOIDES IMMITIS IDENTIFICATION BY DNA PROBE, CULT, TYPING, NUCLEIC",443.0,243.65,19.49,383.2,53
CPT,87149,"HC HISTOPLASMA CAPSULATUM DNA PROBE, CULTURE TYPING NUCLEIC ACID DIR EA ORG",443.0,243.65,19.49,383.2,53
CPT,87149,"HC NANOSPHERE GRAM NEG BLOOD, CULT, TYP, ID BY NA PROBE, DIR PROBE, EA",127.0,69.85,19.49,109.86,53
CPT,87149,"HC NANOSPHERE GRAM POS BLOOD, CULT, TYP, ID BY NA PROBE, DIR PROBE, EA",87.0,47.85,19.49,100.25,53
CPT,87150,DNA/RNA AMPLIFIED PROBE,,,34.11,175.45,23
CPT,87152,CULTURE TYPE PULSE FIELD GEL,,,7.52,38.7,23
CPT,87153,"HC ORGANISM IDENTIFICTION BY 16S RDNA, DNA/RNA SEQUENCING",535.0,294.25,112.13,576.8,53
CPT,87154,CUL TYP ID BLD PTHGN 6+ TRGT,,,211.95,1090.3,23
CPT,87158,CULTURE TYPING ADDED METHOD,,,7.52,38.7,23
CPT,87164,DARK FIELD EXAM SPEC COLLJ,,,10.44,53.7,23
CPT,87166,DARK FIELD EXAM W/O COLLJ,,,10.98,56.5,23
CPT,87168,HC MACROSCOPIC EXAM ARTHROPOD,69.0,37.95,4.15,59.69,53
CPT,87169,"HC ARTHROPOD, MACROSCOPIC EXAMINATION",2727.0,1499.85,4.19,2358.86,53
CPT,87169,HC MACROSCOPIC EXAM PARASITE,80.0,44.0,4.19,69.2,106
CPT,87172,HC PINWORM EXAM,16.0,8.8,4.15,21.35,53
CPT,87176,"HC HOMOGENIZATION, TISSUE, FOR CULTURE",70.0,38.5,5.72,60.55,53
CPT,87177,HC OVA AND PARASITES SMEARS,77.0,42.35,8.65,66.61,106
CPT,87177,"HC OVA AND PARASITES, DIRECT SMEARS",91.0,50.05,8.65,78.72,53
CPT,87181,"HC E WRKSHEET, SUSCEPT STDY, ANTMICROB AGT, AGAR DILUT, PER AGNT",180.0,99.0,4.62,155.7,53
CPT,87181,"HC GM NEG FERMT, SUSCEPT STDY, ANTMICROB AGT, AGAR DILUT, PER AGNT",50.0,27.5,4.62,43.25,53
CPT,87181,"HC GRAM NEG E, SUSCEPT STDY, ANTMICROB AGT, AGAR DILUT, PER AGNT",55.0,30.25,4.62,47.58,53
CPT,87181,"HC GRAM POS E, SUSCEPT STDY, ANTMICROB AGT, AGAR DILUT, PER AGNT",50.0,27.5,4.62,43.25,53
CPT,87181,"HC LACTMASE POS, SUSCEPT STDY, ANTMICROB AGT, MICR/AGAR DILUT, PER PLT",34.0,18.7,4.62,29.41,53
CPT,87181,"HC RESIST ORG, SUSCEPT STDY, ANTMICROB AGT, AGAR DILUT, PER AGNT",50.0,27.5,4.62,43.25,53
CPT,87184,SC STD DISK METHOD PER PLATE,,,7.27,37.4,23
CPT,87185,HC SUSCEPTB STDY ANTMCRB BETA LACTAMASE ENZYM DTCT,72.0,39.6,4.62,62.28,53
CPT,87186,"HC 15 DRUG MIC SENSITIVITY, MICROBE SUSCEPTIBLE MIC",714.0,392.7,8.41,617.61,53
CPT,87186,"HC ANTIBIOT PANEL, SUSCEPT STDY, ANTMICROB AGT, MICR/AGAR DILUT, PER PLT",100.0,55.0,8.41,86.5,53
CPT,87186,"HC ARUP SG SENS, SUSCEPTIBLTY STDY ANTIMICRBIAL MICRO/AGAR DILUT PER PLATE",270.0,148.5,8.41,233.55,53
CPT,87186,"HC ERTA SUSCEPTIBILITY, STDY ANTIMICROBIAL AGENT MICRO/AGAR DILUT PER PLATE",34.0,18.7,8.41,43.25,53
CPT,87186,"HC FUGAL, SUSCEPT STDY, ANTMICROB AGT, MICR/AGAR DILUT, PER PLT",47.0,25.85,8.41,43.25,53
CPT,87186,"HC MERO SUSCEPTIBILITY, STDY ANTIMICROBIAL AGENT MICRO/AGAR DILUT PER PLATE",43.0,23.65,8.41,43.25,53
CPT,87186,"HC RAPID GROW MYCOBAC SENSTV PANEL, SUSCEPT, ANTMICROB AGT, MICR/AGAR DILUT",80.0,44.0,8.41,69.2,53
CPT,87186,"HC STATE RAPD GRW(3), SUSCEPT STDY, ANTMICROB AGT, MICR/AGAR DILUT, PER PLT",666.0,366.3,8.41,576.09,53
CPT,87186,"HC SUSCEPTIBILITY BROTH DIL PN, MICROBE SUSCEPTIBLE MIC",184.0,101.2,8.41,159.16,53
CPT,87187,SC STD MICRODIL/AGAR MLC,,,39.04,200.85,23
CPT,87188,HC SUSCEPTB STDY ANTMCRB MACRBRTH BILL EA ADL DRUG,108.0,59.4,6.45,93.42,53
CPT,87188,HC SUSCEPTB STDY ANTMCRB MACROBRTH NTL JEW MAI EXT,108.0,59.4,6.45,93.42,53
CPT,87188,HC SUSCEPTB STUDY ANTMCRB MACROBROTH FUNGL REF LAB,149.0,81.95,6.45,128.89,53
CPT,87188,HC SUSCEPTB STUDY ANTMCRB MACROBRTH NTL JEWISH MAI,108.0,59.4,6.45,93.42,53
CPT,87190,SC STD MYOBACTERIA PROP METH,,,7.1,36.55,23
CPT,87197,SERUM BACTERICIDAL TITER,,,14.6,75.1,23
CPT,87205,HC SMEAR PRIM SRCE INTERP GM STAIN FLD EOSINOPHIL,60.0,33.0,4.15,51.9,53
CPT,87205,HC SMEAR PRIM SRCE INTERP GM STAIN URIN EOSINOPHIL,144.0,79.2,4.15,124.56,106
CPT,87205,HC SMEAR PRIMARY SOURCE INTERP GRAM STAIN,21.0,11.55,4.15,21.35,53
CPT,87206,HC SMEAR PRIM SRCE INTERP ACID FAST STAIN,89.0,48.95,5.24,76.99,53
CPT,87206,HC SMEAR PRIM SRCE INTERP ACRIDINE ORANGE STAIN,68.0,37.4,5.24,58.82,53
CPT,87206,HC SMEAR PRIM SRCE INTERP CALCOFLOUR STAIN,68.0,37.4,5.24,58.82,53
CPT,87206,HC SMEAR PRIM SRCE INTERP FLRESCNT CYCLOSPORA,250.0,137.5,5.24,216.25,53
CPT,87206,HC SMEAR PRIM SRCE INTERP FLRESCNT ISOSPORA,250.0,137.5,5.24,216.25,53
CPT,87207,"HC CYCLOSPORA EXAM, SMEAR PRIM SRCE SPEC STAIN BODIES/PARASITS",50.0,27.5,5.82,43.25,106
CPT,87207,"HC PARASITE SMEAR BLD, SMEAR, PRIM SOURCE, SPECIAL STAIN INCL BOD/PARASITES",96.0,52.8,5.82,83.04,53
CPT,87207,"HC PARASITE SMEAR BLOOD, PRIM SRC SPEC STAIN FOR INCLUSION BODIES/PARASITES",119.0,65.45,5.82,102.94,53
CPT,87207,"HC SMEAR, PRIM SOURCE, SPECIAL STAIN INCLUSION BOD/PARASITES",104.0,57.2,5.82,106.4,106
CPT,87209,"HC OVA AND PARASITES, SMEAR COMPLEX STAIN",130.0,71.5,17.48,112.45,53
CPT,87209,HC SMEAR COMPLEX STAIN,104.0,57.2,17.48,89.96,53
CPT,87210,HC SMEAR WET MOUNT,77.0,42.35,5.65,66.61,53
CPT,87210,"HC SMEAR, PRIMARY SOURCE W/ INTERP, WET MOUNT FOR INFECTIOUS AGENTS",67.0,36.85,5.65,57.96,159
CPT,87220,HC TISSUE EXAM FOR FUNGI KOH SLIDE,90.0,49.5,4.15,77.85,53
CPT,87230,TOXIN/ANTITOXIN ASY TISS CUL,,,19.19,98.7,23
CPT,87250,VIRUS INOCULATE EGGS/ANIMAL,,,19.01,97.8,23
CPT,87252,"HC ANTIVIRAL ACYCLOVIR INOCULATION,VIRUS ISOLATION",216.0,118.8,25.34,186.84,53
CPT,87252,"HC ANTIVIRAL FOSCARNET INOCULATION,VIRUS ISOLATION",216.0,118.8,25.34,186.84,53
CPT,87252,"HC HERPES SIMPLEX, VIRUS ISOLATION, TISSUE CULTR INOCULATION, OBSERVATION",343.0,188.65,25.34,296.7,53
CPT,87252,"HC HVS INOCULATED, VIRUS INOCULATION TISSUE",97.0,53.35,25.34,130.35,53
CPT,87252,"HC NON-RESPIR (MAYO), VIR ISOL, TISS CULT INOCULATION, OBSV",552.0,303.6,25.34,477.48,53
CPT,87252,"HC VIRAL CULTURE NON RESPIRATORY, TISS CULT INOCULATION CYTOPATHIC EFFECT",122.0,67.1,25.34,130.35,53
CPT,87252,HC VIRUS TISSUE CULTURE INOCULATION ISOLATION,216.0,118.8,25.34,186.84,53
CPT,87253,"HC ANTIVIRAL ACYCLOVIR INOCULATION, VIRUS ISOLATION ,ADDITIONAL",212.0,116.6,19.64,183.38,53
CPT,87253,"HC ANTIVIRAL FOSCARNET INOCULATION,VIRUS ISOLATION ,ADDITIONAL",212.0,116.6,19.64,183.38,53
CPT,87253,"HC HERPES SIMPLEX, VIRUS ISOLATION, ADDL STUDY/DEFINITIVE ID, EA ISOLATE",47.0,25.85,14.1,101.0,53
CPT,87253,"HC HSV INNOCULATION ADDITIONAL, VIRUS INOCULATE TISSUE",46.0,25.3,13.8,101.0,53
CPT,87254,"HC NON-RESPIR (MAYO), VIR ISOL, CENTRIFUGE ENHANCED TECHNIQUE, EA VIRUS",178.0,97.9,19.01,153.97,53
CPT,87255,GENET VIRUS ISOLATE HSV,,,32.91,169.3,23
CPT,87260,ADENOVIRUS AG IF,,,14.03,72.15,23
CPT,87265,PERTUSSIS AG IF,,,11.65,59.9,23
CPT,87267,ENTEROVIRUS ANTIBODY DFA,,,13.04,67.1,23
CPT,87269,"HC GIARDIA, INFC AGNT AG DTCT IMMUNFLUORES",66.0,36.3,13.23,68.05,53
CPT,87270,CHLAMYDIA TRACHOMATIS AG IF,,,11.65,59.9,23
CPT,87271,CYTOMEGALOVIRUS DFA,,,13.04,67.1,23
CPT,87272,"HC CRYPTOSPORIDIUM, INFC AGNT AG DTCT IMMUNFLUORES",107.0,58.85,11.65,92.56,53
CPT,87273,HERPES SIMPLEX 2 AG IF,,,11.65,59.9,23
CPT,87274,HERPES SIMPLEX 1 AG IF,,,11.65,59.9,23
CPT,87275,INFLUENZA B AG IF,,,11.91,61.25,23
CPT,87276,INFLUENZA A AG IF,,,15.62,80.35,23
CPT,87278,LEGION PNEUMOPHILIA AG IF,,,15.17,78.0,23
CPT,87279,PARAINFLUENZA AG IF,,,15.98,82.15,23
CPT,87280,RESPIRATORY SYNCYTIAL AG IF,,,13.04,67.1,23
CPT,87281,HC INFC AGT ANTG DTCT IMFLRSCNT PNEUMOCYST CARINII,354.0,194.7,11.65,306.21,106
CPT,87283,RUBEOLA AG IF,,,59.09,304.0,23
CPT,87285,TREPONEMA PALLIDUM AG IF,,,11.84,60.9,23
CPT,87290,VARICELLA ZOSTER AG IF,,,13.04,67.1,23
CPT,87299,ANTIBODY DETECTION NOS IF,,,15.65,80.5,23
CPT,87300,AG DETECTION POLYVAL IF,,,11.65,59.9,23
CPT,87301,ADENOVIRUS AG IA,,,11.65,59.9,23
CPT,87305,"HC ASPERGILLUS GALC BRONCH, INFC AGNT AG DTCT BY IA",181.0,99.55,11.65,156.57,53
CPT,87305,"HC ASPERGILLUS, INFC AGNT AG DTCT BY IA",329.0,180.95,11.65,284.59,53
CPT,87320,CHLMYD TRACH AG IA,,,14.58,75.0,23
CPT,87324,"HC CLOSTRIDIUM DIFFICILE TOXIN, INFC AGNT AG DTCT BY IA",85.0,46.75,11.65,73.53,53
CPT,87327,CRYPTOCOCCUS NEOFORM AG IA,,,13.04,67.1,23
CPT,87328,"HC INFC AGNT AG DTCT BY IA, CRYPTOSPORIDIUM",39.0,21.45,11.7,69.1,106
CPT,87329,"HC INFC AGNT AG DTCT BY IA, GIARDIA",39.0,21.45,11.65,59.9,106
CPT,87332,CYTOMEGALOVIRUS AG IA,,,11.65,59.9,23
CPT,87335,E COLI 0157 AG IA,,,12.3,63.3,23
CPT,87336,ENTAMOEB HIST DISPR AG IA,,,15.55,80.0,23
CPT,87337,"HC ENTAMOEBA HISTOLYTICA GROUP, INFC AGNT AG DTCT BY IA",124.0,68.2,11.65,107.26,53
CPT,87338,"HC HELICOBACTER PYLORI, STOOL, INFC AGNT AG DTCT BY IA",106.0,58.3,13.98,91.69,53
CPT,87339,H PYLORI AG IA,,,15.55,80.0,23
CPT,87340,"HC HBSAG, INFC AGNT AG DTCT BY IA",156.0,85.8,10.04,134.94,53
CPT,87340,HC HEPATITIS B SURFACE ANTIGEN (DONOR),65.0,35.75,10.04,56.23,53
CPT,87341,"HC HBSAG NEUTRALIZATION, INFC AGNT AG DTCT BY IA",283.0,155.65,10.04,244.8,53
CPT,87350,"HC HBEAG, INFC AGNT AG DTCT BY IA",67.0,36.85,11.21,57.96,53
CPT,87380,"HC HEPATITIS DELTA, INFC AGNT AG DTCT BY IA, HEPATITIS, DELTA AGENT",315.0,173.25,17.85,272.48,53
CPT,87385,"HC HISTOPLASMA CAPSULATUM, INFC AGNT AG DTCT BY IA",334.0,183.7,12.88,288.91,53
CPT,87385,"HC HISTOPLASMA, INFC AGENT ANTIGEN DTCT IM TECH, QUAL/SEMIQUANT MULTI-STEP",184.0,101.2,12.88,159.16,53
CPT,87389,"HC HIV COMBO BY CIA WITH REFLEX, INFECT AGENT ANTIGEN DETECT BY IMMUN TECH",46.0,25.3,13.8,120.4,53
CPT,87389,"HC INFC AGNT AG DTCT BY IA, HIV-1 AG, W HIV-1 & 2 AB",63.0,34.65,18.9,120.4,53
CPT,87390,HIV-1 AG IA,,,23.38,120.3,23
CPT,87391,HIV-2 AG IA,,,21.29,109.5,23
CPT,87400,"HC INFLUENZA, A/B, INFC AGNT AG DTCT BY IA, EA",167.0,91.85,13.73,144.46,53
CPT,87420,RESP SYNCYTIAL VIRUS AG IA,,,13.52,69.55,23
CPT,87425,"HC ROTAVIRUS, INFC AGNT AG DTCT BY IA",144.0,79.2,11.65,124.56,53
CPT,87426,SARSCOV CORONAVIRUS AG IA,,,34.34,176.65,23
CPT,87427,"HC SHIGA-LIKE TOXIN, INFC AGNT AG DTCT BY IA",84.0,46.2,11.65,72.66,53
CPT,87428,SARSCOV & INF VIR A&B AG IA,,,68.33,84.35,21
CPT,87430,STREP A AG IA,,,16.34,84.05,23
CPT,87449,"HC 1-3-BETA-D-GLUCAN, INFC AGNT AG DTCT BY IA, MULT STEP, NOS, EA ORG",295.0,162.25,11.65,255.18,53
CPT,87449,"HC BLASTOMYCES, INFC AGNT AG DTCT BY IA, NOS, EA ORG",214.0,117.7,11.65,185.11,53
CPT,87449,"HC COCCIDIOIDES ANTIGEN, INFC AGNT AG DTCT BY IA, MULT STEP, NOS, EA ORG",147.0,80.85,11.65,127.16,53
CPT,87449,"HC COCCIDIOIDES, INFC AGNT AG DTCT BY IA, NOS, EA ORG",282.0,155.1,11.65,243.93,53
CPT,87451,POLYVALENT MULT ORG EA AG IA,,,10.22,52.55,23
CPT,87467,HEPATITIS B SURFACE AG QUAN,,,14.63,75.25,23
CPT,87468,"HC ANAPLASMA PHAGOCYTOPHILUM BY PCR, INFC AGNT DTCT BY NA, AMP PRB",117.0,64.35,34.11,175.45,53
CPT,87468,"HC TICK BORNE, INFC AGNT DTCT BY NA, ANAPLASMA PHAGOCYTOPHILUM, AMP PRB",129.0,70.95,34.11,175.45,53
CPT,87469,"HC BABESIA MICROTI BY PCR, INFC AGNT DTCT BY NA, AMP PRB",152.0,83.6,34.11,175.45,53
CPT,87469,"HC TICK BORNE, INFC AGNT DTCT BY NA, BABESIA MICROTI, AMB PRB",129.0,70.95,34.11,175.45,53
CPT,87471,HC INFCT AGNT DETECT DNA AMPLIF PROBE BARTONELLA,565.0,310.75,34.11,488.73,53
CPT,87472,BARTONELLA DNA QUANT,,,41.64,214.2,23
CPT,87475,LYME DIS DNA DIR PROBE,,,19.49,100.25,23
CPT,87476,HC INFCT AGNT DETCT DNA AMPLF PROBE LYME DISEASE,633.0,348.15,34.11,547.55,53
CPT,87476,HC INFCT AGNT DETCT DNA AMPLF PROBE LYME TISSUE,295.0,162.25,34.11,255.18,53
CPT,87478,BORRELIA MIYAMOTOI AMP PRB,,,34.11,175.45,23
CPT,87480,CANDIDA DNA DIR PROBE,,,19.49,100.25,23
CPT,87481,CANDIDA DNA AMP PROBE,,,34.11,175.45,23
CPT,87482,CANDIDA DNA QUANT,,,54.18,278.7,23
CPT,87483,"HC MENING-ENCEPHAL PNL, INFC AGNT DTCT BY NA, CNS PATH, MULT AMP,12-25 TARG",1099.0,604.45,329.7,2083.9,53
CPT,87484,"HC EHRLICHIA CHAFFEENSIS BY PCR, INFC AGNT DTCT BY NA, AMP PRB",117.0,64.35,34.11,175.45,53
CPT,87484,"HC TICK BORNE, INFC AGNT DTCT BY NA, EHRLICHIA CHAFFEENSIS, AMP PRB",129.0,70.95,34.11,175.45,53
CPT,87485,CHLMYD PNEUM DNA DIR PROBE,,,19.49,100.25,23
CPT,87486,"HC INFC AGT DTCT BY NA, CHLAMYDOPHILA PNEUMONIAE, AMP PROBE TECH",135.0,74.25,34.11,175.45,53
CPT,87487,CHLMYD PNEUM DNA QUANT,,,41.64,214.2,23
CPT,87490,CHLMYD TRACH DNA DIR PROBE,,,22.11,113.75,23
CPT,87491,"HC CHLAMYDIA TRACH,(LGV) L1-3, INFCT AGNT DETECT BY NA, AMP PROBE TECH",465.0,255.75,34.11,402.23,53
CPT,87491,"HC CHLAMYDIA TRACHOMATIS LGV L1-3, INFC AGT DTCT BY NA, AMP PRB",703.0,386.65,34.11,608.1,53
CPT,87491,HC INFC AGT DTCT BY NA CHLAMYDIA TRACHOMAT AMP PRB,234.0,128.7,34.11,202.41,53
CPT,87491,HC INFC AGT DTCT BY NA CHLAMYDIA TRACHOMAT AMP PRB (2),92.0,50.6,27.6,175.45,53
CPT,87491,HC INFC AGT DTCT BY NA CHLMYD TRACHMAT AMP PRB EYE,161.0,88.55,34.11,175.45,53
CPT,87492,CHLMYD TRACH DNA QUANT,,,51.97,267.35,23
CPT,87493,HC INFC AGT DTCT BY NA CLOSTRIDIUM DIFF AMP PROBE,286.0,157.3,36.23,247.39,53
CPT,87495,CYTOMEG DNA DIR PROBE,,,29.2,150.15,23
CPT,87496,"HC AMNIOTIC, INFCT AGNT DTCT DNA, CMV PCR, AMPLIFIED PROBE TECH",409.0,224.95,34.11,353.79,53
CPT,87496,"HC CONGENTL CYTOMEGALOVIRUS NAAT QUAL, NEONATAL (LESS 21 DAYS) SALIVA/URINE",137.0,75.35,34.11,175.45,53
CPT,87496,HC INFCT AGNT DETCT DNA AMPLF PROBE CYTMEGLV (CMV),273.0,150.15,34.11,236.15,106
CPT,87496,HC INFCT AGNT DTCT DNA AMP PRBE CYTMEGLV (CMV) PCR,409.0,224.95,34.11,353.79,53
CPT,87497,"HC CMV QUANT BY PCR BLOOD SPOT, INFECTIOUS AGENT DETECTION BY NUCLEIC ACID",1561.0,858.55,41.64,1350.27,53
CPT,87497,"HC CMV QUANT EYE, INFCT AGNT DTCT BY NA, CYTOMEGALOVIRUS, QUANTIFICATION",797.0,438.35,41.64,689.41,53
CPT,87497,HC INFC AGT DTCT DNA QUANTFC CYTMEGLV (CMV) WH BLD,436.0,239.8,41.64,377.14,53
CPT,87497,HC INFCT AGNT DTCT DNA QUANTFC CYTMEGLV (CMV) (1),2276.0,1251.8,41.64,1968.74,53
CPT,87498,HC INF AGT DTCT BY NA ENTROVIR REV TRNSCRP&AMP PRB,592.0,325.6,34.11,512.08,53
CPT,87498,"HC INFECT AGENT DETECT BY DNA/RNA, ENTEROVIRUS, AMP PRB, INCLD REV TRNSCRP",370.0,203.5,34.11,320.05,53
CPT,87500,VANOMYCIN DNA AMP PROBE,,,34.11,175.45,23
CPT,87501,INFLUENZA DNA AMP PROB 1+,,,49.87,256.55,23
CPT,87502,INFLUENZA DNA AMP PROBE,,,93.11,479.0,23
CPT,87503,INFLUENZA DNA AMP PROB ADDL,,,28.4,146.1,23
CPT,87505,"HC GASTROINTEST PARASITE PN PCR, INFECT AGENT DETECT BY NA, AMP PROBE TECH",741.0,407.55,124.7,641.45,53
CPT,87505,"HC PCR FECES, INFECT AGNT DTCT BY DNA, GI PATH, AMP PROBE TECH, 3-5 TARGETS",741.0,407.55,124.7,641.45,53
CPT,87506,IADNA-DNA/RNA PROBE TQ 6-11,,,255.63,1314.95,23
CPT,87507,"HC GASTROINTESTINAL PROFILE STOOL PCR, IADNA-DNA/RNA PTHGN MULT PROBE 12-25",1254.0,689.7,376.2,2083.9,53
CPT,87507,"HC GI PANEL, INFC AGNT DTCT BY NA, GASTRO PATH, MULT AMP PRB, 12-15 TARG",1055.0,580.25,316.5,2083.9,53
CPT,87510,GARDNER VAG DNA DIR PROBE,,,19.49,100.25,23
CPT,87511,GARDNER VAG DNA AMP PROBE,,,34.11,175.45,23
CPT,87512,GARDNER VAG DNA QUANT,,,40.59,208.8,23
CPT,87513,H PYLRI CLRTHMCN RST AMP PRB,,,34.11,175.45,23
CPT,87516,"HC DONOR HBV NAT, INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA)",53.0,29.15,15.9,175.45,53
CPT,87517,HC INFC AGT DTCT BY NUCL ACID HEPATITIS B QUANTFC,436.0,239.8,41.64,377.14,53
CPT,87520,HEPATITIS C RNA DIR PROBE,,,30.34,156.1,23
CPT,87521,"HC DONOR HCV NAT, INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA)",40.0,22.0,12.0,175.45,53
CPT,87521,HC INFC AGT DTCT BY NA HEP C REV TRNSCRP & AMP PRB,158.0,86.9,34.11,175.45,53
CPT,87522,HC INFC AGT DTCT BY NA HEP C REV TRNSCRP & QUANTFC,449.0,246.95,41.64,388.39,53
CPT,87522,"HC PCR, INF AGT DTCT BY NA HEP C REV TRNSCP & QNTFC",638.0,350.9,41.64,551.87,53
CPT,87523,HEPATITIS D QUANTIFICATION,,,41.64,214.2,23
CPT,87525,HEPATITIS G DNA DIR PROBE,,,28.96,149.0,23
CPT,87526,HEPATITIS G DNA AMP PROBE,,,38.16,196.3,23
CPT,87527,HEPATITIS G DNA QUANT,,,40.59,208.8,23
CPT,87528,HSV DNA DIR PROBE,,,19.49,100.25,23
CPT,87529,HC HERPES SIMPLEX VIRUS PCR,613.0,337.15,34.11,530.25,53
CPT,87529,"HC HSV TYPE 1&2 QUAL PCR, INFECTIOUS AGENT DETECTION BY NUCLEIC ACID",422.0,232.1,34.11,365.03,53
CPT,87529,"HC HSV TYPES 1 & 2 NAAT, INFC AGT DTCT BY NA DNA AMP",60.0,33.0,18.0,175.45,53
CPT,87529,"HC HSV-1 AND HSV-2 SUBTYPE PCR, INFECT AGT DETECT BY NUCLIEC ACID PROBE",643.0,353.65,34.11,556.2,53
CPT,87529,"HC HSV1 AND 2 PCR, INFECT AGENT DETECT DNA, HERPES SIMPX VIR, AMP PRBE TECH",502.0,276.1,34.11,434.23,53
CPT,87529,HC INFC AGT DTCT DNA HERPES SIMPLEX AMP PRBE (2),282.0,155.1,34.11,243.93,53
CPT,87529,HC INFC AGT DTCT DNA HERPES SIMPLEX VIRUS AMP PRBE,282.0,155.1,34.11,243.93,53
CPT,87529,HC INFC AGT DTCT DNA HERPES SIMPX AMP PRBE PCR FLD,180.0,99.0,34.11,175.45,53
CPT,87529,HC INFC AGT DTCT DNA HERPES SIMPX VIR AMP PRBE PCR,254.0,139.7,34.11,219.71,53
CPT,87530,"HC HSV QUANTITATION EYE, INFCT AGNT DTCT BY NA",389.0,213.95,41.64,336.49,53
CPT,87530,"HC HSV TPE 1&2 QUANT PCR ECH, INFECTIOUS AGENT DETECTION BY NUCLEIC ACID",329.0,180.95,41.64,284.59,53
CPT,87530,HC INFC AGT DTCT BY NA HERPES SIMPLX VIRUS QUANTFC,501.0,275.55,41.64,433.37,53
CPT,87531,HHV-6 DNA DIR PROBE,,,56.38,290.0,23
CPT,87532,HC INFC AGT DTCT BY NUCL ACID HHV-6 AMP PROBE,393.0,216.15,34.11,339.95,53
CPT,87532,"HC PCR TISSUE, INFC AGT DTCT BY NUCL ACID HHV-6 AMP PROBE",408.0,224.4,34.11,352.92,53
CPT,87533,"HC HHV6 INTEGRATION AND TYPING, IADNA HERPES VIRUS-6 QUANTIFICATION",432.5,237.88,40.59,374.11,53
CPT,87533,"HC HUMAN HERPES VIRUS 6 QUANT WB, HHV-6 DNA QUANT",567.0,311.85,40.59,490.46,53
CPT,87533,HC INFC AGT DTCT DNA QUANTFC HERPES 6 (HHV6) (2),829.0,455.95,40.59,717.09,53
CPT,87534,HIV-1 DNA DIR PROBE,,,21.3,109.6,23
CPT,87535,"HC DONOR HIV NAT, INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA)",53.0,29.15,15.9,175.45,53
CPT,87535,"HC HIV 1 DNA QUALITATIVE, INFC AGNT DTCT BY NA, AMP PRB TECHNQ",104.0,57.2,31.2,175.45,53
CPT,87535,HC INFC AGT DTCT BY NA HIV-1 REV TRNSCRP & AMP PRB,501.0,275.55,34.11,433.37,53
CPT,87536,HC INFC AGT DTCT BY NA HIV-1 QUANTFC INCL REV TRNSCRP,466.0,256.3,82.72,425.5,53
CPT,87536,HC INFC AGT DTCT BY NA HIV-1 SUPER QUANTFC PCR CSF,1632.0,897.6,82.72,1411.68,53
CPT,87537,HIV-2 DNA DIR PROBE,,,21.3,109.6,23
CPT,87538,"HC HIV 1/2 RNA QUALITATIVE, INFC AGNT DTCT BY NA; AMP PRB TECHNQ",104.0,57.2,31.2,175.45,53
CPT,87538,"HC HIV-2 PCR QUAL (1), INFC AGNT DTCT BY NA, AMP PRB",897.0,493.35,34.11,775.91,53
CPT,87538,"HC HIV-2 PCR QUAL (2), INFC AGNT DTCT BY NA, AMP PRB",727.0,399.85,34.11,628.86,53
CPT,87539,HIV-2 QUANT&REVRSE TRNSCRIPJ,,,56.98,293.1,23
CPT,87540,LEGION PNEUMO DNA DIR PROB,,,19.49,100.25,23
CPT,87541,"HC INFCT AGNT DETCT DNA AMP, LEGIONELLA PNEUMOPHILA, AMP PROBE TECH",202.0,111.1,34.11,175.45,53
CPT,87542,LEGION PNEUMO DNA QUANT,,,40.59,208.8,23
CPT,87550,MYCOBACTERIA DNA DIR PROBE,,,19.49,100.25,23
CPT,87551,"HC UW NON TB PCR, MYCOBACTERIA SPECIES, INFC AGNT DTCT BY NA, AMP PRB",787.0,432.85,46.89,680.76,53
CPT,87552,MYCOBACTERIA DNA QUANT,,,41.64,214.2,23
CPT,87555,M.TUBERCULO DNA DIR PROBE,,,26.13,134.4,23
CPT,87556,"HC COMPLEX PCR, MYCOBACTERIA TB, INFC AGNT DTCT BY NA, AMP PRB",889.0,488.95,40.52,768.99,53
CPT,87556,HC INFCT AGNT DETECT BY NA AMP PROBE MYCOBACTERIA TB,442.0,243.1,40.52,382.33,53
CPT,87556,HC INFCT AGNT DETECT BY NA AMP PROBE MYCOBACTERIA TB MTB,251.0,138.05,40.52,217.12,53
CPT,87556,HC INFCT AGNT DETECT BY NA AMP PROBE MYCOBACTERIA TB PCR PARAFFIN BLOCK,1240.0,682.0,40.52,1072.6,53
CPT,87557,M.TUBERCULO DNA QUANT,,,41.64,214.2,23
CPT,87560,M.AVIUM-INTRA DNA DIR PROB,,,26.53,136.45,23
CPT,87561,M.AVIUM-INTRA DNA AMP PROB,,,34.11,175.45,23
CPT,87562,M.AVIUM-INTRA DNA QUANT,,,41.64,214.2,23
CPT,87563,"HC INFC AGNT DETECT BY NUCLEIC ACID, MYCOPLASMA GENITALIUM PCR",591.0,325.05,34.11,511.22,53
CPT,87563,"HC MYCOPLASMA GENITALIUM, INFECT AGNT DETECT BY DNA OR RNA, AMP PRB TECHNQ",595.0,327.25,34.11,514.68,106
CPT,87563,"HC MYCOPLASMA SPECIES PCR, IADNA MYCOPLASMA GENITALIUM AMPLIFIED PROBE TECH",208.0,114.4,34.11,179.92,53
CPT,87564,MTB RIFAMPIN RST AMP PRB TQ,,,74.62,383.85,23
CPT,87580,M.PNEUMON DNA DIR PROBE,,,19.49,100.25,23
CPT,87581,HC INFC AGT DTCT DNA AMP PRB MYCPLAS PNEUM PCR CSF,700.0,385.0,34.11,605.5,53
CPT,87581,HC INFC AGT DTCT DNA AMP PRBE MYCPLAS PNEU PRSTGLN,584.0,321.2,34.11,505.16,53
CPT,87581,HC INFCT AGNT DETCT DNA AMP PRBE MYCOPLASMA PNEUM,135.0,74.25,34.11,175.45,53
CPT,87582,M.PNEUMON DNA QUANT,,,294.15,1513.1,23
CPT,87590,N.GONORRHOEAE DNA DIR PROB,,,26.13,134.4,23
CPT,87591,HC INFCT AGNT DETCT DNA AMP PRBE NEISSERIA GONORRH,229.0,125.95,34.11,198.09,53
CPT,87591,HC INFCT AGNT DETCT DNA AMP PRBE NEISSERIA GONORRH (2),89.0,48.95,26.7,175.45,53
CPT,87592,N.GONORRHOEAE DNA QUANT,,,41.64,214.2,23
CPT,87593,"HC INFC AGNT DTCT BY NA, ORTHOPOXVIRUS, AMP PRB, EA",168.5,92.675,32.1,256.55,159
CPT,87594,"HC PNEUMOCYSTIS JIROVECII BY PCR, INFC AGNT DETECT BY NA, AMP PRB TECHNQ",317.0,174.35,34.11,274.21,53
CPT,87623,HPV LOW-RISK TYPES,,,34.11,175.45,23
CPT,87624,"HC DNA, INFC AGT DTCT BY NA HPV HIGH-RISK TYPES",158.0,86.9,34.11,175.45,53
CPT,87624,HC INFC AGT DTCT BY NA HPV HIGH-RISK TYPES,208.0,114.4,34.11,392.71,265
CPT,87625,HPV TYPES 16 & 18 ONLY,,,39.41,202.75,23
CPT,87626,HC INFC AGT DTCT BY NA HPV HIGH-RISK TYPES,117.0,64.35,35.1,351.0,212
CPT,87631,HC INFLUENZA/COVID-19 NUCLEIC ACID AMPLIFICATION TEST,432.0,237.6,129.6,713.15,53
CPT,87632,RESP VIRUS 6-11 TARGETS,,,211.95,1090.3,23
CPT,87633,RESP VIRUS 12-25 TARGETS,,,405.12,2083.9,23
CPT,87634,RSV DNA/RNA AMP PROBE,,,68.24,351.0,23
CPT,87635,"HC INFC AGNT DTCT BY NA, SARS-COV-2, AMP PRB",645.5,355.02500000000003,49.87,963.61,106
CPT,87636,HC INFLUENZA/COVID-19 NUCLEIC ACID AMPLIFICATION TEST,323.0,177.65,96.9,713.15,53
CPT,87636,"HC POCT SARS-COV-2 & FLU A&B, INFC AGNT DTCT BY NA, MULT AMP PRB",323.0,177.65,96.9,713.15,106
CPT,87637,"HC INFCT AGNT DETCT BY NUCLEIC ACID, RSV, INFLUENZA, COVID-19, AMPLIF TEST",376.0,206.8,112.8,713.15,53
CPT,87640,HC INFC AGT DTCT BY NA  STAPHYLOCOCCUS AUREUS AMP PROBE,319.0,175.45,34.11,275.94,53
CPT,87641,HC INFC AGT DTCT BY NUCL ACID MR-STAPH AMP PROBE,320.0,176.0,34.11,276.8,106
CPT,87650,STREP A DNA DIR PROBE,,,19.49,100.25,23
CPT,87651,HC INFC AGT DTCT BY NA STREP A GROUP AMP PROBE,177.0,97.35,34.11,175.45,53
CPT,87652,STREP A DNA QUANT,,,40.59,208.8,23
CPT,87653,HC INFC AGT DTCT BY NA STREP B GROUP AMP PROBE,177.0,97.35,34.11,175.45,53
CPT,87660,TRICHOMONAS VAGIN DIR PROBE,,,19.49,100.25,23
CPT,87661,HC INFC AGT DTCT BY NUCL ACID AMP PRBE TRICHMONAS VAGINALIS,128.5,70.675,34.11,175.45,106
CPT,87661,HC INFC AGT DTCT BY NUCL ACID AMP PRBE TRICHMONAS VAGINALIS (2),83.0,45.65,24.9,175.45,53
CPT,87662,"HC DONOR ZIKA NAT, INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA)",97.0,53.35,29.1,256.55,53
CPT,87662,"HC PCR URINE, INFECT AGENT DETECT BY DNA/RNA, ZIKA VIRUS, AMP PROBE TECH",368.0,202.4,49.87,318.32,53
CPT,87662,"HC PCR, INFECT AGENT DETECT BY DNA/RNA, ZIKA VIRUS, AMP PROBE TECH",368.0,202.4,49.87,318.32,53
CPT,87797,DETECT AGENT NOS DNA DIR,,,29.2,150.15,23
CPT,87798,"HC ACANTHAMOEBA PCR, INFC AGNT DETECT BY NA, NOS; AMP PROBE, EA ORG",1334.0,733.7,34.11,1153.91,53
CPT,87798,"HC ASPERGILLUS SPECIES BY PCR, INFECTIOUS AGENT DETECTION BY NUCLEIC ACID",1193.0,656.15,34.11,1031.95,53
CPT,87798,"HC B. PARAPERTUSSIS NAAT, INFECTIOUS AGENT DETECTION BY NUCLEIC ACID AMP",116.0,63.8,34.11,175.45,53
CPT,87798,"HC B. PERTUSSIS NAAT, INFECTIOUS AGENT DETECTION BY NUCLEIC ACID DNA AMP",116.0,63.8,34.11,175.45,53
CPT,87798,"HC COCCIDIODES PCR, INFC AGNT DTCT BY NA, NOS, AMP PRB TECH, EA ORG",2517.0,1384.35,34.11,2177.21,53
CPT,87798,"HC DENGUE VIRUS (1-4), INFCT AGNT DTCT BY NA, NOS, AMP PROBE TECH, EA ORG",1321.0,726.55,34.11,1142.67,53
CPT,87798,HC DONOR WEST NILE NAT INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA/RNA),247.0,135.85,34.11,213.66,53
CPT,87798,"HC EPSTEIN-BARR PLASMA, INFC AGNT DETECT BY NA, NOS, AMP PRBE TECH, EA ORG",492.0,270.6,34.11,425.58,53
CPT,87798,"HC EPSTEIN-BARR VIR FLD, INFC AGT DTCT BY NA, AMP PRB, EA ORGANISM",1340.0,737.0,34.11,1159.1,53
CPT,87798,"HC GI MICROSPORIDIA, INFC AGNT DTCT BY NA, NOS, AMP PROBE, EA ORG",422.0,232.1,34.11,365.03,53
CPT,87798,"HC GI VIRAL PNL BY PCR, INFCT AGNT DTCT BY NA, NOS, AMP PROBE TECH, EA ORG",174.0,95.7,34.11,175.45,53
CPT,87798,"HC HEPATITIS E, INFC AGNT DTCT BY NA, NOS, AMP PRB, EA ORG",2647.0,1455.85,34.11,2289.66,53
CPT,87798,"HC HISTOPLASMA/BLASTOMYCES, INFC AGNT DTCT BY NA, NOS, AMP PRB, EA ORG",678.0,372.9,34.11,586.47,53
CPT,87798,HC INFC AGT DTCT AMP PRB CMV TOXPL GONDII PCR FLD,1155.0,635.25,34.11,999.08,53
CPT,87798,HC INFC AGT DTCT DNA AMP PRB TOXOPLASMA GONDII (2),506.0,278.3,34.11,437.69,53
CPT,87798,HC INFC AGT DTCT DNA AMP PRBE PARVOVIR B19 BON MRW,797.0,438.35,34.11,689.41,53
CPT,87798,HC INFC AGT DTCT DNA AMP PRBE TROPHERYMA WHIPP,771.0,424.05,34.11,666.92,53
CPT,87798,HC INFCT AGNT DETCT DNA AMPLF PROBE ADENOVIRUS (1),340.0,187.0,34.11,294.1,53
CPT,87798,HC INFCT AGNT DETCT DNA AMPLF PROBE BABESIA,800.0,440.0,34.11,692.0,53
CPT,87798,HC INFCT AGNT DETCT DNA AMPLF PROBE EHRLICHIA,1114.0,612.7,34.11,963.61,53
CPT,87798,HC INFCT AGNT DETCT DNA AMPLF PROBE EHRLICHIA CHAFFEENIS PCR CSF,1951.0,1073.05,34.11,1687.62,53
CPT,87798,HC INFCT AGNT DETCT DNA AMPLF PROBE HTLV-I & II,492.0,270.6,34.11,425.58,53
CPT,87798,HC INFCT AGNT DETCT DNA AMPLF PROBE MUMPS,1450.0,797.5,34.11,1254.25,53
CPT,87798,HC INFCT AGNT DETCT DNA AMPLF PROBE VARC-ZSTR (VZ),340.0,187.0,34.11,294.1,53
CPT,87798,"HC INFCT AGNT DETCT DNA BY NUCLEIC ACID, NOS, AMPLIF TEST GENOGROUP I",210.0,115.5,34.11,181.65,53
CPT,87798,"HC INFCT AGNT DETCT DNA BY NUCLEIC ACID, NOS, AMPLIF TEST GENOGROUP II",210.0,115.5,34.11,181.65,53
CPT,87798,HC INFCT AGNT DETECT BY NA AMP PROBE CRE,296.0,162.8,34.11,256.04,53
CPT,87798,HC INFCT AGNT DETECT BY NA AMP PROBE EPSTEIN-BARR VIR QUAL CSF,355.0,195.25,34.11,307.08,53
CPT,87798,HC INFCT AGNT DETECT BY NA AMP PROBE MYCOPLASMA HOMINIS PCR,1954.0,1074.7,34.11,1690.21,53
CPT,87798,HC INFCT AGNT DETECT BY NA AMP PROBE TUBERCULOSIS RIF,312.0,171.6,34.11,269.88,53
CPT,87798,"HC INFECTIOUS AGNT DETECT BY DNA OR RNA, NOS, AMP PROBE TECH,EA ORGANISM",1638.0,900.9,34.11,1416.87,53
CPT,87798,"HC LEGIONELLA MICDADEI NAAT, INFCT AGNT DETCT DNA AMPLF PROBE NOS",340.0,187.0,34.11,294.1,53
CPT,87798,"HC LEPTOSPIRA PCR, INFC AGNT DTCT BY NA, NOS, AMP PRB, EA ORG",578.0,317.9,34.11,499.97,53
CPT,87798,"HC MEASLES PCR THROAT SWAB, INFC AGNT DETECT BY NA, NOS; AMP PROBE, EA ORG",503.0,276.65,34.11,435.1,53
CPT,87798,"HC MICROSPORIDIA PC, INFCT AGNT DETECT BY NA, NOS, AMP PROBE TECH, EA ORG",432.0,237.6,34.11,373.68,53
CPT,87798,"HC PARVOVIRUS PCR QUANT, INFCT AGNT DTCT BY NA, NOS, AMP PROBE TECH, EA ORG",506.0,278.3,34.11,437.69,53
CPT,87798,"HC PLASMODIUM SPECIES PCR, INFC AGNT DTCT BY NA, NOS, AMP PRB, EA ORG",131.0,72.05,34.11,175.45,53
CPT,87798,"HC PNEUMOCYSTIS JIROVECII, INFC AGNT DTCT BY NA, NOS, AMP PRB, EA ORG",1102.0,606.1,34.11,953.23,53
CPT,87798,"HC PNEUMOCYSTIS PCR, INFC AGNT DTCT BY NA, NOS, AMP PRB, EA ORG",2232.0,1227.6,34.11,1930.68,53
CPT,87798,"HC SHIGA TOXIN 1, INFCT AGNT BY NA, NOS, AMP PROBE TECH, EA ORG",158.0,86.9,34.11,175.45,53
CPT,87798,"HC SHIGA TOXIN 2, INFCT AGNT BY NA, NOS, AMP PROBE TECH, EA ORG",158.0,86.9,34.11,175.45,53
CPT,87798,"HC STREPTOCOCCUS GROUP C/G, INFC AGNT DTCT BY NA, NOS, AMP PRB, EA ORG",83.0,45.65,24.9,175.45,53
CPT,87798,"HC TICK BORNE BABESIA DNA, INFECTIOUS AGENT DETECTION BY NUCLEIC ACID",288.0,158.4,34.11,249.12,53
CPT,87798,"HC TICK BORNE BORRELIA DNA, INFECTIOUS AGENT DETECTION BY NUCLEIC ACID",288.0,158.4,34.11,249.12,53
CPT,87798,"HC TICK BORNE DISEASE PCR, INFCT AGNT DETCT DNA AMPLF PROBE",878.0,482.9,34.11,759.47,53
CPT,87798,"HC TICK BORNE EHLICHIA DNA, INFECTIOUS AGENT DETECTION BY NUCLEIC AC",288.0,158.4,34.11,249.12,53
CPT,87798,"HC TOXOPLASMA GONDI PCR EYE, INFCT AGNT DETECT DNA, AMP PROBE TECH, EA ORG",1539.0,846.45,34.11,1331.24,53
CPT,87798,"HC UREAPLASMA PARVUMPCR, INFECTIOUS AGENT DETECTION BY NUCLEIC ACID",824.0,453.2,34.11,712.76,53
CPT,87798,"HC UREAPLASMA PCR, IADNA NOS AMPLIFIED PROBE TQ EACH ORGANISM",466.0,256.3,34.11,403.09,53
CPT,87798,"HC UREAPLASMA PCR, INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA)",1647.0,905.85,34.11,1424.66,53
CPT,87798,"HC UREAPLASMA UREALYTICUM PCR, INFECTIOUS AGENT DETECTION BY NUCLEIC ACID",824.0,453.2,34.11,712.76,53
CPT,87798,"HC VARICELLA ZOSTER PCR, INFCT AGNT DTCT BY NA, NOS, AMP PROBE TECH, EA ORG",491.0,270.05,34.11,424.72,53
CPT,87798,"HC VIRUS BY PCR TISSUE, INFCT AGNT DTCT BY NA, NOS, AMP PROBE TECH, EA ORG",1706.0,938.3,34.11,1475.69,53
CPT,87798,"HC WEST NILE VIRUS PCR, INFC AGNT DTCT BY NA, NOS, AMP PRB, EA ORG",1071.0,589.05,34.11,926.42,53
CPT,87799,"HC ADENOVIRUS (1), INFC AGNT DTCT BY NA, NOS, QUANTFIC, EA ORG",708.0,389.4,41.64,612.42,53
CPT,87799,"HC ADENOVIRUS (2), INFC AGNT DTCT BY NA, NOS, QUANTFIC, EA ORG",705.0,387.75,41.64,609.83,53
CPT,87799,"HC BK VIRUS PLASMA, INFC AGNT DTCT BY NA, NOS, QUANTFIC, EA ORG",298.0,163.9,41.64,257.77,53
CPT,87799,"HC BK VIRUS URINE, INFC AGNT DTCT BY NA, NOS, QUANTFIC, EA ORG",298.0,163.9,41.64,257.77,53
CPT,87799,"HC BK VIRUS, INFC AGT DTCT BY NA, NOS, QUANT, EA ORGANISM",459.0,252.45,41.64,397.04,53
CPT,87799,"HC EBV, IADNA NOS QUANTIFICATION EACH ORGANISM",526.0,289.3,41.64,454.99,53
CPT,87799,"HC EPSTEIN-BARR (2), INFC AGNT DTCT BY NA, NOS, QUANTFIC, EA ORG",1358.0,746.9,41.64,1174.67,53
CPT,87799,"HC EPSTEIN-BARR PLASMA, INFC AGNT DTCT BY NA, NOS, QUANTFIC, EA ORG",278.0,152.9,41.64,240.47,53
CPT,87799,"HC HEPATITIS D PCR, INFECTIOUS AGENT DETECTION BY NUCLEIC ACID",847.0,465.85,41.64,732.66,53
CPT,87799,"HC HERPES 7 (HHV7) PCR, INFC AGNT DTCT BY NA, NOS, QUANTFIC, EA ORG",1181.0,649.55,41.64,1021.57,53
CPT,87799,"HC HERPES 8 (HHV8), INFC AGNT DTCT BY NA, NOS, QUANTFIC, EA ORG",494.0,271.7,41.64,427.31,53
CPT,87799,"HC JCV DNA ULTRASENSITIVE CSF, IADNA NOS QUANTIFICATION EACH ORGANISM",919.0,505.45,41.64,794.94,53
CPT,87799,"HC PARVOVIRUS B19 (2), INFC AGNT DTCT BY NA, NOS, QUANTFIC, EA ORG",1014.0,557.7,41.64,877.11,53
CPT,87799,HC PARVOVIRUS B19 PCR QUANTITATIVE,567.0,311.85,41.64,490.46,53
CPT,87799,"HC TOXOPLASMA PCR, INFC AGNT DTCT BY NA, NOS, QUANTFIC, EA ORG",1154.0,634.7,41.64,998.21,53
CPT,87799,"HC VZV QUANT EYE, INFCT AGENT DTCT BY NA, NOS, QUANT, EACH ORGANISM",545.0,299.75,41.64,471.43,53
CPT,87799,"HC VZV QUANT PCR, INFECTIOUS AGENT DETECTION BY NUCLEIC ACID",769.0,422.95,41.64,665.19,53
CPT,87800,DETECT AGNT MULT DNA DIREC,,,42.44,218.35,23
CPT,87801,"HC 16 RNA, INFECT AGENT DETECT NUCLEIC ACID, MULTI ORG, AMP PROBE(S) TECH",1941.0,1067.55,68.24,1678.97,53
CPT,87801,"HC BACTERIAL DETECTION PCR, INFC AGNT DTCT BY NA, MULT ORG, AMP PRB",581.0,319.55,68.24,502.57,53
CPT,87801,HC INFC AGT DTCT DNA MULT AMP PRB HIV-1 HCV NAT,128.0,70.4,38.4,351.0,53
CPT,87801,HC INFC AGT DTECT DNA MULTI AMP PRBE HERPES SIMPLX,78.0,42.9,23.4,351.0,53
CPT,87801,"HC UW FUNGAL DETECTION PCR, INFC AGNT DTCT BY NA, MULT ORG, AMP PRB",640.0,352.0,68.24,553.6,53
CPT,87802,STREP B ASSAY W/OPTIC,,,12.38,63.65,23
CPT,87803,CLOSTRIDIUM TOXIN A W/OPTIC,,,15.55,80.0,23
CPT,87804,INFLUENZA ASSAY W/OPTIC,,,16.08,82.75,23
CPT,87806,HIV AG W/HIV1&2 ANTB W/OPTIC,,,31.85,163.85,23
CPT,87807,RSV ASSAY W/OPTIC,,,12.74,65.5,23
CPT,87808,TRICHOMONAS ASSAY W/OPTIC,,,14.87,76.45,23
CPT,87809,"HC INFC AGNT ANTIGEN DETECT BY IMMUNOASSAY W/DIRECT OPTICAL OBS, ADENOVIRUS",55.0,30.25,16.5,108.8,106
CPT,87810,CHLMYD TRACH ASSAY W/OPTIC,,,34.31,176.45,23
CPT,87811,SARS-COV-2 COVID19 W/OPTIC,,,40.22,206.9,23
CPT,87850,N. GONORRHOEAE ASSAY W/OPTIC,,,23.87,122.8,23
CPT,87880,"HC INFECT AGENT ANTIGEN DETECT BY IMMUNOASSAY W/ DIR OPTIC OBSERV, STREP A",205.0,112.75,16.07,177.33,106
CPT,87880,"HC RAPID STREP, INFC AGENT ANTIGEN DETECT BY IMMUNOASSAY W DIRECT OPT OBSRV",88.0,48.4,16.07,82.65,53
CPT,87899,HC INFC AGT ANTG DTCT IMMNASSY OBSV STREP PNEUM,59.0,32.45,15.62,80.35,53
CPT,87899,"HC LEGIONELLA AG, INFC AGNT AG DTCT IMMASSY W/ DIR OPT OBSV, NOS",206.0,113.3,15.62,178.19,53
CPT,87900,"HC CMV, INFC AGNT DRUG SUSCEPT PHENOTYP PREDICT W GENOTYP BIOINF",741.0,407.55,126.7,651.75,53
CPT,87900,"HC HEP C VIR GENOSURE, INFC AGNT DRUG SUSCEPT PHENOTYP PREDICT W/ BIOINFORM",703.0,386.65,126.7,651.75,53
CPT,87900,"HC HEP C VIR NS5A, INFC AGNT DRUG SUSCEPT PHENOTYP PREDICT W GENOTYP BIOINF",821.0,451.55,126.7,710.17,53
CPT,87900,"HC HIV (2), INFC AGNT DRUG SUSCEPT PHENOTYP PREDICT W GENOTYP BIOINF",976.0,536.8,126.7,844.24,53
CPT,87900,"HC HIV-1 GENOSURE ARCHIVE, INFC AGNT DRUG SUSCEPT PHENOTYP PREDICT W GENTYP",821.0,451.55,126.7,710.17,53
CPT,87900,"HC HIV-1 PHENOTYP, INFC AGNT DRUG SUSCEPT PHENOTYP PREDICT W GENOTYP BIOINF",597.0,328.35,126.7,651.75,53
CPT,87901,"HC HIV-1 GENOSURE ARCH, INFC AGNT GENOTYP ANLYS BY NA, REVR TRNSCRIPT&PROT",1285.0,706.75,250.25,1287.25,53
CPT,87901,"HC HIV-1 II, INFC AGNT GENOTYP ANLYS BY NA, REVR TRNSCRIPT&PROTEASE",955.0,525.25,250.25,1287.25,53
CPT,87901,"HC HIV-1(2), INFC AGNT GENOTYP ANLYS BY NA, REVR TRNSCRIPT&PROTEASE",1930.0,1061.5,250.25,1669.45,53
CPT,87902,"HC HCV NS5A DRUG RESIST, INFC AGNT GENOTYPE ANALYS BY NA, HEPATITIS C VIRUS",1531.0,842.05,250.25,1324.32,53
CPT,87902,"HC HEPATITIS C VIRUS HIGH RES, INFC AGNT GENOTYP ANLYS BY NA",687.0,377.85,206.1,1287.25,53
CPT,87902,"HC INFC AGNT GENOTYPE ANALYS BY NA, HEPATITIS C VIRUS",1585.0,871.75,250.25,1371.03,53
CPT,87902,HC INFC AGT GENOTYP ANALY NUCLEIC ACID HEP C SEQUENCING,661.0,363.55,198.3,1287.25,53
CPT,87902,HC INFC AGT GENOTYP ANALY NUCLEIC ACID HEP C VIRUS,862.0,474.1,250.25,1287.25,106
CPT,87902,HC INFC AGT GENOTYP ANALY NUCLEIC ACID HEP C VIRUS NS5A DETECTION,817.0,449.35,245.1,1287.25,53
CPT,87903,HC INF AGT HIV-1 DNA PHENTYP ANLY 1-10 DRUG RESIST,1720.0,946.0,474.98,2443.3,53
CPT,87904,HC PHENOTYPE DNA HIV W CLT ADD,104.0,57.2,25.34,130.35,53
CPT,87905,IA NZMTC ACTV OTH/THN VIRUS,,,11.87,61.1,23
CPT,87906,"HC HIV-1 GENOSURE ARCHIVE, INFC AGNT GENOTYP ANLYS BY NA, OTHER REGION",362.0,199.1,108.6,643.65,53
CPT,87906,"HC HIV-1 INTEGRASE, INFC AGNT GENOTYP ANLYS BY NA, OTHER REGION",784.0,431.2,125.13,678.16,53
CPT,87910,"HC CYTOMEGALOVIRUS RESISTANCE LETERMOVIR, NFCT AGT GENOTYPE NUCLEIC ACID",418.0,229.9,125.4,1287.25,53
CPT,87910,HC INF AGT GENTYP NUCLEIC ACID CYTMEGALVIR UL97-54,1617.0,889.35,250.25,1398.71,53
CPT,87912,HC INFC AGT GENOTYPE ANALY BY NUCLEIC ACID HEP B VIRUS (2),862.0,474.1,250.25,1287.25,53
CPT,87913,NFCT AGT GNTYP ALYS SARSCOV2,,,250.25,1287.25,23
CPT,87999,HC MICROBIOLOGY PROCEDURE,53.0,29.15,15.9,45.85,38
CPT,87999,"HC TROFILE DNA, UNLIST MICROBIOLOGY PROC",4281.0,2354.55,1284.3,3703.07,38
CPT,88000,AUTOPSY (NECROPSY) GROSS,,,205.21,1002.81,7
CPT,88005,AUTOPSY (NECROPSY) GROSS,,,239.46,1170.21,7
CPT,88007,AUTOPSY (NECROPSY) GROSS,,,250.66,1224.94,7
CPT,88012,AUTOPSY (NECROPSY) GROSS,,,205.21,1002.81,7
CPT,88014,AUTOPSY (NECROPSY) GROSS,,,188.08,919.11,7
CPT,88016,AUTOPSY (NECROPSY) GROSS,,,262.19,1281.28,7
CPT,88020,AUTOPSY (NECROPSY) COMPLETE,,,353.43,1727.15,7
CPT,88025,AUTOPSY (NECROPSY) COMPLETE,,,341.9,1670.81,7
CPT,88027,AUTOPSY (NECROPSY) COMPLETE,,,364.63,1781.87,7
CPT,88028,AUTOPSY (NECROPSY) COMPLETE,,,205.21,1002.81,7
CPT,88029,AUTOPSY (NECROPSY) COMPLETE,,,205.21,1002.81,7
CPT,88036,LIMITED AUTOPSY,,,102.44,500.6,7
CPT,88037,LIMITED AUTOPSY,,,91.24,445.87,7
CPT,88040,FORENSIC AUTOPSY (NECROPSY),,,569.84,2784.68,7
CPT,88045,CORONERS AUTOPSY (NECROPSY),,,56.98,278.47,7
CPT,88104,CYTOPATH FL NONGYN SMEARS,,,33.01,202.27,22
CPT,88106,CYTOPATH FL NONGYN FILTER,,,24.26,243.59,22
CPT,88108,HC CYTOPATH CONCENTRATN TECHQ SMEARS & INTERP (2),381.0,209.55,33.01,329.57,53
CPT,88112,HC CYTOPATH CELL ENHANCE LIQUID BASE PREP & INTERP,396.0,217.8,48.74,342.54,53
CPT,88120,CYTP URNE 3-5 PROBES EA SPEC,,,152.85,2592.04,22
CPT,88121,CYTP URINE 3-5 PROBES CMPTR,,,152.85,1788.84,22
CPT,88125,FORENSIC CYTOPATHOLOGY,,,48.74,69.75,22
CPT,88130,SEX CHROMATIN IDENTIFICATION,,,17.48,89.9,22
CPT,88140,SEX CHROMATIN IDENTIFICATION,,,7.77,39.95,22
CPT,88141,CYTOPATH C/V INTERPRET,,,22.4,110.58,22
CPT,88142,CYTOPATH C/V THIN LAYER,,,19.69,101.3,22
CPT,88143,CYTOPATH C/V THIN LAYER REDO,,,22.4,115.2,22
CPT,88147,CYTOPATH C/V AUTOMATED,,,49.14,252.8,22
CPT,88148,CYTOPATH C/V AUTO RESCREEN,,,16.82,86.55,22
CPT,88150,CYTOPATH C/V MANUAL,,,16.82,86.55,22
CPT,88152,CYTOPATH C/V AUTO REDO,,,26.87,138.2,22
CPT,88153,CYTOPATH C/V REDO,,,23.36,120.15,22
CPT,88155,CYTOPATH C/V INDEX ADD-ON,,,14.24,73.25,22
CPT,88160,HC CYTOPATH SMEARS SCREENING & INTERP (1),33.0,18.15,9.9,237.68,53
CPT,88161,HC CYTOPATH SMEARS PREP SCREEN & INTERP,153.0,84.15,24.26,247.34,53
CPT,88161,HC CYTOPATH SMEARS PREP SCRN & INTERP STRICT MORPH,196.0,107.8,24.26,247.34,53
CPT,88162,CYTOPATH SMEAR OTHER SOURCE,,,48.74,384.16,22
CPT,88164,CYTOPATH TBS C/V MANUAL,,,16.82,86.55,22
CPT,88165,CYTOPATH TBS C/V REDO,,,41.03,211.1,22
CPT,88166,CYTOPATH TBS C/V AUTO REDO,,,16.82,86.55,22
CPT,88167,CYTOPATH TBS C/V SELECT,,,16.82,86.55,22
CPT,88172,HC CYTOPATH FINE NDL ASPIR EVALUATION (1),419.0,230.45,98.72,362.44,53
CPT,88173,HC CYTOPATH FINE NDL ASPIR EVALUATION INTERP & RPT,154.0,84.7,46.2,443.17,53
CPT,88174,CYTOPATH C/V AUTO IN FLUID,,,24.66,126.85,22
CPT,88175,HC CYTOPATH PAP THIN LAY PREP AUTO RE-DX WO INTERP,285.0,156.75,25.87,246.53,53
CPT,88175,HC CYTPATH PAP THIN LAY PREP AUTO RE-SCRN WO INTRP,285.0,156.75,25.87,246.53,53
CPT,88177,CYTP FNA EVAL EA ADDL,,,7.9,38.63,22
CPT,88182,HC FLOW CTOMETRY/ CELL CYCLE/ DNA ANALYSIS/ TELOMERE LENGTH,428.0,235.4,48.74,583.21,53
CPT,88184,"HC ALPHA BETA AND GAMMA DELTA T CELLS BY FLOW CYTOMET,MRK,TECH,1ST",389.0,213.95,116.7,388.93,53
CPT,88184,"HC BAND 3 FLUORESCENT STAINING, FLOWCYTOMETRY/ TC 1 MARKER",809.0,444.95,242.7,699.79,53
CPT,88184,"HC CVID, FLOW CYTOMETRY, TECH COMPONENT, FIRST MARKER",380.0,209.0,114.0,388.93,53
CPT,88184,HC FLOW CYTOMETRY TECH COMPONENT 1ST MARKER AHUS CD46,380.0,209.0,114.0,388.93,53
CPT,88184,HC FLOW CYTOMETRY TECH COMPONENT 1ST MARKER BILL,380.0,209.0,114.0,388.93,53
CPT,88184,HC FLOW CYTOMETRY TECH COMPONENT 1ST MARKER HLA ANTBD SOLID,386.0,212.3,115.8,388.93,53
CPT,88184,HC FLOW CYTOMETRY TECH COMPONENT 1ST MARKER IGE RECEPT,380.0,209.0,114.0,388.93,53
CPT,88184,HC FLOW CYTOMETRY TECH COMPONENT 1ST MARKER PGE,380.0,209.0,114.0,388.93,53
CPT,88184,HC FLOW CYTOMETRY TECH COMPONENT 1ST MARKER RBC BAND 3 PROTEIN REDUCT,380.0,209.0,114.0,388.93,53
CPT,88184,HC FLOW CYTOMETRY TECH COMPONENT 1ST MARKER ZAP,380.0,209.0,114.0,388.93,53
CPT,88184,"HC NEUTROPHIL OX BURST, FLOW CYTOMETRY, TECH COMPONENT, FIRST MARKER",380.0,209.0,114.0,388.93,53
CPT,88184,"HC PID2, FLOW CYTOMETRY, TECH COMPONENT, FIRST MARKER",380.0,209.0,114.0,388.93,53
CPT,88184,"HC T-CELL CLONALITY, FLOW CYTOMETRY, TECH COMPONENT, FIRST MARKER",380.0,209.0,114.0,388.93,53
CPT,88184,"HC URTICARIA INDUCED BASOPHIL, FLOW CYTOMET, MRK, TECH, 1ST",402.0,221.1,120.6,388.93,53
CPT,88185,HC ALPHA BETA AND GAMMA DELTA T CELLS ADDITIONAL MARKERS,82.0,45.1,21.05,114.28,53
CPT,88185,"HC CVID, FLOW CYTOMETRY, TECH COMPONENT, ADDITIONAL MARKER",24.0,13.2,7.2,114.28,53
CPT,88185,HC FLOW CYTOMETRY TECH COMPONENT ADDL MARKER,104.0,57.2,21.05,114.28,53
CPT,88185,HC FLOW CYTOMETRY TECH COMPONENT ADDL MARKER AHUS CD46,56.0,30.8,16.8,114.28,53
CPT,88185,HC FLOW CYTOMETRY TECH COMPONENT ADDL MARKER IGE RECEPT,64.0,35.2,19.2,114.28,53
CPT,88185,HC FLOW CYTOMETRY TECH COMPONENT ADDL MARKER ZAP,41.0,22.55,12.3,114.28,53
CPT,88185,"HC NEUTROPHIL OX BURST, FLOW CYTOMETRY, TECH COMPONENT, ADDITIONAL MARKER",42.0,23.1,12.6,114.28,53
CPT,88185,"HC PID2, FLOW CYTOMETRY, TECH COMPONENT, ADDITIONAL MARKER",25.0,13.75,7.5,114.28,53
CPT,88185,"HC T-CELL CLONALITY, FLOW CYTOMETRY, TECH COMPONENT, ADDITIONAL MARKER",7.0,3.85,2.1,114.28,53
CPT,88185,"HC URTICARIA INDUCED BASOPHIL, FLOW CYTOMET, MRK, TECH, EA AD (AD)",81.0,44.55,21.05,114.28,53
CPT,88187,FLOWCYTOMETRY/READ 2-8,,,33.23,169.36,22
CPT,88188,FLOWCYTOMETRY/READ 9-15,,,56.38,296.66,22
CPT,88189,FLOWCYTOMETRY/READ 16 & >,,,76.79,401.75,22
CPT,88199,UNLISTED CYTOPATHOLOGY PX,,,48.74,60.17,20
CPT,88230,HC LYMPHOCYTE TISSUE CULTURE,652.0,358.6,113.23,582.45,53
CPT,88230,HC LYMPHOCYTE TISSUE CULTURE FANCONI CHROMOSOME,1197.0,658.35,113.23,1035.41,53
CPT,88233,HC SKIN TISSUE CULTURE BX,785.0,431.75,136.79,703.65,53
CPT,88233,HC SKIN TISSUE CULTURE BX ADDL TISSUE BILL,709.0,389.95,136.79,703.65,53
CPT,88233,HC SKIN TISSUE CULTURE BX SETUP,692.0,380.6,136.79,703.65,53
CPT,88235,HC TISSUE CULTURE AMNIOTIC FLUID,612.0,336.6,146.09,751.5,53
CPT,88235,HC TISSUE CULTURE CHORIONIC VILLUS CELLS,703.0,386.65,146.09,751.5,53
CPT,88237,HC TISS CULTR NEOPLASTC DISORD BLD BONE MARW SETUP,760.0,418.0,139.73,718.75,53
CPT,88237,HC TISSUE CULTURE NEOPLASTIC DISORDER BONE MARROW,760.0,418.0,139.73,718.75,53
CPT,88239,HC TISSUE CULTURE SOLID TUMOR,784.0,431.2,143.39,737.6,53
CPT,88239,HC TISSUE CULTURE SOLID TUMOR SETUP,616.0,338.8,143.39,737.6,53
CPT,88240,HC CELL CRYOPRESERVE STORAGE,68.0,37.4,12.7,65.35,53
CPT,88241,FROZEN CELL PREPARATION,,,11.75,60.45,22
CPT,88245,CHROMOSOME ANALYSIS 20-25,,,168.32,865.85,22
CPT,88248,HC CHROMOSOME ANALY BREAKG 50-100 FANCONI DEB ADDL,696.0,382.8,168.32,865.85,53
CPT,88249,HC FANCONI CHROMS ANLY BREAKG SYNDRM SCORE 100 CEL,1380.0,759.0,168.32,1193.7,53
CPT,88261,CHROMOSOME ANALYSIS 5,,,256.94,1321.7,22
CPT,88262,HC CHROMS ANALY CNT 15-20 CELLS 2 KARYOTYPE W BAND,630.0,346.5,121.98,627.45,53
CPT,88263,CHROMOSOME ANALYSIS 45,,,146.09,751.45,22
CPT,88264,HC CHROMOSOME ANALYSIS 20-25 CELLS,1520.0,836.0,140.56,1314.8,53
CPT,88267,HC CHROMS ANLY AMN FLD OR CHOR VIL CEL CNT 15 CEL,798.0,438.9,183.29,942.85,53
CPT,88267,HC CHROMS ANLY CHORNC VIL CEL CNT 15 CEL 1 KARYTYP,1334.0,733.7,183.29,1153.91,53
CPT,88269,CHROMOSOME ANALYS AMNIOTIC,,,168.8,868.3,22
CPT,88271,"HC ALK 2P23 FISH PROBE, MOLECULAR CYTOGENETICS DNA PROBE EACH",1869.0,1027.95,20.82,1616.69,53
CPT,88271,"HC ALL (B-CELL) CYTOGENETIC PROBE, MOLECULAR CYTOGENETICS, DNA PROBE, EACH",933.0,513.15,20.82,807.05,53
CPT,88271,"HC AML FISH PROBE, MOL CYTOGEN, DNA PROBE, EA",983.0,540.65,20.82,850.3,53
CPT,88271,"HC DUSP22 (IR) (6P25.3)M FISH, MOLECULAR CYTOGENETICS",1750.0,962.5,20.82,1513.75,53
CPT,88271,"HC ENDOMETRIAL STROMAL TUMOR FISH, MOLECULAR CYTOGENETICS DNA PROBE EACH",1630.0,896.5,20.82,1409.95,53
CPT,88271,"HC ETV6 FISH, MOLECULAR CYTOGENETICS DNA PROBE, EACH",1828.0,1005.4,20.82,1581.22,53
CPT,88271,"HC EWSR1 (22Q12) FISH, MOLECULAR CYTOGENETICS DNA PROBE EACH",1869.0,1027.95,20.82,1616.69,53
CPT,88271,"HC FGFR2 (10Q26.1), FISH, MOL CYTOGEN, DNA PROBE, EA",1341.0,737.55,20.82,1159.97,53
CPT,88271,"HC FISH CYTOGENETICS PROBE, MOLECULAR CYTOGENETICS, DNA PROBE, EACH",1208.0,664.4,20.82,1044.92,53
CPT,88271,"HC FISH DNA PROBE, MOLECULAR CYTOGENETICS, DNA PROBE, EACH",164.0,90.2,20.82,141.86,53
CPT,88271,"HC I(12P) GERM CELL TUMOR FISH, MOLECULAR CYTOGENETICS DNA PROBE",2019.0,1110.45,20.82,1746.44,53
CPT,88271,"HC MAYO MAML2 REARRANGEMENT MEC FISH, MOLECULAR CYTOGENICS DNA PROBE EA",1352.0,743.6,20.82,1169.48,53
CPT,88271,"HC MAYO MYB (6Q23), DNA PROBE, FISH",2016.0,1108.8,20.82,1743.84,53
CPT,88271,"HC MAYO USP6 (17P13) FISH, MOLECULAR CYTOGENETICS DNA PROBE EACH",1630.0,896.5,20.82,1409.95,53
CPT,88271,"HC MET 7Q31 FISHG PROBE, MOLECULAR CYTOGENETICS DNA PROBE EACH",1777.0,977.35,20.82,1537.11,53
CPT,88271,HC MOLECULAR CYTOGENETICS DNA PROBE,284.0,156.2,20.82,245.66,53
CPT,88271,HC MOLECULAR CYTOGENETICS DNA PROBE FDA EACH,991.0,545.05,20.82,857.22,53
CPT,88271,HC MOLECULAR CYTOGENETICS DNA PROBE FISH FGFR,1503.0,826.65,20.82,1300.1,53
CPT,88271,HC MOLECULAR CYTOGENETICS DNA PROBE ROS1 FISH EACH,539.0,296.45,20.82,466.24,53
CPT,88271,"HC MYELOID SARCOMA FISH, MOLECULAR CYTOGENETICS; DNA PROBE, EACH",1415.0,778.25,20.82,1223.98,53
CPT,88271,"HC NR4A3 REARRANGEMENT FISH, MOLECULAR CYTOGENETICS DNA PROBE EACH",2361.0,1298.55,20.82,2042.27,53
CPT,88271,"HC PLASMA CELL PROLIFERATION FISH, MOLECULAR CYTOGENETICS DNA PROBE EACH",2808.0,1544.4,20.82,2428.92,53
CPT,88271,"HC PRKACA REARRANGEMENT, MOL CYTOGEN, DNA PROBE, EA",1341.0,737.55,20.82,1159.97,53
CPT,88271,"HC TFE3, MOLECULAR CYTOGENETICS DNA PROBE, EA",1959.0,1077.45,20.82,1694.54,53
CPT,88271,"HC TFEB, MOLECULAR CYTOGENETICS DNA PROBE, EA",1467.0,806.85,20.82,1268.96,53
CPT,88271,"HC TP63 (3Q28) DNAQ PROBE, MOLECULAR CYTOGENICS DNA EA",1183.0,650.65,20.82,1023.3,53
CPT,88271,"HC UROTHELIAL CANCER, MOLECULAR CYTOGENETICS, DNA PROBE, EACH",258.0,141.9,20.82,223.17,106
CPT,88272,"HC MOLECULAR CYTOGENETICS, CHRMOML IN SITU HYBRIDIZATION, ANALYZE 3-5 CELLS",106.0,58.3,31.8,203.5,53
CPT,88273,HC MOL CYTGN CHROMS IN SIT HYBD ANLY 10-30CEL FISH,369.0,202.95,33.83,319.19,53
CPT,88274,HC MOLECULAR CYTOGENETICS INTERPHASE IN SITU HYBRIDIZATION 25-99 CELLS,288.0,158.4,41.19,249.12,53
CPT,88275,"HC AML, MOL CYTOGEN, INTERPHASE ISH, ANALYZE 100-300 CELLS",903.0,496.65,49.76,781.1,53
CPT,88275,HC FISH ANALYZE 100-300 CELLS,288.0,158.4,49.76,255.95,53
CPT,88275,"HC FISH INTERPHASE 100-300, MOLECULAR CYTOGENETICS",101.0,55.55,30.3,255.95,53
CPT,88275,HC MOL CYT INTRPHS INSIT HYBD ANLY 100-300CEL ROS1,771.0,424.05,49.76,666.92,53
CPT,88275,HC MOL CYTGN INTRPH 5 IN SIT HYBD ANLY 100-300 CEL,717.0,394.35,49.76,620.21,53
CPT,88275,HC MOL CYTGN INTRPHS IN SITU HYBD ANLY 100-300 CELLS FISH FGFR,625.0,343.75,49.76,540.63,53
CPT,88280,HC CHROMOSOME ANALYSIS ADDL KARYOTYPE EA STUDY,82.0,45.1,24.6,167.35,53
CPT,88280,"HC NEOPLASTIC DISEASE, CHROMOSOME ANALYSIS, ADDL KAROTYPES, EA STUDY",139.0,76.45,32.53,167.35,53
CPT,88283,CHROMOSOME BANDING STUDY,,,66.68,343.0,22
CPT,88285,HC CHROMOSOME COUNT ADDITIONAL,112.0,61.6,26.15,134.55,53
CPT,88289,HC CHROMOSOME STUDY ADDITIONAL,266.0,146.3,33.47,230.09,53
CPT,88291,CYTO/MOLECULAR REPORT,,,31.63,156.78,22
CPT,88299,UNLISTED CYTOGENETIC STUDY,,,48.74,60.17,20
CPT,88300,HC LEVEL I SURG PATH GROSS EXAM ONLY,113.0,62.15,24.26,97.75,53
CPT,88302,HC LEVEL II SURGICAL PATHOLOGY COMPLEX,255.0,140.25,24.26,220.58,53
CPT,88304,HC LEVEL III SURG PATH GROSS & MICROSCOPIC EXAM,352.0,193.6,48.74,304.48,53
CPT,88305,"HC ENF NERVE, LEVEL IV SURGICAL PATHOLOGY",634.0,348.7,48.74,548.41,53
CPT,88305,HC LEVEL IV PROSTATE NEEDLE BX SURG PATH GROSS & MICROSCOPIC EXAM,379.0,208.45,48.74,327.84,53
CPT,88305,HC LEVEL IV SURG PATH GROSS & MICROSCOPIC EXAM,258.5,142.175,41.4,327.84,159
CPT,88305,"HC NML MUSCLE, LEVEL IV SURG PATH GROSS & MICROSCOPIC EXAM",59.5,32.73,17.85,166.33,53
CPT,88305,"HC NML NERVE, LEVEL IV SURG PATH GROSS & MICROSCOPIC EXAM",59.5,32.73,17.85,166.33,53
CPT,88307,HC BONE HISTOMORPHOLOGY LEVEL V,7078.0,3892.9,315.04,6122.47,53
CPT,88307,HC LEVEL V SURG PATHOLOGY GROSS & MICROSCOPIC EXAM,872.5,479.875,236.4,1001.72,159
CPT,88307,"HC NML MUSCLE, LEVEL V SURG PATHOLOGY GROSS & MICROSCOPIC EXAM",441.0,242.55,132.3,1001.72,53
CPT,88307,"HC NML NERVE, LEVEL V SURG PATHOLOGY GROSS & MICROSCOPIC EXAM",441.0,242.55,132.3,1001.72,53
CPT,88309,HC LEVEL VI SURG PATH GROSS & MICROSCOPIC EXAM,1146.0,630.3,340.5,1417.0,159
CPT,88311,HC DECALCIFY TISSUE,109.0,59.95,8.23,94.29,53
CPT,88312,"HC SPECIAL STAIN, GRP I MICROORGANISMS",673.0,370.15,48.74,582.15,53
CPT,88312,HC SPECIAL STAINS GROUP I,240.0,132.0,48.74,414.21,53
CPT,88312,HC SPECIAL STAINS GROUP I_NEPHROPATH,526.0,289.3,48.74,454.99,53
CPT,88313,HC BONE HISTOMORPHOLOGY SPECIAL STAIN,323.0,177.65,33.01,335.34,53
CPT,88313,HC MAYO SPECIAL STAINS GROUP II_CONGO RED IHC,533.0,293.15,33.01,461.05,53
CPT,88313,"HC NML MUSCLE, SPECIAL STAINS GROUP II",347.0,190.85,33.01,335.34,53
CPT,88313,"HC NML NERVE, SPECIAL STAINS GROUP II",347.0,190.85,33.01,335.34,53
CPT,88313,HC SPECIAL STAIN GROUP II,371.0,204.05,33.01,335.34,53
CPT,88313,HC SPECIAL STAIN II,710.0,390.5,33.01,614.15,53
CPT,88313,"HC SPECIAL STAIN, GROUP II, ALL OTHER",218.0,119.9,33.01,335.34,53
CPT,88313,HC SPECIAL STAINS GROUP II,240.0,132.0,33.01,335.34,106
CPT,88313,HC SPECIAL STAINS GROUP II (2),470.0,258.5,33.01,406.55,53
CPT,88313,HC SPECIAL STAINS GROUP II PUCH MOD BENHOLD,715.0,393.25,33.01,618.48,53
CPT,88313,HC SPECIAL STAINS GROUP II_BONE MARROW IRON,240.0,132.0,33.01,335.34,53
CPT,88313,HC SPECIAL STAINS GROUP II_MAYO,718.0,394.9,33.01,621.07,53
CPT,88314,"HC NML MUSCLE, SPECIAL HISTOCHEM STAINS ON FROZ TISS BLOCK ADD-ON",281.0,154.55,69.17,336.95,53
CPT,88314,"HC NML NERVE, SPECIAL HISTOCHEM STAINS ON FROZ TISS BLOCK (ADD-ON)",281.0,154.55,69.17,336.95,53
CPT,88319,"HC MUSCLE, SPECIAL STAINS GROUP III ENZYME CONSTITUENTS",911.0,501.05,273.3,931.81,53
CPT,88319,"HC NERVE, SPECIAL STAINS GROUP III ENZYME CONSTITUENTS",911.0,501.05,273.3,931.81,53
CPT,88319,HC NML SPECIAL STAIN GROUP III,911.0,501.05,273.3,931.81,53
CPT,88319,HC SPECIAL STAINS GROUP III ENZYME_BONE MARROW NOS ESTERASE,911.0,501.05,273.3,931.81,53
CPT,88321,HC CONSULTATION & REPORT REFERRED SLIDES,646.0,355.3,33.01,558.79,106
CPT,88321,HC CONSULTATION & REPORT REFERRED SLIDES_MAYO,592.0,325.6,33.01,512.08,53
CPT,88323,HC CONSULT & RPT REFER SLIDE REQUIRE SLIDE PREP,634.0,348.7,48.74,548.41,53
CPT,88323,HC MICROSLIDE CONSULT BONE HISTOMORPHOLOGY QUAL,3062.0,1684.1,48.74,2648.63,53
CPT,88325,HC COMPREHENSIVE SURGICAL PATHOLOGY CONSULT,655.0,360.25,152.85,753.26,53
CPT,88329,PATH CONSLTJ DRG SURG,,,33.01,270.18,22
CPT,88331,HC PATH CONSULT INTRAOP 1 BLOC,248.0,136.4,74.4,214.52,53
CPT,88332,PATH CONSLTJ SURG EA ADD BLK,,,24.38,118.04,22
CPT,88333,HC INTRAOP CYTO PATH CONSULT 1,911.0,501.05,153.45,931.81,530
CPT,88334,HC INTRAOP CYTO PATH CONSULT 2,164.0,90.2,19.1,141.86,106
CPT,88341,"HC ARUP IHC, IHC/ICC, PER SPCMN, EA AD SGL AB STAIN (AD)",161.0,88.55,48.3,281.69,53
CPT,88341,"HC ATRX, IHC OR ICC, PER SPECIMEN, EA ADDL SGL ANTBD STAIN PROC (ADD)",338.0,185.9,57.64,292.37,53
CPT,88341,"HC CARIS IHC ADDITIONAL IHC/ ICC, PER SPCMN, EA AD SGL AB STAIN (AD)",129.0,70.95,38.7,281.69,53
CPT,88341,"HC GSPMC IHC, IHC/ICC, PER SPCMN, EA AD SGL AB STAIN (AD)",184.0,101.2,55.2,281.69,53
CPT,88341,"HC IHC OR ICC, PER SPECIMEN, EA ADDL SGL ANTBD STAIN PROC (ADD)",529.0,290.95,57.64,720.55,159
CPT,88341,"HC IHC OR ICC, PER SPECIMEN, INITIAL SINGLE ANTIBODY STAIN PROC, MSH-6",255.0,140.25,57.64,281.69,53
CPT,88341,"HC IHC OR ICC, PER SPECIMEN, INITIAL SINGLE ANTIBODY STAIN PROC, PMS-2",255.0,140.25,57.64,281.69,53
CPT,88341,"HC IHC STAIN (IU), PER SPECIMEN, EA ADDL SGL ANTBD STAIN PROC (ADD)",264.0,145.2,57.64,281.69,53
CPT,88341,"HC IHC STAIN ADDL (NEOGENOMICS), IMHISTOCHEM/CYTCHM EA ADDL AB SLIDE",528.0,290.4,57.64,456.72,53
CPT,88341,"HC MAYO IHC STAIN AND RETURN (NG), PER SPEC, EA ADDL SGL ANTBD STAIN PROC (ADD)",519.0,285.45,57.64,448.94,53
CPT,88341,"HC MAYO IHC STAIN AND RETURN ADDITIONAL, ANTIBODY SLIDE",384.0,211.2,57.64,332.16,53
CPT,88341,"HC MLH-2, IHC OR ICC, PER SPECIMEN, EA ADDL SGL ANTBD STAIN PROC (ADD)",255.0,140.25,57.64,281.69,53
CPT,88341,"HC MSH-6, IHC OR ICC, PER SPECIMEN, EA ADDL SGL ANTBD STAIN PROC (ADD)",280.0,154.0,57.64,281.69,53
CPT,88341,"HC NEPHROPATH, IHC OR ICC, PER SPECIMEN, EA ADDL SGL ANTBD STAIN PROC (ADD)",395.0,217.25,57.64,341.68,53
CPT,88341,"HC NML MUSCLE, IHC OR ICC, PER SPECIMEN, EA ADDL SGL ANTBD STAIN PROC (ADD)",345.0,189.75,57.64,298.43,53
CPT,88341,"HC NML NERVE, IHC OR ICC, PER SPECIMEN, EA ADDL SGL ANTBD STAIN PROC (ADD)",129.0,70.95,38.7,281.69,53
CPT,88341,"HC PDL-1, IHC OR ICC, PER SPECIMEN, EA ADDL SGL ANTBD STAIN PROC (ADD)",888.0,488.4,57.64,768.12,53
CPT,88341,"HC PMS-2, IHC OR ICC, PER SPECIMEN, EA ADDL SGL ANTBD STAIN PROC (ADD)",280.0,154.0,57.64,281.69,53
CPT,88341,"HC PROPATH, IHC OR ICC, PER SPECIMEN, EA ADDL SGL ANTBD STAIN PROC (ADD)",378.0,207.9,57.64,326.97,53
CPT,88341,"HC SOX-11, IHC OR ICC, PER SPECIMEN, EA ADDL SGL ANTBD STAIN PROC (ADD)",338.0,185.9,57.64,292.37,53
CPT,88342,HC ARUP IMUNHIST-CYTCHEM PER SPECMN INIT SGL ANTBD STAIN IHC (1),377.0,207.35,113.1,326.11,53
CPT,88342,"HC ATRX IHC, PER SPECIMEN, INITIAL SINGLE ANTIBODY STAIN PROC",377.0,207.35,113.1,326.11,53
CPT,88342,"HC ATRX, IHC OR ICC, PER SPECIMEN, INITIAL SINGLE ANTIBODY STAIN PROC",377.0,207.35,113.1,326.11,53
CPT,88342,"HC CARIS IHC 1ST MARKER, IHC/ ICC, PER SPCMN, INIT SGL AB STAIN",185.0,101.75,55.5,316.02,53
CPT,88342,"HC ICH STAIN & RETURN (CHW),  IHC OR ICC, PER SPEC, INI SGL AB STAIN PROC",505.0,277.75,151.5,436.83,53
CPT,88342,"HC IHC OR ICC, PER SPECIMEN, INITIAL SINGLE AB STAIN PROC, BRACHYURY IHC",430.0,236.5,129.0,371.95,53
CPT,88342,"HC IHC OR ICC, PER SPECIMEN, INITIAL SINGLE ANTIBODY STAIN PROC, BAF47",430.0,236.5,129.0,371.95,53
CPT,88342,"HC IHC OR ICC, PER SPECIMEN, INITIAL SINGLE ANTIBODY STAIN PROC, IDH1 IHC",430.0,236.5,129.0,371.95,53
CPT,88342,"HC IHC OR ICC, PER SPECIMEN, INITIAL SINGLE ANTIBODY STAIN PROC, MLH-1",377.0,207.35,113.1,326.11,53
CPT,88342,"HC IHC STAIN (IU), PER SPECIMEN, INITIAL SINGLE ANTIBODY STAIN PROC",377.0,207.35,113.1,326.11,53
CPT,88342,"HC IHC STAIN (NEOGENOMICS), IMMUNOHISTO ANTB 1ST STAIN",268.0,147.4,80.4,316.02,53
CPT,88342,"HC IMMUNOPEROXIDE, IHC/ICC, PER SPCMN, INIT SGL AB STAIN",430.0,236.5,129.0,371.95,106
CPT,88342,HC IMUNHIST-CYTCHEM PER SPECMN INIT SGL ANTBD STAIN,430.0,236.5,129.0,371.95,53
CPT,88342,HC IMUNHIST-CYTCHEM PER SPECMN INIT SGL ANTBD STN IMMUNOSTAIN EA,423.0,232.65,126.9,365.9,53
CPT,88342,"HC MAYO STAIN AND RETURN, IHC OR ICC, PER SPEC, INIT SINGLE ANTIBODY STAIN PROC",197.0,108.35,59.1,316.02,53
CPT,88342,"HC NEOGENOMICS IHC STAIN AND RETURN (NG), PER SPEC, INITIAL SINGLE ANTIBODY STAIN PROC",377.0,207.35,113.1,326.11,53
CPT,88342,"HC NML MUSCLE, IHC OR ICC, PER SPECIMEN, INITIAL SINGLE ANTIBODY STAIN PROC",377.0,207.35,113.1,326.11,53
CPT,88342,"HC NML NERVE, IHC OR ICC, PER SPECIMEN, INITIAL SINGLE ANTIBODY STAIN PROC",377.0,207.35,113.1,326.11,53
CPT,88342,"HC PD-L1 IHC KEYTRUDA, IHC OR ICC, PER SPECIMEN, INITIAL SGL AB STAIN PROC",352.0,193.6,105.6,316.02,53
CPT,88342,"HC PDL-1, IHC OR ICC, PER SPECIMEN, INITIAL SINGLE ANTIBODY STAIN PROC",451.0,248.05,135.3,390.12,53
CPT,88342,"HC PHENOPATH IHC STAIN, PER SPECIMEN, INITIAL SINGLE ANTIBODY STAIN PROC",380.0,209.0,114.0,328.7,53
CPT,88342,HC PML IMUNHIST-CYTCHEM PER SPECMN INIT SGL ANTBD STAIN IHC (2),194.0,106.7,58.2,316.02,53
CPT,88342,HC PROPATH IMUNHIST-CYTCHEM PER SPECMN INIT SGL ANTBD STAIN IHC (3),430.0,236.5,129.0,371.95,53
CPT,88342,"HC SOX-11, IHC OR ICC, PER SPECIMEN, INITIAL SINGLE ANTIBODY STAIN PROC",377.0,207.35,113.1,326.11,53
CPT,88342,"HC UCSF, IHC OR ICC, PER SPECIMEN, INITIAL SINGLE ANTIBODY STAIN PROC",439.0,241.45,131.7,379.74,53
CPT,88344,HC IMMUNOHIST-CYTOCHEM PER SPECIMEN EA MULTIPLEX ANTIBD STAIN,535.0,294.25,160.5,626.68,53
CPT,88344,"HC IMMUNOHISTOCHEMISTRY IHC STAIN, PER SPECIMEN EA MULTIPLEX ANTIBODY SLIDE",543.0,298.65,162.9,626.68,53
CPT,88346,"HC BASEMENT MEMB ZONE, IMMUNFLUORES, PER SPCMN, INITIAL SGL AB STAIN",357.0,196.35,107.1,560.69,53
CPT,88346,HC BONE HISTOMORPHOLOGY IMMUNOFLUROESCENCE,3820.0,2101.0,174.14,3304.3,53
CPT,88346,"HC CELIAC PROMETHEUS EMA IGA, IMMUNFLUORES, PER SPCMN, INITIAL SGL AB STAIN",341.0,187.55,102.3,560.69,53
CPT,88346,"HC CUTANEOUS, IMMUNFLUORES, PER SPCMN, INITIAL SGL AB STAIN",372.0,204.6,111.6,560.69,53
CPT,88346,"HC DERM, IMMUNOFLUORESCENCE, PER SPECIMEN, INIT SGL ANTBD STAIN PROC",341.0,187.55,102.3,560.69,53
CPT,88346,"HC ENTEROCYTE, IMMUNOFLUORESCENCE, PER SPECIMEN, INIT SGL ANTBD STAIN PROC",412.0,226.6,123.6,560.69,53
CPT,88346,"HC EPITHELIAL BMZ IGA, IMMUNFLUORES, PER SPCMN, INITIAL SGL AB STAIN",341.0,187.55,102.3,560.69,53
CPT,88346,"HC EPITHELIAL BMZ IGG AB, IMMUNFLUORES, PER SPCMN, INITIAL SGL AB STAIN",341.0,187.55,102.3,560.69,53
CPT,88346,"HC EPITHELIAL CELL SURF, IMMUNFLUORES, PER SPCMN, INITIAL SGL AB STAIN",341.0,187.55,102.3,560.69,53
CPT,88346,"HC IBD, IMMUNFLUORES, PER SPCMN, INITIAL SGL AB STAIN",341.0,187.55,102.3,560.69,53
CPT,88346,"HC IF 88346 STAIN (MAYO), IMMUNOFLUOR, PER SPEC, INIT SGL ANTBD STAIN PROC",341.0,187.55,102.3,560.69,53
CPT,88346,"HC IMMUNOBULLOUS, IMMUNFLUORES, PER SPCMN, INITIAL SGL AB STAIN",341.0,187.55,102.3,560.69,53
CPT,88346,"HC IMMUNOFLUORESCENCE, PER SPECIMEN, INIT SGL ANTBD STAIN PROC",341.0,187.55,102.3,560.69,53
CPT,88346,"HC IMMUNOFLUORESCENCE, PER SPECIMEN, INIT SGL ANTBD STAIN PROC (1)",341.0,187.55,102.3,560.69,53
CPT,88346,"HC IMMUNOFLUORESCENCE, PER SPECIMEN, INIT SGL ANTBD STAIN PROC (2)",341.0,187.55,102.3,560.69,53
CPT,88346,"HC NML MUSCLE, IMMUNOFLUORESCENCE, PER SPECIMEN, INIT SGL ANTBD STAIN PROC",341.0,187.55,102.3,560.69,53
CPT,88346,"HC NML NERVE, IMMUNOFLUORESCENCE, PER SPECIMEN, INIT SGL ANTBD STAIN PROC",341.0,187.55,102.3,560.69,53
CPT,88346,"HC PARANEOPLASTIC PEMPHIGUS, IMMUNFLUORES, PER SPCMN, INITIAL SGL AB STAIN",341.0,187.55,102.3,560.69,53
CPT,88346,"HC PEMPHIGOID, IMMUNFLUORES, PER SPCMN, INITIAL SGL AB STAIN",357.0,196.35,107.1,560.69,53
CPT,88346,"HC PEMPHIGUS IGA, IMMUNOFLUORES, PER SPECMN, INIT SGL AB STAIN PROC",341.0,187.55,102.3,560.69,53
CPT,88348,HC ELECTRON MICROSCOPY,1899.0,1044.45,569.7,1900.41,53
CPT,88348,HC ELECTRON MICROSCOPY DIAGNOSTIC (2),1787.0,982.85,536.1,1900.41,53
CPT,88348,"HC NML MUSCLE, ELECTRON MICROSCOPY, DIAGNOSTIC",1506.0,828.3,451.8,1900.41,53
CPT,88348,"HC NML NERVE, ELECTRON MICROSCOPY, DIAGNOSTIC",1507.0,828.85,452.1,1900.41,53
CPT,88350,"HC BASEMENT MEMB ZONE, IMMUNFLUORES, PER SPCMN, EA ADL SGL AB STAIN (AD)",191.0,105.05,57.3,422.26,53
CPT,88350,"HC CUTANEOUS, IMMUNFLUORES, PER SPCMN, EA ADL SGL AB STAIN (AD)",313.0,172.15,86.63,422.26,53
CPT,88350,"HC DERM IF, IMMUNOFLORESCENCE, PER SPECIMEN, EA ADDL ANTBD STAIN (ADD)",497.0,273.35,86.63,429.91,53
CPT,88350,"HC ENTEROCYTE, IMMUNOFLORESCENCE, PER SPECIMEN, EA ADDL ANTBD STAIN (ADD)",494.0,271.7,86.63,427.31,53
CPT,88350,"HC EPITHELIAL BMZ IGA, IMMUNFLUORES, PER SPCMN, EA ADL SGL AB STAIN (AD)",333.0,183.15,86.63,422.26,53
CPT,88350,"HC EPITHELIAL BMZ IGG, IMMUNFLUORES, PER SPCMN, EA ADL SGL AB STAIN (AD)",336.0,184.8,86.63,422.26,53
CPT,88350,"HC EPITHELIAL CELL SURF, IMMUNFLUORES, PER SPCMN, EA ADL SGL AB STAIN (AD)",333.0,183.15,86.63,422.26,53
CPT,88350,"HC IBD SENSITIVITY, IMMUNFLUORES, PER SPCMN, EA ADL SGL AB STAIN (AD)",234.0,128.7,70.2,422.26,53
CPT,88350,"HC IMMUNOBULLOUS, IMMUNFLUORES, PER SPCMN, EA ADL SGL AB STAIN (AD)",441.0,242.55,86.63,422.26,53
CPT,88350,"HC IMMUNOFLORESCENCE, PER SPECIMEN, EA ADDL ANTBD STAIN (ADD)",269.0,147.95,69.9,422.26,106
CPT,88350,"HC NML MUSCLE, IMMUNOFLORESCENCE, PER SPECIMEN, EA ADDL ANTBD STAIN (ADD)",233.0,128.15,69.9,422.26,53
CPT,88350,"HC NML NERVE, IMMUNOFLORESCENCE, PER SPECIMEN, EA ADDL ANTBD STAIN (ADD)",233.0,128.15,69.9,422.26,53
CPT,88350,"HC PARANEOPLAS PEMPHIGUS, IMMUNFLUORES, PER SPCMN, EA ADL SGL AB STAIN (AD)",265.0,145.75,79.5,422.26,53
CPT,88350,"HC PEMPHIGOID, IMMUNFLUORES, PER SPCMN, EA ADL SGL AB STAIN (AD)",191.0,105.05,57.3,422.26,53
CPT,88350,"HC PEMPHIGUS IGA, IMMUNOFLUORES, PER SPECMN, EA ADL SGL AB STAIN PROC (AD)",447.0,245.85,86.63,422.26,53
CPT,88355,M/PHMTRC ALYS SKELETAL MUSC,,,152.85,289.19,22
CPT,88356,"HC ENF, MORPHOMETRIC ANALYSIS, NERVE",1384.0,761.2,48.74,1197.16,53
CPT,88358,ANALYSIS TUMOR,,,152.85,435.14,22
CPT,88360,"HC CARIS IHC QUANT, MORPHMTR ANLYS, TUM, PER SPCMN, EA SGL AB STAIN, MAN",185.0,101.75,55.5,370.75,53
CPT,88360,"HC DLL3 IHC MORPHMTR ANLYS, TUM IHC, PER SPCMN, EA SGL AB STAIN, MAN",617.0,339.35,152.85,533.71,53
CPT,88360,"HC DLL3(SP347), MORPHMTR ANLYS, TUM IHC, PER SPCMN, EA SGL AB STAIN, MAN",562.0,309.1,152.85,486.13,53
CPT,88360,"HC HER 2/NEU TISS, MORPHMTR ANLYS, TUM IHC, PER SPCMN, EA SGL AB STAIN, MAN",698.0,383.9,152.85,603.77,53
CPT,88360,"HC HER2 IHC, MORPH ANLY TUMOR IMNHISTCHEM, PER SPECMN, EA SGL ANTBD STN",301.0,165.55,90.3,370.75,53
CPT,88360,"HC IHC GASTRIC, MORPH ANLY TUMOR IMNHISTCHEM, PER SPECMN, EA SGL ANTBD STN",1012.0,556.6,152.85,875.38,53
CPT,88360,"HC IHC QUANT MORPHMTR ANLYS, TUM IHC, PER SPCMN, EA SGL AB STAIN, MAN",267.0,146.85,80.1,370.75,53
CPT,88360,"HC KI-67 AB, MORPHMETR ANLYS, TUM IHC, PER SPCMN, EA SGL AB STAIN, MANUAL",307.0,168.85,92.1,370.75,53
CPT,88360,HC MORPH ANLY TUMOR IMNHISTCHEM PER SPECMN INIT SGL ANTBD STAIN TECH,454.0,249.7,136.2,392.71,106
CPT,88360,HC MORPH ANLY TUMOR PER SPECMN INIT SGL ANTBD STN HER-2 NEU PROTEIN,535.0,294.25,152.85,462.78,53
CPT,88360,"HC PD-L1 22C3, MORPHMTR ANLYS, TUM IHC, PER SPCMN, EA SGL AB STAIN, MAN",557.0,306.35,152.85,481.81,53
CPT,88360,"HC SDHB BY IHC, TUMOR IMMUNOHISTOCHEM/MANUAL",307.0,168.85,92.1,370.75,53
CPT,88361,"HC QUANT, MORPHMTR ANLYS, TUM IHC, PER SPCMN, EA SGL AB STAIN, COMP-ASST",389.0,213.95,116.7,388.93,53
CPT,88362,HC NML NERVE TEASING PREPARATIONS,873.0,480.15,261.9,931.81,53
CPT,88363,XM ARCHIVE TISSUE MOLEC ANAL,,,24.26,110.43,22
CPT,88364,"HC HPV RNA ISH (NEOGENOMICS) ADDL, INSITU HYBRIDIZATION EA ADDL PROBE STAIN",731.0,402.05,101.45,632.32,53
CPT,88364,"HC HPV SUBTYPES, IN-SITU HYBRID (FISH) PER SPECIMEN EA ADDL SGL PROBE STAIN",1155.0,635.25,101.45,999.08,53
CPT,88364,HC IN-SITU HYBRID (FISH) PER SPECIMEN EA ADDL SGL PROBE STAIN,88.0,48.4,26.4,494.69,53
CPT,88365,"HC CARIS ISH, PER SPCMN, INITIAL SGL PROBE STAIN PROC",253.0,139.15,75.9,662.63,53
CPT,88365,"HC HPV E6/E7 ISH, INSITU HYBRIDIZATION 1ST PROBE STAIN",3181.0,1749.55,152.85,2751.57,53
CPT,88365,"HC HPV HIGH RISK (ARUP), ISH, PER SPCMN, INITIAL SGL PROBE STAIN PROC",832.0,457.6,152.85,719.68,53
CPT,88365,"HC HPV HIGH RISK DNA, ISH, PER SPECIMEN, INIT SINGLE PROBE STAIN",1870.0,1028.5,152.85,1617.55,53
CPT,88365,"HC HPV LOW RISK DNA ISH, IN SITU HYBRIDIZATION 1ST PROBE STAIN",2359.0,1297.45,152.85,2040.54,53
CPT,88365,"HC HPV LOW RISK ISH, INSITU HYBRIDIZATION",1083.0,595.65,152.85,936.8,53
CPT,88365,"HC HPV RNA ISH (NEOGENOMICS), IN SITU HYBRIDIZATION 1ST PROBE STAIN",710.0,390.5,152.85,662.63,53
CPT,88365,HC IN SITU HYBRID (FISH) EA PROBE EPSTEIN-BARR (1),943.0,518.65,152.85,815.7,53
CPT,88365,HC IN SITU HYBRIDIZATION (ISH) INITIAL,280.0,154.0,84.0,662.63,53
CPT,88365,HC IN-SITU HYBRID (FISH) PER SPECMN INIT SGL PRB STN HPV ISH,372.0,204.6,111.6,662.63,53
CPT,88365,HC IN-SITU HYBRID (FISH) PER SPECMN INIT SGL PRB STN HPV SUBTYPES,1119.0,615.45,152.85,967.94,53
CPT,88365,HC IN-SITU HYBRID (FISH) PER SPECMN INIT SGL PROBE STAIN,1013.5,557.425,152.85,1243.01,106
CPT,88365,"HC IN-SITU HYBRID JC VIRUS, PER SPECIMEN, INITIAL SINGLE PROBE STAIN PX",963.0,529.65,152.85,833.0,53
CPT,88366,"HC FUS GENE REARRANGEMENT, ISH, PER SPCMN, EA MULTIPLEX PROBE STAIN",1312.0,721.6,174.14,1134.88,53
CPT,88366,"HC MET GENE AMP, FISH TECH, PER SPECIMEN, EA MULTIPLEX PROBE STAIN PROC",955.0,525.25,174.14,1045.72,53
CPT,88366,"HC RET GENE, FISH TECH, PER SPECIMEN, EA MULTIPLEX PROBE STAIN PROC",849.0,466.95,174.14,1045.72,53
CPT,88366,"HC TFE3 GENE REARRANGEMENT FISH, INSITU HYBRIDIZATION",1128.0,620.4,174.14,1045.72,53
CPT,88367,"HC TP53 CEP 17, MORPHOMETRIC ANLYS, ISH QUANT/SEMIQ, CPTR TECH, INIT PROBE",448.0,246.4,134.4,388.93,53
CPT,88368,HC MORPH ANLY IN SITU HYBRID MANUAL PER SPECMN INIT SGL PROBE STAIN,1029.0,565.95,308.7,890.09,53
CPT,88368,HC MORPH ANLY IN SITU PER SPECMN INIT SGL PRB STN HER-2 NEU GENE AMPLF,1016.0,558.8,304.8,878.84,53
CPT,88369,M/PHMTRC ALYSISHQUANT/SEMIQ,,,88.27,430.31,23
CPT,88371,PROTEIN WESTERN BLOT TISSUE,,,21.61,111.15,22
CPT,88372,PROTEIN ANALYSIS W/PROBE,,,25.48,131.1,22
CPT,88373,M/PHMTRC ALYS ISHQUANT/SEMIQ,,,43.15,210.86,23
CPT,88374,"HC BCR ABL FISH, MORPHOMETRIC ANALYSIS, IN SITU HYBRIDIZATION",823.0,452.65,152.85,1254.44,53
CPT,88374,"HC HER2 CEP 17, MORPHOMETRIC ANLYS, ISH QUANT/SEMIQ, CPTR TECH, EA MULTIPRB",785.0,431.75,152.85,1254.44,53
CPT,88374,"HC P16 CDKN2A/CC9 FISH, MORPHMTR ANLYS, COMP-ASST, PER SPCMN,EA MULTPLX PRB",984.0,541.2,152.85,1254.44,53
CPT,88374,"HC SMS RARA, MORPHOMETRIC ANLYS, ISH QUANT/SEMIQ, CPTR TECH, EA MULTIPRB",784.0,431.2,152.85,1254.44,53
CPT,88375,OPTICAL ENDOMICROSCPY INTERP,,,43.48,228.75,23
CPT,88377,"HC B CELL LYMPHOMA FISH, MORPHOMETRIC ALYS ISHQUANT/SEMIQ MNL EACH MULTIPRB",1474.0,810.7,152.85,1601.05,53
CPT,88377,"HC CARIS CISH, MORPHMTR ANLYS, ISH, MAN, PER SPCMN, EA MULTIPLEX PRB",574.0,315.7,152.85,1601.05,53
CPT,88377,"HC CIC (19Q13) REARRANGEMENT FISH (TC), MORPHOMETRIC ALYSIS, IN SITU HYBRID",1474.0,810.7,152.85,1601.05,53
CPT,88377,"HC ERBB2, MORTHOMETRC ANALYSIS, ISH QUANT/SEMIQ, MANUAL, EACH MULTI PROBE",1397.0,768.35,152.85,1601.05,53
CPT,88377,"HC FISH MANUAL, MORPHMTR ANLYS, ISH, MAN, PER SPCMN, EA MULTIPLEX PRB",1474.0,810.7,152.85,1601.05,53
CPT,88377,"HC FISH PROBE NEOGENOMICS, MORPHOMETRIC ANYLS, IN SITU HYBRID, PER SPEC, EA",1474.0,810.7,152.85,1601.05,53
CPT,88377,"HC MYB/NFIB TRANSLOC, MORPHMTR ANLYS, ISH, MAN, PER SPCMN, EA MULTIPLEX PRB",901.0,495.55,152.85,1601.05,53
CPT,88377,"HC PROBE EA ADDITL (BLYM), MORPHOMETRIC ALYS ISHQUANT/SEMIQ MNL EA MULTIPRB",919.0,505.45,152.85,1601.05,53
CPT,88377,"HC SM LYMPHOCYTIC LYMPHOMA FISH, MORPHMTR ANLYS, PER SPCMN, EA MULTPLX PRB",1366.0,751.3,152.85,1601.05,53
CPT,88377,"HC T CELL LYMPHOMA FISH, MORPHOMETRIC ANYLS, IN SITU HYBRID, PER SPEC, EA",1474.0,810.7,152.85,1601.05,53
CPT,88380,"HC MAYO MICRODISSECTION, LASER CAPTURE",1462.0,804.1,69.83,1264.63,53
CPT,88380,"HC MICRODISSECTION, AMYLOID PROTEIN",939.0,516.45,69.83,812.24,53
CPT,88381,"HC ARUP MICRODISSECTION, SLIDE REVIEW, TECH",359.0,197.45,107.7,853.63,53
CPT,88381,"HC CARIS MICRODISSECTION, MANUAL",330.0,181.5,99.0,853.63,53
CPT,88381,"HC CKIT MUTATION, MICRODISSECTION, MANUAL",484.0,266.2,145.2,853.63,53
CPT,88381,HC CYTOGENOMIC MIP MICRODISSECTION (TC) PREP IDENTIFIED TARGET MANUAL,501.0,275.55,150.3,853.63,53
CPT,88381,"HC KIT MELANOMA, MICRODISSECTION PREP IDENTIFIED TARGET MANUAL",364.0,200.2,109.2,853.63,53
CPT,88381,"HC KRAS MUTATION DETECTION BY IDYLLA, MICRODISSECTION, MANUAL",157.0,86.35,47.1,853.63,53
CPT,88381,"HC KRAS MUTATIONS, MICRODISSECTION, MANUAL",550.0,302.5,165.0,853.63,53
CPT,88381,"HC MAYO PDGFRA MUTATION, MICRODISSECTION, MANUAL",493.0,271.15,147.9,853.63,53
CPT,88381,HC MGMT GENE MICRODISSECTION,393.0,216.15,117.9,853.63,53
CPT,88381,"HC MOLAR PREGNANCY, MICRODISSECTION, MANUAL",307.0,168.85,92.1,853.63,53
CPT,88381,"HC NEOGENOMICS, MICRODISSECTION, MANUAL",299.0,164.45,89.7,853.63,53
CPT,88381,"HC NRAS EXON 4, MICRODISSECTION MANUAL",544.0,299.2,163.2,853.63,53
CPT,88381,"HC SOLID TUMOR MUTATION MICRODISSECTION, MANUAL",990.0,544.5,175.56,856.35,53
CPT,88381,"HC SOMATIC OVERGROWTH MICRODISSECTION, MANUAL",484.0,266.2,145.2,853.63,53
CPT,88381,"HC UPMC BRAIN TUMOR MICRODISSECTION TC, MICRODISSECTION MANUAL",338.0,185.9,101.4,853.63,53
CPT,88387,MACROSCOPIC XM DSJ&PREP TISS,,,7.58,35.94,22
CPT,88388,Lab/Pathology,,,64.92,64.92,1
CPT,88388,Laboratory,,,64.92,64.92,1
CPT,88399,UNLISTED SURGICAL PATH PX,,,48.74,60.17,20
CPT,88720,BILIRUBIN TOTAL TRANSCUT,,,4.88,25.1,23
CPT,88738,HGB QUANT TRANSCUTANEOUS,,,4.88,25.1,22
CPT,88740,TRANSCUTANEOUS CARBOXYHB,,,9.11,46.85,23
CPT,88741,TRANSCUTANEOUS METHB,,,9.11,46.85,23
CPT,89049,CHCT FOR MAL HYPERTHERMIA,,,152.85,1337.59,23
CPT,89050,HC CELL COUNT MISC BODY FLUIDS,91.0,50.05,4.58,78.72,53
CPT,89051,HC CELL COUNT MISC BDY FLUIDS W DIFFERENTIAL COUNT,102.0,56.1,5.45,88.23,53
CPT,89055,LEUKOCYTE ASSESSMENT FECAL,,,4.15,21.35,23
CPT,89060,HC CRYSTAL ID BY LIGHT MICROSCOPY W WO POLARZ LENS ANALYS BILE FLD,273.0,150.15,7.13,236.15,53
CPT,89060,HC CRYSTAL ID BY LIGHT MICROSCOPY W WO POLARZ LENS ANALYS SYNOVIAL FLD,78.0,42.9,7.13,67.47,53
CPT,89125,SPECIMEN FAT STAIN,,,5.72,29.4,23
CPT,89160,EXAM FECES FOR MEAT FIBERS,,,4.72,24.25,23
CPT,89190,HC NASAL SMEAR FOR EOSINOPHILS,41.0,22.55,5.63,35.47,53
CPT,89220,SPUTUM SPECIMEN COLLECTION,,,85.84,188.7,23
CPT,89230,COLLECT SWEAT FOR TEST,,,11.8,60.17,23
CPT,89240,"HC EOSINOPHILS SPUTUM, UNLISTED MISC PATHOLOGY TEST",58.0,31.9,17.4,60.17,53
CPT,89250,"HC CULTURE OF OOCYTE EMBRYO, LESS THAN 4 DAYS",753.0,414.15,152.85,5166.95,53
CPT,89251,CULTR OOCYTE/EMBRYO <4 DAYS,,,152.85,5374.59,23
CPT,89253,HC EMBRYO HATCHING,357.0,196.35,107.1,308.81,53
CPT,89254,HC OOCYTE IDENTIFICATION,995.0,547.25,152.85,860.68,53
CPT,89255,HC PREPARE EMBRYO FOR TRANSFER,318.0,174.9,48.74,275.07,53
CPT,89257,HC SPERM IDENTIFICATION FROM ASPIRATION,426.0,234.3,48.74,368.49,53
CPT,89258,HC CRYOPRESERVATION EMBRYO(S),1497.0,823.35,449.1,1294.91,53
CPT,89259,HC CRYOPRESERVATION SPERM,424.0,233.2,127.2,366.76,53
CPT,89260,HC SPERM ISOLATION SIMPLE,234.0,128.7,48.74,202.41,53
CPT,89261,"HC SPERM ISOLATION COMPLEX, ZYMOT 0",445.0,244.75,48.74,384.93,53
CPT,89261,"HC SPERM ISOLATION COMPLEX, ZYMOT 1",632.0,347.6,48.74,546.68,53
CPT,89261,"HC SPERM ISOLATION COMPLEX, ZYMOT 2",832.0,457.6,48.74,719.68,53
CPT,89264,HC IDENTIFY SPERM TISSUE,477.0,262.35,48.74,412.61,53
CPT,89268,HC INSEMINATION OF OOCYTES,518.0,284.9,152.85,448.07,53
CPT,89272,HC EXTENDED CULTURE OF OOCYTES,933.0,513.15,279.9,931.81,53
CPT,89280,"HC ASSIST FERTILIZATION MICROTECHQ, LESS THAN OR EQUAL TO 10 OOCYTES",1288.0,708.4,386.4,1114.12,53
CPT,89281,"HC ASSIST FERTILIZATION MICROTECHQ, GREATER THAN 10 OOCYTES",995.0,547.25,152.85,860.68,53
CPT,89290,"HC BX OOCYTE MICROTECHQ, LESS THAN OR EQUAL TO 5 EMBRYOS",1036.0,569.8,152.85,896.14,53
CPT,89291,"HC BX OOCYTE MICROTECHQ, GREATER THAN 5 EMBRYOS",1476.0,811.8,152.85,1276.74,53
CPT,89300,SEMEN ANALYSIS W/HUHNER,,,9.57,49.2,23
CPT,89310,HC SEMEN COUNT & MOTILITY,127.0,69.85,8.37,109.86,53
CPT,89310,HC SEMEN COUNT & MOTILITY DONOR W PREWASH,127.0,69.85,8.37,109.86,53
CPT,89310,HC SEMEN COUNT & MOTILITY DONOR WO PREWASH,222.0,122.1,8.37,192.03,53
CPT,89320,HC SEMEN ANAL VOL COUNT MOT,124.0,68.2,11.96,107.26,53
CPT,89320,"HC SEMEN ANLYSIS, VOLUME, COUNT, MOTILITY, AND DIFFERENTIAL",217.0,119.35,11.96,187.71,53
CPT,89321,HC PRE-POST VASECTOMY SEMEN ANLY SPERM DETECTION,73.0,40.15,11.71,63.15,53
CPT,89321,HC SEMEN ANAL SPERM DETECTION,72.0,39.6,11.71,77.85,159
CPT,89322,HC SEMEN ANAL STRICT CRITERIA,264.0,145.2,15.07,228.36,53
CPT,89325,SPERM ANTIBODY TEST,,,10.37,53.35,23
CPT,89329,SPERM EVALUATION TEST,,,19.04,97.95,23
CPT,89330,EVALUATION CERVICAL MUCUS,,,10.09,51.9,23
CPT,89331,HC RETROGRADE EJACULATION ANAL,149.0,81.95,19.04,128.89,53
CPT,89335,HC CRYOPRESERVE TESTICULAR TISS,366.0,201.3,48.74,316.59,53
CPT,89337,HC CRYOPRESERVATION MATURE OOCYTE(S),1214.0,667.7,152.85,1050.11,53
CPT,89342,HC STORAGE (PER YEAR) EMBRYO(S),275.0,151.25,82.5,237.88,53
CPT,89343,HC STORAGE (PER YEAR) SPERM SEMEN,275.0,151.25,82.5,237.88,53
CPT,89344,HC STORAGE (PER YR) REPROD TISS TESTICULAR OVARIAN,275.0,151.25,82.5,237.88,53
CPT,89346,HC STORAGE (PER YEAR) OOCYTE(S),282.0,155.1,84.6,388.93,53
CPT,89352,HC THAWING CRYOPRESRVED EMBRYO,242.0,133.1,72.6,209.33,53
CPT,89353,HC THAW CRYOPRESRVED SPERM DONOR,84.0,46.2,25.2,72.66,53
CPT,89353,HC THAW CRYOPRESRVED SPERM PARTNER,84.0,46.2,25.2,72.66,53
CPT,89354,HC THAW CRYOPRSVRD REPROD TISS,236.0,129.8,70.8,204.14,53
CPT,89356,HC THAWING CRYOPRESRVED OOCYTE,242.0,133.1,72.6,209.33,53
CPT,89398,HC EOSIN Y VIABILITY,112.0,61.6,33.6,96.88,53
CPT,90281,HUMAN IG IM,,,51.29,63.32,6
CPT,90283,HUMAN IG IV,,,78.54,96.97,6
CPT,90284,HUMAN IG SC,,,19.75,24.38,6
CPT,90291,CMV IG IV,,,1810.12,2234.71,6
CPT,90371,HEP B IG IM,,,125.62,881.96,23
CPT,90375,Rabies Immune Globulin 1500 UNIT/5ML Solution 5 mL Vial,14300.37,7865.21,240.72,12369.82,53
CPT,90375,Rabies Immune Globulin 300 UNIT/ML Solution 1 mL Vial,3689.7,2029.34,240.72,3191.59,53
CPT,90375,rabies immune globulin 300 UNIT/2ML Solution 2 mL Vial,3635.38,1999.46,240.72,3144.6,53
CPT,90376,RABIES IG HEAT TREATED,,,298.21,368.16,21
CPT,90377,RABIES IG HT&SOL HUMAN IM/SC,,,215.1,1600.43,23
CPT,90378,palivizumab 100 MG/ML Solution 1 mL Vial,14449.26,7947.1,641.4,12498.61,53
CPT,90380,nirsevimab-alip 50 mg/0.5 mL Solution Prefilled Syringe 0.5 mL Syringe,3018.1,1659.96,905.43,2610.66,38
CPT,90381,nirsevimab-alip 100 mg/mL Solution Prefilled Syringe 1 mL Syringe,3018.1,1659.96,905.43,2610.66,38
CPT,90384,RH IG FULL-DOSE IM,,,102.86,126.99,6
CPT,90385,RH IG MINIDOSE IM,,,51.74,63.88,6
CPT,90386,RH IG IV,,,569.02,702.49,6
CPT,90389,TETANUS IG IM,,,668.85,825.74,6
CPT,90396,VARICELLA-ZOSTER IG IM,,,1933.81,2432.68,21
CPT,90399,UNLISTED IMMUNE GLOBULIN,,,367.38,453.56,6
CPT,90460,IM ADMIN 1ST/ONLY COMPONENT,,,21.29,21.93,15
CPT,90461,IM ADMIN EACH ADDL COMPONENT,,,8.1,8.34,15
CPT,90471,"HC IMMUNIZATION ADMINISTRATION, FIRST VACCINE",83.0,45.65,24.9,74.49,4000
CPT,90472,"HC IMMUNIZATION ADMINISTRATION, EA ADDITIONAL VACCINE (ADD ON CODE)",59.0,32.45,13.63,51.04,3700
CPT,90473,IMMUNE ADMIN ORAL/NASAL,,,72.32,74.49,15
CPT,90474,IMMUNE ADMIN ORAL/NASAL ADDL,,,11.15,11.48,15
CPT,90480,"HC IMMZ ADMIN IM SARS-COV-2 VACC, SINGLE DOSE",67.0,36.85,20.1,57.96,2900
CPT,90581,ANTHRAX VACCINE SC OR IM,,,99.65,123.02,6
CPT,90585,BCG VACCINE PERCUT,,,175.03,216.09,6
CPT,90586,BCG VACCINE INTRAVESICAL,,,128.75,1054.08,8
CPT,90587,DENGUE VACC QUAD 3 DOSE SUBQ,,,68.0,83.95,6
CPT,90611,"smallpox and monkeypox, live, non-replicating vaccine 0.5 ML Suspension 0.5 mL Vial",850.4,467.72,0.01,735.6,53
CPT,90619,MENACWY-TT VACCINE IM,,,177.05,218.58,6
CPT,90620,meningococcal group B vaccine Suspension Prefilled Syringe 0.5 mL Syringe,747.83,411.31,213.92,646.87,38
CPT,90621,meningococcal group B vaccine Suspension Prefilled Syringe 0.5 mL Syringe,654.83,360.16,195.9,566.43,38
CPT,90622,VACCINIA VRS VAC 0.3 ML PERQ,,,0.01,0.01,21
CPT,90623,MENACWY-TT MENB-FHBP VACC IM,,,236.97,292.56,6
CPT,90632,hepatitis A vaccine 1440 EL U/ML Suspension 1 mL Syringe,318.14,174.98,61.49,490.59,38
CPT,90633,hepatitis A 720 EL U/0.5ML Suspension Prefilled Syringe 0.5 mL Syringe,148.86,81.88,36.05,128.76,38
CPT,90634,HEPA VACC PED/ADOL 3 DOSE,,,24.99,30.86,6
CPT,90636,hepatitis A/hepatitis B vaccine 720-20 ELU-MCG/ML Suspension Prefilled Syringe 1 mL Syringe,421.18,231.65,111.04,364.32,38
CPT,90644,HIB-MENCY VACC 6WK-18M0 IM,,,18.89,23.32,6
CPT,90647,haemophilus b polysac conjugate vaccine 7.5 MCG/0.5 ML Suspension 0.5 mL Vial,118.08,64.95,31.37,102.14,38
CPT,90648,HIB PRP-T VACCINE 4 DOSE IM,,,13.37,16.51,6
CPT,90649,4VHPV VACCINE 3 DOSE IM,,,90.27,111.44,6
CPT,90651,human papillomavirus (HPV) 9-valent Suspension Prefilled Syringe 0.5 mL Syringe,967.74,532.26,290.32,837.1,38
CPT,90653,IIV ADJUVANT VACCINE IM,,,71.69,563.56,23
CPT,90655,IIV3 VACC NO PRSV 0.25 ML IM,,,11.06,13.65,6
CPT,90656,influenza trivalent vaccine 0.5 mL Suspension Prefilled Syringe 0.5 mL Syringe,20.0,11.0,6.0,150.86,53
CPT,90657,IIV3 VACCINE SPLT 0.25 ML IM,,,9.39,73.78,23
CPT,90658,IIV3 VACCINE SPLT 0.5 ML IM,,,18.77,147.56,23
CPT,90660,LAIV3 VACCINE INTRANASAL,,,24.79,194.87,23
CPT,90661,CCIIV3 VAC ABX FR 0.5 ML IM,,,31.64,248.74,23
CPT,90662,influenza trivalent HIGH-DOSE vaccine 0.5 mL Suspension Prefilled Syringe 0.5 mL Syringe,71.0,39.05,21.3,563.56,53
CPT,90670,PCV13 VACCINE IM,,,221.51,1741.43,23
CPT,90671,PCV15 VACCINE IM,,,217.7,1762.76,23
CPT,90672,LAIV4 VACCINE INTRANASAL,,,26.09,32.21,6
CPT,90673,RIV3 VACCINE NO PRESERV IM,,,71.69,563.56,23
CPT,90675,"rabies vaccine, PCEC Recon Susp 1 Each Vial",1190.6,654.83,281.44,2106.2,53
CPT,90676,RABIES VACCINE ID,,,227.08,280.34,21
CPT,90677,pneumococcal 20-valent conjugate 0.5 ML Suspension Prefilled Syringe 0.5 mL Syringe,864.76,475.62,255.9,2112.08,53
CPT,90678,RSV bivalent RSVpreF vaccine 120 MCG/0.5ML Recon Soln 1 Each Vial,965.22,530.88,289.57,834.92,38
CPT,90679,RSV adjuvanted RSVpreF3 vaccine 120 MCG/0.5ML Recon Susp 1 Each Box,963.81,530.1,289.14,833.7,38
CPT,90680,RV5 VACC 3 DOSE LIVE ORAL,,,101.69,125.54,6
CPT,90681,RV1 VACC 2 DOSE LIVE ORAL,,,95.21,117.54,6
CPT,90683,RSV VACC MRNA LIPID NANO IM,,,298.79,368.88,6
CPT,90684,PCV21 VACCINE IM,,,281.52,2213.26,23
CPT,90690,TYPHOID VACCINE ORAL,,,77.49,95.67,6
CPT,90691,typhoid vi polysaccharide 25 MCG/0.5ML Solution Prefilled Syringe 0.5 mL Syringe,465.3,255.92,101.45,402.48,38
CPT,90696,DTAP-IPV VACCINE 4-6 YRS IM,,,131.0,161.72,6
CPT,90697,DTAP-IPV-HIB-HEPB VACCINE IM,,,321.28,396.64,6
CPT,90698,DTAP-IPV/HIB VACCINE IM,,,115.9,143.09,6
CPT,90700,Diphtheria/acellular pertussis/tetanus vaccine 25-58-10 LF-MCG/0.5 Suspension 0.5 mL Syringe,105.31,57.93,30.38,91.09,38
CPT,90702,DT VACCINE UNDER 7 YRS IM,,,14.45,17.83,6
CPT,90707,"measles, mumps, & rubella vaccine Recon Susp 1 Each Vial",350.72,192.9,96.31,303.37,38
CPT,90710,MMRV VACCINE SC,,,286.07,353.18,6
CPT,90713,poliovirus (inactivated) vaccine Injection 5 mL Vial,2430.53,1336.8,45.96,2102.41,38
CPT,90714,tetanus/diphtheria toxoids (Td) 2-2 LF/0.5ML Suspension 0.5 mL Vial,108.75,59.82,28.75,245.5,38
CPT,90714,tetanus/diphtheria toxoids (Td) 5-2 LFU Injection 0.5 mL Syringe,153.1,84.21,28.75,245.5,38
CPT,90715,tetanus/diphtheria/acellular pertussis (Tdap) vaccine 5-2.5-18.5 LF-MCG/0.5 Suspension 0.5 mL Vial,183.49,100.92,33.17,268.04,38
CPT,90715,tetanus/diphtheria/acellular pertussis (Tdap) vaccine 5-2.5-18.5 LF-MCG/0.5 Suspension Prefilled Syringe 0.5 mL Syringe,183.49,100.92,33.17,268.04,38
CPT,90716,varicella virus vaccine (live) 1350 PFU/0.5ML Recon Susp 1 Each Vial,578.97,318.44,173.69,500.81,38
CPT,90717,yellow fever Injection 1 Each Vial,706.77,388.73,151.61,611.36,38
CPT,90723,DTAP-HEP B-IPV VACCINE IM,,,97.72,120.64,6
CPT,90732,PPSV23 VACC 2 YRS+ SUBQ/IM,,,114.6,900.92,23
CPT,90733,MPSV4 VACCINE SUBQ,,,71.38,88.12,6
CPT,90734,Meningococcal A C Y&W-135 oligosaccharide Solution 0.5 mL Vial,528.25,290.54,156.09,456.94,38
CPT,90736,HZV VACCINE LIVE SUBQ,,,114.15,140.92,6
CPT,90738,INACTIVATED JE VACC IM,,,262.49,324.05,6
CPT,90739,hepatitis B vac recomb adj 20 MCG/0.5ML Solution Prefilled Syringe 0.5 mL Syringe,856.05,470.83,144.5,1198.53,53
CPT,90740,hepatitis B vaccine dialysis 40 mcg/mL Suspension 1 mL Vial,1023.67,563.02,135.79,1109.84,53
CPT,90743,HEPB VACC 2 DOSE ADOLESC IM,,,64.52,507.26,23
CPT,90744,hepatitis B vaccine 10 mcg/0.5 mL Suspension Prefilled Syringe 0.5 mL Syringe,113.31,62.33,26.42,213.77,53
CPT,90746,HEPB VACCINE 3 DOSE ADULT IM,,,60.43,475.07,23
CPT,90747,HEPB VACC 4 DOSE IMMUNSUP IM,,,120.85,950.06,23
CPT,90748,HIB-HEPB VACCINE IM,,,39.73,49.04,6
CPT,90750,zoster recombinant adjuvanted vaccine 50 MCG/0.5ML Recon Susp 1 Each Vial,680.38,374.21,204.11,588.53,38
CPT,90759,HEP B VAC 3AG 10MCG 3 DOS IM,,,63.39,498.29,23
CPT,90785,HC INTERA COMPLEXITY (AD),161.0,88.55,13.88,483.0,53
CPT,90791,HC PSYCH DX EVALUATION,363.0,199.65,108.9,483.0,106
CPT,90791,HC PSYCH DX EVALUATION 15 MIN,316.0,173.8,79.8,483.0,212
CPT,90791,HC PSYCH DX EVALUATION 30 MIN,375.0,206.25,112.5,483.0,106
CPT,90791,HC PSYCH DX EVALUATION 45 MIN,453.0,249.15,135.9,483.0,106
CPT,90791,HC PSYCH DX EVALUATION 60 MIN,474.0,260.7,142.2,483.0,106
CPT,90791,HC TELEHEALTH PSYCH DX EVALUATION 15 MIN,239.0,131.45,71.7,483.0,106
CPT,90791,HC TELEHEALTH PSYCH DX EVALUATION 30 MIN,338.0,185.9,101.4,483.0,106
CPT,90791,HC TELEHEALTH PSYCH DX EVALUATION 45 MIN,409.0,224.95,122.7,483.0,106
CPT,90791,HC TELEHEALTH PSYCH DX EVALUATION 60 MIN,427.0,234.85,128.1,483.0,106
CPT,90792,HC PSYCH DX EVAL W MEDICAL SVCS,381.0,209.55,114.3,483.0,53
CPT,90832,"HC PSYCHOTHERAPY, 30 MINUTES WITH PATIENT",347.0,190.85000000000002,84.3,357.25,318
CPT,90832,"HC TELEHEALTH PSYCHOTHERAPY, 30 MINUTES WITH PATIENT",254.0,139.7,76.2,219.71,106
CPT,90833,PSYTX W PT W E/M 30 MIN,,,70.72,72.84,15
CPT,90834,"HC PSYCHOTHERAPY, 45 MINUTES WITH PATIENT",388.0,213.4,116.4,335.62,318
CPT,90834,"HC TELEHEALTH PSYCHOTHERAPY, 45 MINUTES WITH PATIENT",349.0,191.95,104.7,301.89,106
CPT,90836,PSYTX W PT W E/M 45 MIN,,,89.81,92.5,15
CPT,90837,"HC PSYCHOTHERAPY, 60 MINUTES WITH PATIENT",381.0,209.55,114.3,329.57,318
CPT,90837,"HC TELEHEALTH PSYCHOTHERAPY, 60 MINUTES WITH PATIENT",343.0,188.65,102.9,296.7,106
CPT,90838,PSYTX W PT W E/M 60 MIN,,,118.81,122.37,15
CPT,90839,HC PSYCH THER CRISIS INITIAL 60 MIN,388.0,213.4,116.4,335.62,212
CPT,90839,HC TELEHEALTH PSYCH THER CRISIS INITIAL 60 MIN,349.0,191.95,104.7,301.89,106
CPT,90840,HC PSYCH THER CRISIS EA ADDL 30 MIN,188.0,103.4,56.4,162.62,212
CPT,90840,HC TELEHEALTH PSYCH THER CRISIS EA ADDL 30 MIN,170.0,93.5,51.0,147.05,106
CPT,90845,PSYCHOANALYSIS,,,163.27,168.17,15
CPT,90846,FAMILY PSYTX W/O PT 50 MIN,,,163.27,168.17,15
CPT,90847,FAMILY PSYTX W/PT 50 MIN,,,163.27,168.17,15
CPT,90849,MULTIPLE FAMILY GROUP PSYTX,,,163.27,168.17,15
CPT,90853,HC GROUP PSYCHOTHERAPY,316.0,173.8,94.0,273.34,106
CPT,90863,PHARMACOLOGIC MGMT W/PSYTX,,,23.28,23.98,15
CPT,90865,NARCOSYNTHESIS,,,163.27,168.17,15
CPT,90867,TCRANIAL MAGN STIM TX PLAN,,,316.44,325.94,15
CPT,90868,TCRANIAL MAGN STIM TX DELI,,,316.44,325.94,15
CPT,90869,TCRAN MAGN STIM REDETEMINE,,,316.44,325.94,15
CPT,90870,ELECTROCONVULSIVE THERAPY,,,539.2,555.37,15
CPT,90875,PSYCHOPHYSIOLOGICAL THERAPY,,,54.63,56.27,15
CPT,90876,PSYCHOPHYSIOLOGICAL THERAPY,,,96.28,99.17,15
CPT,90880,HYPNOTHERAPY,,,94.0,96.82,15
CPT,90885,PSY EVALUATION OF RECORDS,,,43.67,44.98,15
CPT,90887,INTERPJ/EXPLNAJ RSLT PSYC XM,,,79.99,82.39,15
CPT,90899,UNLISTED PSYC SVC/THERAPY,,,30.27,31.18,15
CPT,90901,"HC AT, BIOFEEDBACK TRAINING  BY ANY MODALITY",151.0,83.05,37.93,130.62,53
CPT,90901,HC EMG BIOFEEDBACK TRAINING 15 MIN_OT,157.0,86.35,37.93,384.0,53
CPT,90901,HC EMG BIOFEEDBACK TRAINING 15 MIN_PT,157.0,86.35,37.93,384.0,53
CPT,90901,HC EMG BIOFEEDBACK TRAINING 30 MIN_OT,312.0,171.6,37.93,384.0,53
CPT,90901,HC EMG BIOFEEDBACK TRAINING 30 MIN_PT,312.0,171.6,37.93,384.0,53
CPT,90912,BFB TRAINING 1ST 15 MIN,,,74.74,76.98,15
CPT,90913,BFB TRAINING EA ADDL 15 MIN,,,30.11,31.02,15
CPT,90935,HC HEMODIALYSIS ADDITIONAL HOUR,104.0,57.2,31.2,732.39,53
CPT,90935,HC HEMODIALYSIS TREATMENT MAX 4 HR,1468.0,807.4,440.4,1269.82,53
CPT,90937,HEMODIALYSIS REPEATED EVAL,,,94.41,97.24,15
CPT,90945,HC CONTINOUS RENAL REPLACEMENT THERAPY,2848.0,1566.4,432.72,2463.52,2173
CPT,90945,HC PERITONEAL DIALYSIS,622.0,342.1,186.6,538.03,2173
CPT,90947,DIALYSIS REPEATED EVAL,,,112.43,115.8,15
CPT,90951,ESRD SERV 4 VISITS P MO <2YR,,,1071.13,1103.26,15
CPT,90954,ESRD SERV 4 VSTS P MO 2-11,,,924.46,952.2,15
CPT,90955,ESRD SRV 2-3 VSTS P MO 2-11,,,483.89,498.4,15
CPT,90956,ESRD SRV 1 VISIT P MO 2-11,,,323.9,333.61,15
CPT,90957,ESRD SRV 4 VSTS P MO 12-19,,,709.61,730.9,15
CPT,90958,ESRD SRV 2-3 VSTS P MO 12-19,,,462.21,476.08,15
CPT,90959,ESRD SERV 1 VST P MO 12-19,,,301.91,310.97,15
CPT,90960,ESRD SRV 4 VISITS P MO 20+,,,329.04,338.91,15
CPT,90961,ESRD SRV 2-3 VSTS P MO 20+,,,273.2,281.4,15
CPT,90962,ESRD SERV 1 VISIT P MO 20+,,,188.92,194.59,15
CPT,90963,ESRD HOME PT SERV P MO <2YRS,,,558.73,575.5,15
CPT,90964,ESRD HOME PT SERV P MO 2-11,,,479.05,493.42,15
CPT,90965,ESRD HOME PT SERV P MO 12-19,,,461.18,475.02,15
CPT,90966,ESRD HOME PT SERV P MO 20+,,,273.2,281.4,15
CPT,90967,ESRD SVC PR DAY PT <2,,,16.18,16.66,15
CPT,90968,ESRD SVC PR DAY PT 2-11,,,15.86,16.33,15
CPT,90969,ESRD SVC PR DAY PT 12-19,,,15.53,16.0,15
CPT,90970,ESRD SVC PR DAY PT 20+,,,9.02,9.3,15
CPT,90997,HEMOPERFUSION,,,81.23,83.67,15
CPT,91010,HC ESOPHAGUS MOTILITY STUDY,1397.0,768.35,419.1,8446.0,53
CPT,91013,HC ESOPHGL MOTIL W STIM PERFUS,519.0,285.45,23.26,8446.0,53
CPT,91020,GASTRIC MOTILITY STUDIES,,,539.2,3533.0,21
CPT,91022,DUODENAL MOTILITY STUDY,,,539.2,3533.0,21
CPT,91030,ACID PERFUSION OF ESOPHAGUS,,,539.2,3533.0,21
CPT,91034,HC GASTROESOPHAGEAL REFLUX TEST,1417.0,779.35,425.1,8446.0,53
CPT,91035,HC G-ESOPH REFLUX TEST W TELEMETRY PH ELECTRODE PLC,1417.0,779.35,425.1,8446.0,53
CPT,91037,HC ESOPH IMPED FUNCTION TEST 1 HR,973.0,535.15,291.9,8446.0,53
CPT,91038,"HC ESOPH IMPED FUNCT TEST, GREATER THAN 1 HR, UP TO 24 HRS",1188.0,653.4,356.4,8446.0,106
CPT,91040,ESOPH BALLOON DISTENSION TST,,,539.2,3533.0,21
CPT,91065,HC BREATH HYDROGEN OR METHANE TEST,422.0,232.1,126.6,8446.0,53
CPT,91110,HC GI TRACT CAPSULE ENDOSCOPY ESOPH THRU ILEUM I&R,2611.0,1436.05,783.3,8446.0,53
CPT,91111,GI TRC IMG INTRAL ESOPHAGUS,,,952.75,6766.0,21
CPT,91112,HC GI TRANSIT & PRESSURE MEASURE WIRELESS CAPSULE,2009.0,1104.95,602.7,8446.0,53
CPT,91113,GI TRC IMG INTRAL COLON I&R,,,926.48,954.27,15
CPT,91117,COLON MOTILITY 6 HR STUDY,,,316.44,3533.0,21
CPT,91120,HC RECTAL SENSATION TONE COMPLIANCE TEST,696.0,382.8,208.8,8446.0,53
CPT,91122,HC ANORECTAL MANOMETRY,784.0,431.2,235.2,8446.0,53
CPT,91132,ELECTROGASTROGRAPHY,,,316.44,3533.0,21
CPT,91133,ELECTROGASTROGRAPHY W/TEST,,,130.99,3533.0,21
CPT,91200,"HC LIVER ELASTOGRAPHY, MECH INDUCED SHEAR WAVE, W/O IMAGING",459.0,252.45,137.7,668.0,106
CPT,91299,UNLISTED DX GI PROCEDURE,,,158.99,3533.0,21
CPT,91304,"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 mL dosage, for intramus",,,138.7,1090.4,23
CPT,91318,SARSCOV2 VAC 3MCG TRS-SUC IM,,,65.55,67.52,15
CPT,91319,SARSCV2 VAC 10MCG TRS-SUC IM,,,94.8,97.64,15
CPT,91320,SARSCV2 VAC 30MCG TRS-SUC IM,,,168.37,173.42,15
CPT,91321,SARSCOV2 VAC 25 MCG/.25ML IM,,,147.06,151.47,15
CPT,91322,Moderna 12+ COVID-19 mRNA 50 mcg/0.5 mL Suspension Prefilled Syringe 0.5 mL Syringe,412.04,226.63,123.61,356.41,53
CPT,92002,INTRM OPH EXAM NEW PATIENT,,,130.96,134.89,15
CPT,92004,COMPRE OPH EXAM NEW PT 1/>,,,130.96,134.89,15
CPT,92012,"HC EYE AND MEDICAL EXAMINATION FOR DIAGNOSIS AND TREATMENT, INTERMIDIATE",144.0,79.2,46.0,134.89,80
CPT,92014,COMPRE OPH EXAM EST PT 1/>,,,130.96,134.89,15
CPT,92015,DETERMINE REFRACTIVE STATE,,,17.77,18.3,15
CPT,92018,COMPL OPH EXAM GENERAL ANES,,,2370.75,9469.0,21
CPT,92019,LMTD OPH EXAM GENERAL ANES,,,2370.75,9469.0,21
CPT,92020,HC GONIOSCOPY,260.0,143.0,78.0,603.0,106
CPT,92025,HC COMPUTERIZED CORNEAL TOPOGRAPHY UNILAT OR BILAT I&R,181.0,99.55,54.3,603.0,106
CPT,92025,HC LASER SCANNING TOPOGRAPHY,181.0,99.55,54.3,603.0,106
CPT,92060,HC SENSORIMOTOR EXAM FOR OCULAR DEVIATION W/ I&R,151.0,83.05,45.3,603.0,106
CPT,92065,"HC ORTHOPTIC TRAINING, PERFORM BY A PHYS/OTH QUAL HEALTH CARE PROFESSIONAL",196.0,107.8,37.62,603.0,106
CPT,92066,ORTHOP TRAING SUPVJ PHYS/QHP,,,60.36,62.17,15
CPT,92071,HC FIT CONTACT LENS TX OCULAR SURFACE DISEASE,250.0,137.5,33.88,799.0,106
CPT,92072,HC INIT FIT CONTACT LENS FOR MGMT OF KERATOCONUS,359.0,197.45,107.7,799.0,106
CPT,92081,"HC VISUAL FIELD EXAM, UNILATERAL OR BILATERAL  W/ I&R, LIMITED",276.0,151.8,60.36,603.0,106
CPT,92082,"HC VISUAL FIELD EXAM, UNILATERAL OR BILATERAL W/ I&R, INTERMEDIATE",251.0,138.05,60.36,603.0,106
CPT,92083,"HC VISUAL FIELD EXAM, UNILATERAL OR BILATERAL W/ I&R, EXTENDED",469.0,257.95,130.99,603.0,106
CPT,92100,HC SERIAL TONOMETRY EXAM(S),155.0,85.25,46.5,603.0,106
CPT,92132,"HC COMPUTERIZED OPHTHALMIC DX IMG, ANT SEG, W/ I&R, UNILAT/BILAT",211.0,116.05,60.36,603.0,106
CPT,92133,"HC COMPTRD OPHTHALM DX IMG, PST SEG, W/ I&R, UNI/BILAT, OPTIC NERV",239.0,131.45,60.36,603.0,106
CPT,92134,"HC COMPUTERIZED OPHTHALM DX IMG, PST SEG, W/I&R, UNI/BILAT, RETINA",254.0,139.7,60.36,603.0,106
CPT,92136,HC OPHTHALM BIOMETRY BY PARTIAL COHERENCE INTERFEROMETRY W/ IOL POWER CALC,400.0,220.0,120.0,603.0,106
CPT,92137,"HC COMPTRD OPHTHALM DX IMG, PST SEG W/I&R, UNI/BILAT, RET INCL OCT ANGRPHY",348.0,191.4,104.4,603.0,106
CPT,92145,CORNEAL HYSTERESIS DETER,,,60.36,62.17,15
CPT,92201,"HC OPHTHALMOSCOPY, EXTENDED W/ RTA DRAWING & SCLERAL DEPRESSION I&R UNI/BI",227.0,124.85,60.36,603.0,106
CPT,92202,"HC OPHTHALMOSCOPY, EXTENDED W/ OPTIC NERVE/MACULA DRAWING I&R UNI/BI",227.0,124.85,60.36,603.0,106
CPT,92227,"HC IMG RETINA FOR DETECT/MNTR DISEASE, REMOTE CLIN STAFF RVW, UNILAT/BILAT",64.5,35.48,19.35,603.0,106
CPT,92228,IMG RTA DETC/MNTR DS PHY/QHP,,,39.89,41.08,15
CPT,92229,IMG RTA DETC/MNTR DS POC ALY,,,60.36,62.17,15
CPT,92230,FLUORESCEIN ANGIOSCOPY I&R,,,539.2,555.37,15
CPT,92235,"HC EMMES FLUORSCEIN ANGIOGRAPHY W/ MULTFRAME IMAG, UNILAT/BILAT",1023.0,562.65,306.9,884.9,106
CPT,92235,"HC FLUORESCEIN ANGIOGRAPHY W/ MULTFRAME IMAG, UNILAT/BILAT",1023.0,562.65,306.9,884.9,106
CPT,92235,"HC FLUORSCEIN ANGIOGRAPHY RESEARCH W/ MULTFRAME IMAG, UNILAT/BILAT",370.0,203.5,46.0,325.94,80
CPT,92240,"HC INDOCYANINE-GREEN ANGIOGRAPHY INCLD MULTIFRAME IMAG W/ I&R, UNILAT/BILAT",805.0,442.75,241.5,696.33,106
CPT,92242,FLUORESCEIN&ICG ANGIOGRAPHY,,,553.78,553.78,1
CPT,92242,"HC FLUORESCEIN & ICG ANGIOGRAPHY INCLD MULITFRAME IMAG W/ I&R, UNILAT/BILAT",1152.0,633.6,316.44,996.48,106
CPT,92250,HC AUTOFLUORESCENCE,325.0,178.75,97.5,603.0,106
CPT,92250,HC FUNDUS AUTOFLUORESCENCE RESEARCH,161.0,88.55,46.0,139.27,80
CPT,92250,HC FUNDUS PHOTOGRAPHY,325.0,178.75,97.5,603.0,106
CPT,92250,HC FUNDUS PHOTOGRAPHY RESEARCH,155.0,85.25,46.0,134.92,80
CPT,92260,OPHTHALMODYNAMOMETRY,,,39.89,41.08,15
CPT,92265,"HC NEEDLE OCULOELECTROMYOGRAPHY, 1/MORE EXTRAOCULAR MUSCLES, 1/BOTH EYES",175.0,96.25,52.5,603.0,53
CPT,92270,HC ELECTRO-OCULOGRAPHY W/I&R,350.0,192.5,105.0,603.0,106
CPT,92273,"HC ELECTRORETINOGRAPHY, W/ INTERP AND REPORT, FULL FIELD",907.0,498.85,272.1,784.56,106
CPT,92274,"HC ELECTRORETINOGRAPHY, W/ INTERP AND REPORT, MULTIFOCAL (MFERG)",548.0,301.4,158.99,603.0,106
CPT,92283,HC COLOR TESTING COMPREHENSIVE,386.0,212.3,60.36,603.0,106
CPT,92283,HC COLOR TESTING LTD,386.0,212.3,60.36,603.0,106
CPT,92284,DX DARK ADAPTATION EXAM I&R,,,405.5,417.67,15
CPT,92285,HC EMMES EYE PHOTOGRAPHY RETINAL LTD,315.0,173.25,39.89,603.0,106
CPT,92285,HC PHOTOGRAPHS EXTERNAL,315.0,173.25,39.89,603.0,106
CPT,92285,HC PHOTOGRAPHS RETINAL LTD,315.0,173.25,39.89,603.0,106
CPT,92286,"HC ANT SEG IMAG W/ I&R, W/ SPECULAR MICROSCOPY & ENDOTHELIAL CELL ANALYSIS",436.0,239.8,130.8,603.0,106
CPT,92287,ANT SGM IMG IR FLRSCN ANGRPH,,,130.99,134.92,15
CPT,92310,CONTACT LENS FITTING OU,,,92.04,94.8,15
CPT,92311,CONTACT LENS FITG APHAKIA 1,,,405.5,417.67,15
CPT,92312,CONTACT LENS FITG APHAKIA OU,,,130.99,134.92,15
CPT,92313,C-LENS FITG CORNEOSCLRL LENS,,,130.99,134.92,15
CPT,92314,HC CONTACT LENS FIT REGULAR,374.0,205.7,79.71,603.0,106
CPT,92314,HC CONTACT LENS FIT THERAPEU,374.0,205.7,79.71,603.0,106
CPT,92315,C-LENS FITG TECH APHAKIA 1,,,130.99,134.92,15
CPT,92316,C-LENS FITG TECH APHAKIA OU,,,130.99,134.92,15
CPT,92317,C-LENS FITG TECH CORNEOSCLRL,,,39.89,41.08,15
CPT,92325,MODIFICATION OF CONTACT LENS,,,130.99,134.92,15
CPT,92326,REPLACEMENT OF CONTACT LENS,,,60.36,62.17,15
CPT,92340,FIT SPECTACLES MONOFOCAL,,,32.3,33.27,15
CPT,92341,FIT SPECTACLES BIFOCAL,,,36.88,37.99,15
CPT,92342,FIT SPECTACLES MULTIFOCAL,,,39.75,40.95,15
CPT,92352,FIT APHAKIA SPECTCL MONOFOCL,,,60.36,62.17,15
CPT,92353,FIT APHAKIA SPECTCL MULTIFOC,,,60.36,62.17,15
CPT,92354,FITG SPECT LOW VIS 1SYSTEM,,,39.89,41.08,15
CPT,92355,FITG SPECT LW VIS CMPND LENS,,,39.89,41.08,15
CPT,92358,APHAKIA PROSTH SERVICE TEMP,,,60.36,62.17,15
CPT,92370,RPR&REFITG SPECT XCP APHAKIA,,,28.21,29.06,15
CPT,92371,RPR&REFIT SPCT PRSTH APHAKIA,,,60.36,62.17,15
CPT,92499,UNLISTED OPH SVC/PROCEDURE,,,24.89,25.63,15
CPT,92502,EAR AND THROAT EXAMINATION,,,517.5,3533.0,21
CPT,92504,HC BINOCULAR MICROSCOPY SEPARATE DX PROC,49.0,26.95,14.7,42.39,53
CPT,92507,HC SPEECH LANGUAGE THERAPY 15 MIN,155.0,85.25,46.5,384.0,265
CPT,92507,HC SPEECH LANGUAGE THERAPY 30 MIN,306.0,168.3,73.02,384.0,265
CPT,92507,HC SPEECH LANGUAGE THERAPY 45 MIN,425.0,233.75,73.02,384.0,265
CPT,92507,HC SPEECH LANGUAGE THERAPY 60 MIN,614.0,337.7,73.02,531.11,265
CPT,92507,HC SPEECH LANGUAGE THERAPY 75 MIN,1001.0,550.55,73.02,865.87,265
CPT,92507,HC SPEECH LANGUAGE THERAPY 90 MIN,1153.0,634.15,73.02,997.35,159
CPT,92507,HC TELEHEALTH SLP SPEECH LANGUAGE THERAPY 15 MIN,115.0,63.25,34.5,384.0,159
CPT,92507,HC TELEHEALTH SLP SPEECH LANGUAGE THERAPY 30 MIN,229.0,125.95,68.7,384.0,159
CPT,92507,HC TELEHEALTH SLP SPEECH LANGUAGE THERAPY 45 MIN,319.0,175.45,73.02,384.0,159
CPT,92507,HC TELEHEALTH SLP SPEECH LANGUAGE THERAPY 60 MIN,461.0,253.55,73.02,398.77,159
CPT,92508,HC GROUP SPEECH LANGUAGE THERAPY 15 MIN,121.0,66.55,22.85,384.0,212
CPT,92508,HC GROUP SPEECH LANGUAGE THERAPY 30 MIN,245.0,134.75,22.85,384.0,212
CPT,92508,HC GROUP SPEECH LANGUAGE THERAPY 45 MIN,366.0,201.3,22.85,384.0,212
CPT,92508,HC GROUP SPEECH LANGUAGE THERAPY 60 MIN,487.0,267.85,22.85,421.26,212
CPT,92511,HC NASOPHARYNGOSCOPY,526.0,289.3,151.5,473.16,212
CPT,92512,HC NASAL FUNCTION STUDIES RHINOMANOMETRY,757.0,416.35,227.1,654.81,53
CPT,92516,HC FACIAL NERVE FUNCTION TEST,696.0,382.8,208.8,602.04,53
CPT,92517,"HC VESTIBULAR EVOKED MYOGENIC POTENTIAL TESTING, CVEMP",642.0,353.1,158.99,555.33,53
CPT,92518,"HC VESTIBULAR EVOKED MYOGENIC POTENTIAL TESTING, OVEMP",642.0,353.1,158.99,555.33,53
CPT,92519,"HC VESTIBULAR EVOKED MYOGENIC POTENTIAL TESTING, CVEMP & OVEMP",897.0,493.35,269.1,775.91,53
CPT,92520,HC LARYNGEAL FUNCTION STUDIES,255.0,140.25,76.5,384.0,53
CPT,92521,HC EVALUATION SPEECH FLUENCY 15 MIN,183.0,100.65,54.9,384.0,265
CPT,92521,HC EVALUATION SPEECH FLUENCY 30 MIN,343.0,188.65,102.9,384.0,265
CPT,92521,HC EVALUATION SPEECH FLUENCY 45 MIN,457.0,251.35,127.16,395.31,265
CPT,92521,HC EVALUATION SPEECH FLUENCY 60 MIN,611.0,336.05,127.16,528.52,265
CPT,92521,HC EVALUATION SPEECH FLUENCY 75 MIN,765.0,420.75,127.16,661.73,212
CPT,92521,HC TELEHEALTH SLP EVAL SPEECH FLUENCY 15 MIN,161.0,88.55,48.3,384.0,159
CPT,92521,HC TELEHEALTH SLP EVAL SPEECH FLUENCY 30 MIN,258.0,141.9,77.4,384.0,159
CPT,92521,HC TELEHEALTH SLP EVAL SPEECH FLUENCY 45 MIN,348.0,191.4,104.4,384.0,159
CPT,92521,HC TELEHEALTH SLP EVAL SPEECH FLUENCY 60 MIN,461.0,253.55,127.16,398.77,159
CPT,92522,HC EVALUATION SPEECH PRODUCTION 15 MIN,217.0,119.35,65.1,384.0,265
CPT,92522,HC EVALUATION SPEECH PRODUCTION 30 MIN,402.0,221.1,105.47,384.0,265
CPT,92522,HC EVALUATION SPEECH PRODUCTION 45 MIN,688.0,378.4,105.47,595.12,265
CPT,92522,HC EVALUATION SPEECH PRODUCTION 60 MIN,916.0,503.8,105.47,792.34,265
CPT,92522,HC EVALUATION SPEECH PRODUCTION 75 MIN,1147.0,630.85,105.47,992.16,265
CPT,92522,HC EVALUATION SPEECH PRODUCTION 90 MIN,1377.0,757.35,105.47,1191.11,53
CPT,92522,HC TELEHEALTH SLP EVAL SPEECH SOUND PRODUCTION 15 MIN,195.0,107.25,58.5,384.0,159
CPT,92522,HC TELEHEALTH SLP EVAL SPEECH SOUND PRODUCTION 30 MIN,384.0,211.2,105.47,384.0,159
CPT,92522,HC TELEHEALTH SLP EVAL SPEECH SOUND PRODUCTION 45 MIN,575.0,316.25,105.47,497.38,159
CPT,92522,HC TELEHEALTH SLP EVAL SPEECH SOUND PRODUCTION 60 MIN,766.0,421.3,105.47,662.59,159
CPT,92523,HC EVAL SPEECH SOUND PRODUCTN W LANG COMPREHENSION 15 MIN,224.0,123.2,67.2,384.0,265
CPT,92523,HC EVAL SPEECH SOUND PRODUCTN W LANG COMPREHENSION 30 MIN,355.0,195.25,106.5,384.0,265
CPT,92523,HC EVAL SPEECH SOUND PRODUCTN W LANG COMPREHENSION 45 MIN,533.0,293.15,159.9,461.05,265
CPT,92523,HC EVAL SPEECH SOUND PRODUCTN W LANG COMPREHENSION 60 MIN,711.0,391.05,213.3,615.02,265
CPT,92523,HC EVAL SPEECH SOUND PRODUCTN W LANG COMPREHENSION 75 MIN,888.0,488.4,217.22,768.12,265
CPT,92523,HC EVAL SPEECH SOUND PRODUCTN W LANG COMPREHENSION 90 MIN,1065.0,585.75,217.22,921.23,159
CPT,92523,HC TELEHEALTH SLP EVAL SPEECH SOUND PROD W LANG 15 MIN,213.0,117.15,63.9,384.0,159
CPT,92523,HC TELEHEALTH SLP EVAL SPEECH SOUND PROD W LANG 30 MIN,425.0,233.75,127.5,384.0,159
CPT,92523,HC TELEHEALTH SLP EVAL SPEECH SOUND PROD W LANG 45 MIN,636.0,349.8,190.8,550.14,159
CPT,92523,HC TELEHEALTH SLP EVAL SPEECH SOUND PROD W LANG 60 MIN,845.0,464.75,217.22,730.93,159
CPT,92524,HC BEHAVIORAL QUAL ANALYSIS VOICE RESONANCE 15 MIN,91.0,50.05,27.3,384.0,265
CPT,92524,HC BEHAVIORAL QUAL ANALYSIS VOICE RESONANCE 30 MIN,164.0,90.2,49.2,384.0,265
CPT,92524,HC BEHAVIORAL QUAL ANALYSIS VOICE RESONANCE 45 MIN,260.0,143.0,78.0,384.0,265
CPT,92524,HC BEHAVIORAL QUAL ANALYSIS VOICE RESONANCE 60 MIN,343.0,188.65,102.9,384.0,265
CPT,92524,HC BEHAVIORAL QUAL ANALYSIS VOICE RESONANCE 75 MIN,423.0,232.65,103.81,384.0,265
CPT,92524,HC BEHAVIORAL QUAL ANALYSIS VOICE RESONANCE 90 MIN,497.0,273.35,103.81,429.91,53
CPT,92524,HC TELEHEALTH SLP VOICE AND RESONANCE ANALYSIS 15 MIN,103.0,56.65,30.9,384.0,159
CPT,92524,HC TELEHEALTH SLP VOICE AND RESONANCE ANALYSIS 30 MIN,192.0,105.6,57.6,384.0,159
CPT,92524,HC TELEHEALTH SLP VOICE AND RESONANCE ANALYSIS 45 MIN,284.0,156.2,85.2,384.0,159
CPT,92524,HC TELEHEALTH SLP VOICE AND RESONANCE ANALYSIS 60 MIN,385.0,211.75,103.81,384.0,159
CPT,92526,HC SWALLOW ORAL OR MOTOR TREATMENT 15 MIN,255.0,140.25,76.5,384.0,265
CPT,92526,HC SWALLOW ORAL OR MOTOR TREATMENT 30 MIN,511.0,281.05,80.5,442.02,265
CPT,92526,HC SWALLOW ORAL OR MOTOR TREATMENT 45 MIN,769.0,422.95,80.5,665.19,265
CPT,92526,HC SWALLOW ORAL OR MOTOR TREATMENT 60 MIN,1072.0,589.6,80.5,927.28,265
CPT,92526,HC SWALLOW ORAL OR MOTOR TREATMENT 75 MIN,1328.0,730.4,80.5,1148.72,159
CPT,92526,HC SWALLOW ORAL OR MOTOR TREATMENT 90 MIN,1532.0,842.6,80.5,1325.18,53
CPT,92526,HC TELEHEALTH SLP SWALLOW ORAL OR MOTOR TREATMENT 15 MIN,193.0,106.15,57.9,384.0,159
CPT,92526,HC TELEHEALTH SLP SWALLOW ORAL OR MOTOR TREATMENT 30 MIN,385.0,211.75,80.5,384.0,159
CPT,92526,HC TELEHEALTH SLP SWALLOW ORAL OR MOTOR TREATMENT 45 MIN,577.0,317.35,80.5,499.11,159
CPT,92526,HC TELEHEALTH SLP SWALLOW ORAL OR MOTOR TREATMENT 60 MIN,781.0,429.55,80.5,675.57,159
CPT,92531,"HC SPONTANEOUS NYSTAGMUS, INCLUDING GAZE",92.0,50.6,27.6,471.0,38
CPT,92537,"HC CALORIC VESTIBULAR TEST WITH RECORDING, BILATERAL, BITHERMAL",346.0,190.3,103.8,471.0,53
CPT,92538,"HC CALORIC VESTIBULAR TEST W RECORD, BILAT, MONOTHERMAL (1 IRRIG PER EAR)",346.0,190.3,103.8,471.0,53
CPT,92540,HC BASIC VESTIBULAR EVALUATION,346.0,190.3,103.8,471.0,53
CPT,92541,HC SPONTANEOUS NYSTAGMUS TEST GAZE & FIXATION,283.0,155.65,84.9,471.0,53
CPT,92542,HC POSITIONAL NYSTAGMUS TEST MINIMUM 4 POSITIONS,283.0,155.65,84.9,471.0,53
CPT,92544,HC OPTOKINETIC TRACKING TEST BIDIRECTIONAL,346.0,190.3,103.8,471.0,53
CPT,92545,HC OSCILLATING TRACKING TEST,696.0,382.8,208.8,602.04,53
CPT,92546,HC SINUSOIDAL ROTATIONAL TEST,346.0,190.3,103.8,471.0,53
CPT,92547,HC USE OF VERTICAL ELECTRODES ENG ONLY QUANTITY 1,146.0,80.3,9.6,471.0,53
CPT,92548,CDP-SOT 6 COND W/I&R,,,130.99,134.92,15
CPT,92549,CDP-SOT 6 COND W/I&R MCT&ADT,,,130.99,134.92,15
CPT,92550,HC TYMPANOMETRY & REFLEX THRESH,346.0,190.3,103.8,471.0,53
CPT,92551,PURE TONE HEARING TEST AIR,,,11.56,11.91,15
CPT,92552,HC PURE TONE AUDIOMETRY AIR,276.0,151.8,82.8,471.0,53
CPT,92553,HC PURE TONE AUDIOMETRY AIR AND BONE,311.0,171.05,93.3,471.0,53
CPT,92553,HC PURE TONE AUDIOMETRY AIR AND BONE 52 REDUCED,346.0,190.3,103.8,471.0,53
CPT,92555,HC SPEECH THRESHOLD AUDIOMETRY,177.0,97.35,53.1,471.0,53
CPT,92556,HC SPEECH AUDIOMETRY THRESHOLD AND DISCRIM,221.0,121.55,60.36,471.0,53
CPT,92557,HC COMPREHENSIVE HEARING TEST,346.0,190.3,103.8,471.0,53
CPT,92558,EVOKED AUDITORY TEST QUAL,,,8.7,8.96,15
CPT,92562,LOUDNESS BALANCE TEST,,,316.44,325.94,15
CPT,92563,TONE DECAY HEARING TEST,,,39.89,41.08,15
CPT,92565,HC STENGER TEST PURE TONE,135.0,74.25,40.5,471.0,53
CPT,92567,HC TYMPANOMETRY (IMPEDANCE TESTING),277.0,152.35,39.89,471.0,106
CPT,92568,ACOUSTIC REFL THRESHOLD TST,,,39.89,41.08,15
CPT,92570,HC ACOUSTIC IMMITTANCE TESTING,381.0,209.55,114.3,471.0,53
CPT,92571,FILTERED SPEECH TEST,,,39.89,41.08,15
CPT,92572,STAGGERED SPONDAIC WORD TEST,,,158.99,163.76,15
CPT,92575,SENSORINEURAL ACUITY LVL TST,,,39.89,41.08,15
CPT,92576,SYNTHETIC SENTENCE ID TEST,,,39.89,41.08,15
CPT,92577,STENGER TEST SPEECH,,,539.2,555.37,15
CPT,92579,HC VISUAL AUDIOMETRY (VRA),346.0,190.3,103.8,471.0,53
CPT,92582,HC CONDITIONING PLAY AUDIOMETRY,346.0,190.3,103.8,471.0,53
CPT,92583,HC SELECT PICTURE AUDIOMETRY,135.0,74.25,40.5,471.0,53
CPT,92584,HC ELECTROCOCHLEOGRAPHY,346.0,190.3,103.8,471.0,53
CPT,92587,HC EVOKED OTOACOUSTIC EMISSIONS LTD,696.0,382.8,208.8,602.04,53
CPT,92588,HC EVOKED OTOACOUSTIC EMISSION COMPRHNSV DX EVAL,696.0,382.8,208.8,602.04,53
CPT,92590,HC HEARING AID EXAM & SELECTION MONAURAL,150.0,82.5,45.0,471.0,38
CPT,92590,"HC MINOR, HEARING AID EXAM & SELECTION MONAURAL",100.0,55.0,30.0,471.0,38
CPT,92591,HC HEARING AID EXAM & SELECTION BINAURAL,150.0,82.5,45.0,471.0,38
CPT,92591,"HC MINOR, HEARING AID EXAM & SELECTION, BINAURAL",100.0,55.0,30.0,471.0,38
CPT,92592,HC HEARING AID CHECK MONAURAL,50.0,27.5,15.0,471.0,38
CPT,92592,HC HEARING AID CHECK REPR MINOR MONAURAL,25.0,13.75,7.5,471.0,38
CPT,92592,HC LINK PROGRAMMING 1 HOUR,100.0,55.0,30.0,471.0,38
CPT,92592,HC LINK PROGRAMMING 1/2 HOUR,50.0,27.5,15.0,471.0,38
CPT,92593,HC HEARING AID CHECK BINAURAL,80.0,44.0,24.0,471.0,38
CPT,92593,HC HEARING AID CHECK REPR MINOR BINAURAL,50.0,27.5,15.0,471.0,38
CPT,92594,HC ELECTRO HEARING AID TEST ONE,50.0,27.5,15.0,471.0,38
CPT,92595,HC ELECTRO HEARING AID TEST BOTH,80.0,44.0,24.0,471.0,38
CPT,92596,EAR PROTECTOR EVALUATION,,,39.89,41.08,15
CPT,92597,HC EVAL FOR USE AND/OR FITTING VOICE PROSTH DEVICE 15 MIN,302.0,166.1,69.04,384.0,106
CPT,92597,HC EVAL FOR USE AND/OR FITTING VOICE PROSTH DEVICE 30 MIN,603.0,331.65,69.04,521.6,106
CPT,92597,HC EVAL FOR USE AND/OR FITTING VOICE PROSTH DEVICE 45 MIN,906.0,498.3,69.04,783.69,106
CPT,92597,HC EVAL FOR USE AND/OR FITTING VOICE PROSTH DEVICE 60 MIN,1208.0,664.4,69.04,1044.92,106
CPT,92597,HC EVAL FOR USE AND/OR FITTING VOICE PROSTH DEVICE 75 MIN,1513.0,832.15,69.04,1308.75,106
CPT,92597,HC EVAL FOR USE AND/OR FITTING VOICE PROSTH DEVICE 90 MIN,1813.0,997.15,69.04,1568.25,106
CPT,92601,COCHLEAR IMPLT F/UP EXAM <7,,,158.99,163.76,15
CPT,92602,REPROGRAM COCHLEAR IMPLT <7,,,158.99,163.76,15
CPT,92603,"HC DX ANALYSIS COCHLEAR IMPL, AGE 7 YEARS OR OLDER, W/ PROGRAMMING",829.0,455.95,158.99,717.09,53
CPT,92604,"HC DX ANALYSIS COCHLEAR IMPL, AGE 7 YEARS OR OLDER, SUBSEQ REPROGRAMMING",407.0,223.85,122.1,471.0,53
CPT,92605,EX FOR NONSPEECH DEVICE RX,,,84.2,86.73,15
CPT,92606,NON-SPEECH DEVICE SERVICE,,,72.76,74.95,15
CPT,92607,HC EX FOR SPEECH DEVICE RX 1 HR,641.0,352.55,117.54,554.47,212
CPT,92607,HC TELEHEALTH EX FOR SPEECH DEVICE RX 1 HR,482.0,265.1,117.54,416.93,53
CPT,92608,HC EX FOR SPEECH DEVICE RX EA ADDL 30 MIN,147.0,80.85,44.1,384.0,212
CPT,92608,HC TELEHEALTH EX FOR SPEECH DEVICE RX EA ADDL 30 MIN,110.0,60.5,33.0,384.0,53
CPT,92609,HC THERAPY FOR USE OF SPEECH DEVICE 30 MIN,433.0,238.15,97.86,384.0,212
CPT,92609,HC THERAPY FOR USE OF SPEECH DEVICE 45 MIN,611.0,336.05,97.86,528.52,212
CPT,92609,HC THERAPY FOR USE OF SPEECH DEVICE 60 MIN,812.0,446.6,97.86,702.38,212
CPT,92609,HC THERAPY FOR USE OF SPEECH DEVICE 75 MIN,968.0,532.4,97.86,837.32,212
CPT,92609,HC THERAPY FOR USE OF SPEECH DEVICE 90 MIN,1160.0,638.0,97.86,1003.4,212
CPT,92610,EVALUATE SWALLOWING FUNCTION,,,141.51,141.51,1
CPT,92610,HC SWALLOWING FUNCTION EVALUATION 15 MIN,252.0,138.6,75.6,384.0,265
CPT,92610,HC SWALLOWING FUNCTION EVALUATION 30 MIN,505.0,277.75,80.86,436.83,265
CPT,92610,HC SWALLOWING FUNCTION EVALUATION 45 MIN,755.0,415.25,80.86,653.08,265
CPT,92610,HC SWALLOWING FUNCTION EVALUATION 60 MIN,1006.0,553.3,80.86,870.19,265
CPT,92610,HC SWALLOWING FUNCTION EVALUATION 75 MIN,1258.0,691.9,80.86,1088.17,159
CPT,92610,HC SWALLOWING FUNCTION EVALUATION 90 MIN,1511.0,831.05,80.86,1307.02,159
CPT,92611,HC FLUORO SWALLOWING FUNCTION EVALUATION 105 MIN,1259.0,692.45,85.98,1089.04,106
CPT,92611,HC FLUORO SWALLOWING FUNCTION EVALUATION 120 MIN,1438.0,790.9,85.98,1243.87,106
CPT,92611,HC FLUORO SWALLOWING FUNCTION EVALUATION 15 MIN,180.0,99.0,54.0,384.0,265
CPT,92611,HC FLUORO SWALLOWING FUNCTION EVALUATION 30 MIN,359.0,197.45,85.98,384.0,265
CPT,92611,HC FLUORO SWALLOWING FUNCTION EVALUATION 45 MIN,539.0,296.45,85.98,466.24,265
CPT,92611,HC FLUORO SWALLOWING FUNCTION EVALUATION 60 MIN,657.0,361.35,85.98,568.31,265
CPT,92611,HC FLUORO SWALLOWING FUNCTION EVALUATION 75 MIN,899.0,494.45,85.98,777.64,265
CPT,92611,HC FLUORO SWALLOWING FUNCTION EVALUATION 90 MIN,1079.0,593.45,85.98,933.34,265
CPT,92611,MOTION FLUOROSCOPY/SWALLOW,,,150.46,150.46,1
CPT,92612,ENDOSCOPY SWALLOW (FEES) VID,,,325.27,325.27,1
CPT,92612,HC FLEXIBLE ENDOSCOPIC EVAL OF SWALLOWING BY CINE OR VIDEO RECORDING,733.0,403.15,185.87,634.05,159
CPT,92613,ENDOSCOPY SWALLOW (FEES) I&R,,,33.92,34.94,15
CPT,92614,LARYNGOSCOPIC SENSORY VID,,,140.16,245.28,16
CPT,92615,LARYNGOSCOPIC SENSORY I&R,,,30.09,31.0,15
CPT,92616,FEES W/LARYNGEAL SENSE TEST,,,215.42,376.99,16
CPT,92617,FEES W/LARYNGEAL SENSE I&R,,,37.75,38.88,15
CPT,92618,EX FOR NONSPEECH DEV RX ADD,,,29.5,30.39,15
CPT,92620,HC AUDITORY FUNCTION 60 MIN,346.0,190.3,103.8,471.0,53
CPT,92621,HC EVAL CENTRAL AUDITORY FUNCTION W RPT EA ADDL 15 MIN,135.0,74.25,20.41,471.0,53
CPT,92622,"HC DX ANALYS, PROG & VERIFC OF AN AUD OI SOUND PROCESSOR, 1ST 60 MIN",231.0,127.05,69.3,471.0,53
CPT,92623,"HC DX ANALYS, PROG & VERIFC OF AN AUD OI SOUND PROCESSOR, EA 15 MIN (AD)",58.0,31.9,17.4,471.0,53
CPT,92625,HC TINNITUS ASSESSMENT,346.0,190.3,103.8,471.0,53
CPT,92626,"HC EVAL AUD FUNCT FOR CANDIDACY/POSTOP STATUS SURG IMPL DEV, 1ST HR",346.0,190.3,103.8,471.0,53
CPT,92627,"HC EVAL AUD FUNCT CANDIDACY/POSTOP STATUS SURG IMPL DEV, EA AD 15 MIN (AD)",80.0,44.0,19.14,471.0,53
CPT,92640,"DX ANLYS W/ PROGRAMMING OF AUDITORY BRAINSTEM IMPL, PER HOUR",407.0,223.85,122.1,471.0,53
CPT,92650,AEP SCR AUDITORY POTENTIAL,,,24.4,25.13,15
CPT,92651,"HC ABR COMPREHENSV, AEP, FOR HEARING STATUS DETERM, BROADBAND STIMULI",696.0,382.8,208.8,602.04,53
CPT,92652,"HC ABR COMPREHENSV, AEP, FOR THRESHOLD ESTIMATION AT MULT FREQ",950.0,522.5,285.0,821.75,53
CPT,92652,"HC AUDITORY EVOKED POTENTIALS, FOR THRESHOLD ESTIMATION AT MULT FREQ",773.0,425.15,231.9,668.65,53
CPT,92653,"HC ABR COMPREHENSV, AEP, NEURODIAGNOSTIC",950.0,522.5,285.0,821.75,53
CPT,92653,"HC AUDITORY EVOKED POTENTIALS, NEURODIAGNOSTIC",773.0,425.15,231.9,668.65,53
CPT,92700,HC BONE CONDUCTION DISPENSING FEE MONAURAL,258.0,141.9,24.89,471.0,53
CPT,92700,HC SMELL TEST,140.0,77.0,24.89,471.0,53
CPT,92700,HC ULTRA HIGH FREQUENCY THRESHOLDS,359.0,197.45,24.89,471.0,53
CPT,92700,"HC VERTICAL HEAD IMPULSE TEST, UNLISTED OTORHINOLARYNGOLOGICAL SERVICE",159.0,87.45,24.89,471.0,53
CPT,92920,HC PTCA SGL MAJOR BRANCH,13254.0,7289.7,3976.2,21696.0,53
CPT,92921,HC PTCA EA ADDL MAJOR BRANCH,12189.0,6703.95,3656.7,21696.0,38
CPT,92924,HC PERCUT TRNSLUM CORONARY ATHRECT SGL MAJ BRNCH,22604.0,12432.2,6781.2,21696.0,53
CPT,92925,OP Surgery - Grouper Table,,,12463.0,21512.0,6
CPT,92928,HC PERCUT TRNCATH PLC INTRCOR STNT SGL MAJ BRNCH,19590.0,10774.5,5877.0,21696.0,53
CPT,92929,HC PERCUT TRNCATH PLC INTRCOR STNT EA ADDL BRNCH,24828.0,13655.4,7448.4,21696.0,38
CPT,92933,HC PTC ATHRECT W INTRCOR STNT ANGIOPLAST SGL BRNCH,29311.0,16121.05,8793.3,25354.02,53
CPT,92934,OP Surgery - Grouper Table,,,10315.0,17804.0,6
CPT,92934,PTCA,,,21696.0,21696.0,1
CPT,92937,HC PERCUT TRNSLM REVASC COR ART BYPSS GRFT SGL VSL,20569.0,11312.95,6170.7,21696.0,53
CPT,92938,HC PERCUT TRNSLM REVASC COR ART BYPSS GRFT (ADD ON),30084.0,16546.2,9025.2,26022.66,38
CPT,92941,HC PERCUT TRNSLM RESVASC OCCLUSION AMI SGL VESSEL,24808.0,13644.4,559.92,21696.0,53
CPT,92943,HC PERCUT TRNSLM RESVASC CHRONIC OCCLUSION SGL VSL,27513.0,15132.15,8253.9,23798.75,53
CPT,92944,OP Surgery - Grouper Table,,,10315.0,17804.0,6
CPT,92944,PTCA,,,21696.0,21696.0,1
CPT,92950,HC CARDIOPULMONARY RESUSCITATION,1829.0,1005.95,316.44,2313.0,212
CPT,92953,HC TEMPORARY TRANSCUTANEOUS PACING,1950.0,1072.5,585.0,8446.0,53
CPT,92960,"HC CARDIOVERSION, ELECTIVE, ELECTRICAL CONVERSION OF ARRHYTHMIA, EXTERNAL",2084.0,1146.2,625.2,2313.0,159
CPT,92961,HC CARDIOVERSION ELECTRIC INT,2030.0,1116.5,609.0,2313.0,53
CPT,92970,CARDIOASSIST INTERNAL,,,159.66,4602.0,21
CPT,92971,CARDIOASSIST EXTERNAL,,,85.57,4602.0,21
CPT,92972,HC PERCUTANEOUS TRANSLUMINAL CORONARY LITHOTRIPSY (AD),15641.0,8602.55,131.88,24494.0,53
CPT,92973,HC PERCUT CORONARY THROMBECTOMY MECHANICAL,11627.0,6394.85,149.2,10057.36,53
CPT,92974,HC CATH PLACE CARDIO BRACHYTX,5849.0,3216.95,136.61,8446.0,53
CPT,92975,APC,,,317.84,327.37,15
CPT,92975,OP Surgery - Grouper Table,,,2453.0,4602.0,7
CPT,92977,APC,,,337.06,347.18,15
CPT,92977,OP Surgery - Grouper Table,,,835.0,4258.0,7
CPT,92978,"HC ENDOLUM IMAG CORONARY VESSEL/GRAFT BY IVUS/OCT, INITIAL VESSEL (ADD ON)",5624.0,3093.2,835.0,8446.0,38
CPT,92979,"HC ENDOLUM IMAG CORONARY VESSEL/GRAFT BY IVUS/OCT, EA ADDL VESSEL (ADD ON)",3628.0,1995.4,835.0,8446.0,38
CPT,92986,HC REVISION OF AORTIC VALVE,10218.0,5619.9,3065.4,17804.0,53
CPT,92987,HC REVISION OF MITRAL VALVE,14511.0,7981.05,4353.3,19884.0,53
CPT,92990,HC PERCUTANEOUS BALLON VALVULOPLASTY; PULMONARY VALVE,21222.0,11672.1,6366.6,19884.0,53
CPT,92997,"HC PERCUTANEOUS TRANSLUM PULM ART BALLOON ANGIOPLASTY, SINGLE VESSEL",36466.0,20056.3,10315.0,31543.09,53
CPT,92998,"HC PERCUTAN TRANSLUM PULM ART BALLOON ANGIOPLASTY, EA ADDL VESSEL (ADD ON)",9867.0,5426.85,271.03,17804.0,53
CPT,93000,ELECTROCARDIOGRAM COMPLETE,,,13.14,13.54,15
CPT,93005,"HC ELECTRCARDGR, ROUTINE ECG W/AT LST 12 LEADS,TRACING ONLY, W/O INTERP-RPT",357.0,196.35000000000002,60.36,391.85,530
CPT,93010,ELECTROCARDIOGRAM REPORT,,,7.46,7.69,15
CPT,93015,CV STRESS TEST SUPVJ I&R,,,68.03,70.07,15
CPT,93016,CV STRESS TEST SUPVJ ONLY,,,19.62,20.2,15
CPT,93017,HC CARDIOVASC STRESS TEST TRACING ONLY WO INT&RPT,1110.0,610.5,316.44,960.15,106
CPT,93018,CV STRESS TEST I&R ONLY,,,13.22,13.61,15
CPT,93024,ERGONOVINE PROVOCATION TEST,,,405.5,417.67,15
CPT,93025,MICROVOLT T-WAVE ASSESS,,,158.99,163.76,15
CPT,93040,RHYTHM ECG WITH REPORT,,,12.19,12.55,15
CPT,93041,HC RHYTHM ECG TRACING,160.0,88.0,48.0,260.0,53
CPT,93042,RHYTHM ECG REPORT,,,6.2,6.38,15
CPT,93050,ART PRESSURE WAVEFORM ANALYS,,,24.89,25.63,15
CPT,93150,THERAPY ACTIVATION IPNSS,,,93.28,96.08,15
CPT,93151,INTERROG&PRGRMG IPNSS,,,93.28,96.08,15
CPT,93152,INTERROG&PRGRMG IPNSS POLYSM,,,304.77,313.91,15
CPT,93153,INTERROG W/O PRGRMG IPNSS,,,93.28,96.08,15
CPT,93224,XTRNL ECG REC UP TO 48 HRS,,,65.25,67.21,15
CPT,93225,"HC ECG RECORDING UP TO 48 HRS BY CONT RHYTHM RECORD & STORAGE, RECORD ONLY",759.0,417.45,130.99,1220.0,53
CPT,93226,XTRNL ECG REC<48 HR SCAN A/R,,,60.36,62.17,15
CPT,93227,XTRNL ECG REC<48 HR R&I,,,17.06,17.57,15
CPT,93228,REMOTE 30 DAY ECG REV/REPORT,,,23.28,23.98,15
CPT,93229,REMOTE 30 DAY ECG TECH SUPP,,,316.44,325.94,15
CPT,93241,XTRNL ECG REC>48HR<7D,,,248.46,255.91,15
CPT,93242,"HC EXT ECG RECORD MORE THAN 48 HRS UP TO 7 DAYS, BY CONT REC & STORAGE",793.0,436.15,39.89,1220.0,53
CPT,93243,EXT ECG>48HR<7D SCAN A/R,,,130.99,134.92,15
CPT,93244,EXT ECG>48HR<7D REV&INTERPJ,,,21.34,21.98,15
CPT,93245,EXT ECG>7D<15D REC SCAN A/R,,,258.74,266.51,15
CPT,93246,"HC EXT ECG RECORD MORE THAN 7 DAYS UP TO 15 DAYS, BY CONT REC & STORAGE",816.0,448.8,39.89,1220.0,53
CPT,93247,EXT ECG>7D<15D SCAN A/R,,,130.99,134.92,15
CPT,93248,EXT ECG>7D<15D REV&INTERPJ,,,23.58,24.28,15
CPT,93260,HC PROGRAM DEVICE EVAL W ITERATV ADJ IMPL SUBQ LEAD DEFIB SYS,183.0,100.65,37.89,2313.0,212
CPT,93261,HC INTERROGATION DEVICE EVAL IMPL SUBQ LEAD DEFIB SYS,164.0,90.2,37.89,2313.0,212
CPT,93264,"HC REMOTE MNTR WIRELESS P-ART PRS SNR UP TO 30 DAYS, INCLD REC ITP ALYS RPT",94.5,51.98,28.35,2313.0,53
CPT,93268,ECG RECORD/REVIEW,,,156.24,160.93,15
CPT,93270,HC ECG RECORDING,816.0,448.8,37.89,705.84,53
CPT,93271,ECG/MONITORING AND ANALYSIS,,,93.28,96.08,15
CPT,93272,ECG/REVIEW INTERPRET ONLY,,,22.3,22.97,15
CPT,93278,HC ECG SIGNAL AVERAGED,584.0,321.2,60.36,505.16,53
CPT,93279,"HC PROG DEV EVAL W/ ITERATV ADJ, SGL LD/LDLESS PMK SYS IN 1 CARD CHAMBER",291.0,160.05,37.89,2313.0,212
CPT,93280,HC PROGRM EVAL W ITERATV ADJ DUAL LEAD PACEMKR SYS,344.0,189.2,37.89,2313.0,212
CPT,93281,HC PROGRM EVAL W ITERATV ADJ MULT LEAD PACEMKR SYS,278.0,152.9,37.89,2313.0,212
CPT,93282,HC PROGRAM DEV EVAL W ITERATV ADJ SGL LEAD TRANSVEN IMPL DEFIB,450.0,247.5,37.89,2313.0,212
CPT,93283,HC PROGRAM DEV EVAL W ITERATV ADJ DUAL LEAD TRANSVEN IMPL DEFIB,470.0,258.5,37.89,2313.0,212
CPT,93284,HC PROGRAM DEV EVAL W ITERTAV ADJ MULT LEAD TRANSVEN IMPL DEFIB,470.0,258.5,37.89,2313.0,212
CPT,93285,"HC PROG DEV EVAL W/ ITERATV ADJ, SUBCUT CARD RHYTHM MONITOR",164.0,90.2,37.89,2313.0,212
CPT,93286,HC PERI-PROC EVAL & PROGRAM PACEMAKER SYSTEM,335.0,184.25,41.18,2313.0,159
CPT,93287,HC PERI-PROC DEVICE EVAL & PROGRAM LEAD IMPL DEFIB SYS,328.0,180.4,47.89,2313.0,159
CPT,93288,"HC INTERG DEV EVAL W/ ANLYS, W CONN, REC &DISCON, SGL/DL/MULT LD/LDLESS PMK",198.0,108.9,37.89,2313.0,212
CPT,93289,HC INTERROGATION DEVICE EVAL LEAD TRANSVEN IMPL DEFIB SYS,329.0,180.95,37.89,2313.0,212
CPT,93290,INTERROG DEV EVAL ICPMS IP,,,37.89,39.03,15
CPT,93291,"HC INTERG DEV EVAL W/ ANLYS, W CONN, REC & DISCON, SUBCUT CARD RHYTHM MONIT",190.0,104.5,24.89,2313.0,212
CPT,93292,WCD DEVICE INTERROGATE,,,37.89,39.03,15
CPT,93293,HC TRANSTELEPH RHYTHM STRIP EVAL PACEMKR SYS,248.0,136.4,37.89,2313.0,53
CPT,93294,REM INTERROG EVL PM/LDLS PM,,,26.96,27.76,15
CPT,93295,DEV INTERROG REMOTE 1/2/MLT,,,33.34,34.34,15
CPT,93296,"HC INTERG DEV EVAL REMOTE, ONCE EV 90 DAYS, SGL/DL/MULT LD/LDLESS PMK/ICD",299.0,164.45,37.89,2313.0,159
CPT,93297,REM INTERROG DEV EVAL ICPMS,,,37.89,39.03,15
CPT,93298,REM INTERROG DEV EVAL SCRMS,,,37.89,39.03,15
CPT,93303,HC TTE CONGENITAL CARDIAC ANOMALIES COMPLETE,2640.0,1452.0,515.0,2283.6,53
CPT,93304,HC TTE CONGENITAL CARDIAC ANOMALIES FOLLOW-UP LTD,1808.0,994.4,515.0,1563.92,53
CPT,93306,HC TTE W DOPPLER COMPL,4178.0,2297.9,515.0,3613.97,159
CPT,93307,TTE W/O DOPPLER COMPLETE,,,245.64,253.0,15
CPT,93308,HC TTE FOLLOW-UP OR LTD STUDY,1276.0,701.8,245.64,1103.74,371
CPT,93312,HC TEE REAL-TIME 2D W PROBE IMAG ACQUISITION I & R,3441.0,1892.55,515.0,3067.29,265
CPT,93313,HC TEE REAL-TIME 2D W PROBE PLACE ONLY,2407.0,1323.85,515.0,2082.06,53
CPT,93314,HC TEE REAL-TIME 2D IMAG ACQUISITION I & R,2134.0,1173.7,205.2,1845.91,53
CPT,93315,HC TEE CONGENT CARDIAC ANOMAL W PRB IMAG ACQ I & R,2615.0,1438.25,515.0,2289.66,159
CPT,93316,HC TEE CONGENT CARDIAC ANOMAL W PROBE PLACE ONLY,2192.0,1205.6,515.0,1896.08,53
CPT,93317,HC TEE CONGENT CARDIAC ANOMAL IMAG ACQ I & R,2002.0,1101.1,515.0,1731.73,38
CPT,93318,HC TEE MONITOR PROBE PLC REAL-TIME 2D IMMEDIATE,2685.0,1476.75,515.0,2322.53,159
CPT,93319,3D ECHO IMG CGEN CAR ANOMAL,,,49.72,51.22,15
CPT,93320,HC DOPPLER ECHOCARD PULSE WAVE W SPECTRAL DISPLAY,1305.0,717.75,46.56,1128.83,53
CPT,93321,HC DOPPLR ECHO PLSE WAVE SPECT DISPL FOLLW-UP LTD,698.0,383.9,22.91,876.0,53
CPT,93325,HC DOPPLER ECHO COLOR FLOW MAPPING,1153.0,634.15,21.15,997.35,159
CPT,93350,STRESS TTE ONLY,,,557.18,573.9,15
CPT,93351,HC 2D TTE WO CONTRAST CONTINOUS ECG,5422.0,2982.1,515.0,4690.03,53
CPT,93352,ADMIN ECG CONTRAST AGENT,,,32.36,33.33,15
CPT,93355,HC TEE FOR GUID OF TRANSCATH INTRACARDIAC INTERVENTION,3467.0,1906.85,204.11,2998.96,106
CPT,93356,HC MYOCRD STRAIN IMG SPECKLE TRCK ASSMT MYOCRD MECH (ADD ON),600.0,330.0,33.67,876.0,53
CPT,93451,HC RIGHT HEART CATH,17510.0,9630.5,3268.52,16799.0,53
CPT,93452,LEFT HRT CATH W/VENTRCLGRPHY,,,3268.52,16799.0,22
CPT,93453,HC RIGHT & LEFT HEART CATHETERIZATION,14676.0,8071.8,3268.52,16799.0,53
CPT,93454,HC CORONARY ARTERY ANGIO S&I,15483.0,8515.65,3268.52,16799.0,53
CPT,93455,HC CORONARY ART GRFT ANGIO S&I,13261.0,7293.55,3268.52,16799.0,53
CPT,93456,HC R HRT CORONARY ARTERY ANGIO,16503.0,9076.65,3268.52,16799.0,53
CPT,93457,HC R HRT ART GRFT ANGIO,13275.0,7301.25,3268.52,16799.0,53
CPT,93458,HC L HRT ARTERY VENTRICLE ANGIO,28840.0,15862.0,3268.52,24946.6,53
CPT,93459,HC L HRT ART GRFT ANGIO,22474.0,12360.7,3268.52,19440.01,53
CPT,93460,HC RIGHT & LEFT HEART ART CATHETERIZATION W INJ LT,18105.0,9957.75,3268.52,16799.0,53
CPT,93461,HC RT LT HRT ART CATH W INJ LT VENTRIGR BYPAS GRFT,14996.0,8247.8,3268.52,16799.0,53
CPT,93462,HC L HRT CATH TRNSPTL PUNCTURE,10804.0,5942.2,175.97,13639.0,53
CPT,93463,HC DRUG ADMIN & HEMODYNMIC MEAS,501.0,275.55,88.38,8446.0,53
CPT,93464,HC EXERCISE W HEMODYNAMIC MEAS,690.0,379.5,198.51,8446.0,53
CPT,93503,HC INSERT AND PLACE FLOW DIRECTED CATH FOR MONITOR PURPOSE,6199.0,3409.45,1578.61,13639.0,106
CPT,93505,HC HEART LINING BX,6830.0,3756.5,2049.0,14658.0,53
CPT,93563,HC INJ CONGENITAL CARD CATH,7504.0,4127.2,44.89,8446.0,53
CPT,93564,HC INJ HRT CONGNTL ART GRFT,10975.0,6036.25,46.92,9493.38,53
CPT,93565,"HC INJ PROC DURING CARDIAC CATH, SELECTV LEFT VENTRICULR/ATRIAL ANGIO (ADD)",7504.0,4127.2,22.83,8446.0,53
CPT,93566,HC INJ R VENTR ATRIAL ANGIO,10975.0,6036.25,22.6,9493.38,53
CPT,93567,HC INJ SUPRVLV AORTOGRAPHY,898.0,493.9,31.78,8446.0,53
CPT,93568,"HC INJ PROCEDURE DURING CARDIAC CATH, FOR NONSEL PULM ART ANGIOGRAPHY (AD)",982.0,540.1,39.99,8446.0,53
CPT,93569,NJX CTH SLCT P-ART ANGRP UNI,,,34.12,3533.0,21
CPT,93571,HC INTRVSC DOPLR PRESS COR FLO RSRV MEAS 1ST VSL,3726.0,2049.3,1117.8,3222.99,38
CPT,93572,HC INTRVSC DOPLR PRESS COR FLO RSRV MEAS EA AD VSL,2919.0,1605.45,875.7,2524.94,38
CPT,93573,NJX CATH SLCT P-ART ANGRP BI,,,56.84,3533.0,21
CPT,93574,NJX CATH SLCT PULM VN ANGRPH,,,63.13,3533.0,21
CPT,93575,NJX CATH SLCT P ANGRPH MAPCA,,,83.93,3533.0,21
CPT,93580,HC TRANSCATH CLOSURE OF ASD,48225.0,26523.75,13725.0,41714.63,53
CPT,93581,HC TRANSCATH CLOSURE OF VSD,48225.0,26523.75,13725.0,41714.63,53
CPT,93582,HC PERCUTANEOUS TRANSCATHETER CLOSURE OF PDA,42991.0,23645.05,12897.3,37187.22,53
CPT,93583,"HC ALCOHOL SEPTAL ABLATION, PERCUTANEOUS TRANSCATH SEPTAL REDUCTION THERAPY",30045.0,16524.75,628.2,25988.93,53
CPT,93584,VNGRPH CHD ANOM/PERSIST SVC,,,53.2,54.79,15
CPT,93585,VNGRPH CHD AZYGS/HEMIAZYGS,,,50.0,51.5,15
CPT,93586,VNGRPH CHD CORONARY SINUS,,,63.43,65.34,15
CPT,93587,VNGRPH CHD VNVN CLTRL AT/ABV,,,93.29,96.09,15
CPT,93588,VNGRPH CHD VNVN CLTRL BELOW,,,94.35,97.18,15
CPT,93590,"HC PERCUTANEOUS TRANSCATH CL OF PARAVALVULAR LEAK, INI OCCL DEV, MITRAL VAL",33430.0,18386.5,10029.0,28916.95,53
CPT,93591,"HC PERQ TRANSCATH CLSR PARAVALVULAR LEAK, INIT OCCLUSION DEV, AORTIC VALVE",41399.0,22769.45,12419.7,35810.14,53
CPT,93592,PERQ TRANSCATH CLOSURE EACH,,,349.99,3533.0,21
CPT,93593,"HC RT HEART CATH FOR CHD(S) INCL IMG GUID, NORMAL NATIVE CONNECTIONS",10091.0,5550.05,3027.3,16799.0,53
CPT,93594,"HC RT HEART CATH FOR CHD(S) INCL IMG GUID, ABNORMAL NATIVE CONNECTIONS",12683.0,6975.65,3268.52,16799.0,53
CPT,93595,L HRT CATH CHD NM/ABN NT CNJ,,,3268.52,16799.0,22
CPT,93596,"HC RT & LT HEART CATH FOR CHD(S) INCL IMG GUID, NORMAL NATIVE CONNECTIONS",12813.0,7047.15,3268.52,16799.0,53
CPT,93597,"HC RT & LT HEART CATH FOR CHD(S) INCL IMG GUID, ABNORMAL NATIVE CONNECTIONS",12813.0,7047.15,3268.52,16799.0,53
CPT,93598,CAR OUTP MEAS DRG CATH CHD,,,835.0,3533.0,6
CPT,93600,HC BUNDLE OF HIS RECORDING,19006.0,10453.3,1350.0,19314.0,53
CPT,93602,INTRA-ATRIAL RECORDING,,,3917.0,19314.0,22
CPT,93603,RIGHT VENTRICULAR RECORDING,,,1233.66,19314.0,22
CPT,93609,INTRA-VNTR MAPG TCHYCAR SITE,,,835.0,19314.0,7
CPT,93610,INTRA-ATRIAL PACING,,,3917.0,19314.0,22
CPT,93612,INTRAVENTRICULAR PACING,,,3917.0,19314.0,22
CPT,93613,HC INTRACARDIAC ELETROPHYS 3D MAPPING,10279.0,5653.45,247.02,19314.0,53
CPT,93615,ESOPHAGEAL RECORDING,,,1233.66,19314.0,22
CPT,93616,ESOPHAGEAL RECORDING W/PACG,,,1233.66,19314.0,22
CPT,93618,INDCTJ ARRHYTHMIA ELEC PACG,,,1233.66,19314.0,22
CPT,93619,HC COMPRHNSV ELECTRPHYS EVAL WO ARRHYTH INDUCT RT,15584.0,8571.2,1350.0,19314.0,53
CPT,93620,HC COMPRHNSV ELECTRPHYS EVAL W ARRHYTH INDUCT RT,18700.0,10285.0,1350.0,19314.0,53
CPT,93621,HC COMPRHNSV ELCTRPHYS EVAL W ARRHYTH INDCT LT ATR,12109.0,6659.95,1350.0,19314.0,38
CPT,93622,COMP EP EVAL L VENTR PAC&REC,,,835.0,19314.0,7
CPT,93623,HC STIMULATION PACING HEART POST IV DRUG INFUSN,5521.0,3036.55,1350.0,19314.0,38
CPT,93624,EP F-UP STUDY PACG&REC,,,7711.03,17804.0,21
CPT,93631,NTRAOP EPICAR&ENDCAR PAC&MAP,,,835.0,19314.0,7
CPT,93640,EP EVAL 1/2CHMBR PACG CVDFB,,,835.0,3533.0,6
CPT,93641,HC ELECTROPHYS EVAL PAC CVDFB LEADS W TEST PLS GEN,4928.0,2710.4,1350.0,4262.72,38
CPT,93642,HC ELECTROPHYS EVAL TRANSVEN PAC CVDFB PRG REPRG PARAMETERS,5376.0,2956.8,1233.66,4650.24,53
CPT,93644,EP EVAL SUBQ IMPL DFB,,,177.61,3533.0,21
CPT,93650,HC INTRACARD CATH ABLATION ATRIOVENTR NODE FUNCTN,25628.0,14095.4,1350.0,22168.22,53
CPT,93653,"HC COMPRHSV ELECTROPHYS EVAL, TX SUPRAVENTRIC TACHYCARDIA BY ABLATION",44726.0,24599.3,1350.0,38687.99,53
CPT,93654,"HC COMPRHSV ELECTROPHYS EVAL, TX VENTRIC TACHYCARDIA/FOCUS VENTRIC ECTOPY",45429.0,24985.95,1350.0,39296.09,53
CPT,93655,HC INTRACARD CATH ABLATION DISCRETE MECH ARRHYTHM (AD),17320.0,9526.0,260.32,19314.0,53
CPT,93656,"HC COMPRHSV ELECTROPHYS EVAL TRNSSEPT CATH, ABLAT ATR FIB BY PULM VEIN ISOL",45949.0,25271.95,1350.0,39745.89,53
CPT,93657,HC COMPRHSV EP EVAL TRNSEPT CATH TX ATRIAL FIB ADD,13522.0,7437.1,260.63,19314.0,53
CPT,93660,HC CARDIOVASC FUNCTION EVAL W TILT TABLE EVAL,2578.0,1417.9,539.2,2313.0,106
CPT,93662,HC INTRACARDIAC ECG (ICE),8177.0,4497.35,1350.0,7073.11,38
CPT,93668,"HC PERIPHERAL ARTERIAL DISEASE (PAD) REHABILITATION, PER SESSION",151.0,83.05,45.3,2313.0,53
CPT,93701,BIOIMPEDANCE CV ANALYSIS,,,130.99,134.92,15
CPT,93702,"HC BIOIMPED SPECTROSCOPY (BIS), EXTRACELL FLUID ANALY FOR LYMPHEDEMA ASSESS",373.0,205.15,111.9,322.65,106
CPT,93724,HC ELECTRONIC ALYS ANTITACHYCARDIA PACEMAKER SYS,5219.0,2870.45,304.77,4514.44,53
CPT,93740,HC TEMPERATURE GRADIENT STUDIES,257.0,141.35,77.1,834.0,53
CPT,93745,SET-UP CARDIOVERT-DEFIBRILL,,,304.77,3533.0,21
CPT,93750,HC INTERROGATION VAD IN PERSON,521.0,286.55,93.28,834.0,159
CPT,93770,DETERMINATION VENOUS PRESS,,,7.14,7.35,15
CPT,93784,AMBL BP MNTR W/SOFTWARE,,,42.64,43.92,15
CPT,93786,HC AMBL BLD PRESSURE MONITORING 24 HRS REC ONLY,283.0,155.65,84.9,603.0,159
CPT,93788,HC AMBL BLD PRESS MONITOR 24 HRS SCAN ANLYS W RPT,377.0,207.35,113.1,603.0,159
CPT,93790,AMBL BP MNTR W/SW I&R,,,16.73,17.23,15
CPT,93792,PT/CAREGIVER TRAING HOME INR,,,63.16,65.06,15
CPT,93793,ANTICOAG MGMT PT WARFARIN,,,10.57,10.89,15
CPT,93797,HC CARDIAC REHAB WO CONTINUOUS ECG MONITOR,316.0,173.8,94.8,346.0,53
CPT,93798,"HC PHASE II INIT EVAL, CARDIAC REHAB, W/ CONT ECG MONITORING (PER SESSION)",473.0,260.15,127.95,409.15,53
CPT,93798,"HC PHASE II, CARDIAC REHAB, W/ CONT ECG MONITORING (PER SESSION)",487.0,267.85,127.95,421.26,53
CPT,93799,"HC EP DRUG INFUSION, UNLISTED CARDIOVASCULAR SERVICE OR PROCEDURE",557.0,306.35,158.99,8446.0,53
CPT,93799,"HC TAVR - TRANSCORATID APPROACH, UNLISTED CARDIOVASCULAR SERVICE OR PROC",49847.0,27415.85,158.99,43117.66,53
CPT,93880,"HC DUPLEX SCAN EXTRACRANIAL ARTERIES, COMPLETE BILATERAL STUDY",2324.5,1278.475,245.64,2308.69,371
CPT,93882,"HC UNILAT/LTD, DUPLEX SCAN EXTRACRANIAL ARTERIES",825.0,453.75,108.06,834.0,265
CPT,93886,HC TRANSCRAN DOPPLER STUDY INTRACRAN ART COMPL,955.0,525.25,245.64,826.08,159
CPT,93888,HC TRANSCRAN DOPPLER STUDY INTRACRAN ART LTD,537.0,295.35,108.06,668.0,159
CPT,93892,TCD EMBOLI DETECT W/O INJ,,,108.06,111.3,15
CPT,93893,HC TRANSCRAN DOPPLR STDY INTRCRAN ART VEN-ARTL SHUNT W INJ,537.0,295.35,108.06,668.0,53
CPT,93896,VSRCTV STD TCD ICR ART COMPL,,,165.52,170.49,15
CPT,93897,EMBOLI DETCJ WO IV MBUBB NJX,,,207.93,214.17,15
CPT,93898,VEN-ARTL SHUNT DET MBUBB NJX,,,218.0,224.54,15
CPT,93922,HC LTD BILAT UPR LWR EXTREMITY ART STUDY 1-2 LVLS,708.0,389.4,130.99,834.0,106
CPT,93923,"HC BILAT COMPL NONINV UP/LOW EXTREM ART, 3 OR MORE LVLS/SGL LVL PROVOCATIVE",1431.0,787.05,158.99,1237.82,106
CPT,93924,"HC BILAT COMPL, NONINVASIVE LOW EXTREM ART, AT REST FOLLOW TREADMILL STRESS",1139.0,626.45,158.99,985.24,53
CPT,93925,"HC DUPLEX SCAN LOWER EXTREMITY ART OR ART BYPASS GRAFTS, COMPLETE BILAT",1906.0,1048.3,245.64,1648.69,106
CPT,93926,"HC UNILAT OR LTD, DUPLEX SCAN LOWER EXTREM ART OR ARTERIAL BYPASS GRAFTS",1565.0,860.75,108.06,1353.73,371
CPT,93930,"HC BILAT COMPL, DUPLEX SCAN UPPER EXTREM ART OR ARTERIAL BYPASS GRAFTS",1228.0,675.4,245.64,1062.22,106
CPT,93931,"HC UNILAT/LTD, DUPLEX SCAN UPPER EXTREM ART OR ARTERIAL BYPASS GRAFTS",1193.0,656.15,108.06,1031.95,636
CPT,93970,"HC BILAT COMPL, DUPLEX SCAN EXTREM VEINS INCL RESPONSES TO COMPRESSION",2644.5,1454.475,245.64,2872.67,318
CPT,93970,"HC BILAT COMPL, DUPLEX SCAN LOWER EXTREM VEINS INCL RESPONSE TO COMPRESSION",3321.0,1826.55,245.64,2872.67,53
CPT,93970,"HC BILAT COMPL, DUPLEX SCAN UPPER EXTREM VEINS INCL RESPONSE TO COMPRESSION",3321.0,1826.55,245.64,2872.67,53
CPT,93971,"HC UNILAT/LTD, DUPLEX SCAN EXTREM VEINS INCL RESPONSES TO COMPRESSION",1260.0,693.0,108.06,1095.09,477
CPT,93971,"HC UNILAT/LTD, DUPLEX SCAN LOWER EXTREM VEINS INCL RESPONSES TO COMPRESSION",1266.0,696.3,108.06,1095.09,53
CPT,93971,"HC UNILAT/LTD, DUPLEX SCAN UPPER EXTREM VEINS INCL RESPONSES TO COMPRESSION",1266.0,696.3,108.06,1095.09,53
CPT,93975,"HC DUPLEX SCAN ART INFLOW VEN OUTFLOW ABD, PELV, SCRTL CONT/RETROPERIT ORGN",1822.0,1002.1,245.64,1849.37,212
CPT,93976,"HC LTD, DUPLEX SCAN ART INFLOW VEN OUTFLOW ABD, PELV, SCROTAL CONTENTS",1332.5,732.875,108.06,1218.79,477
CPT,93978,"HC DUPLEX SCAN AORTA, IVC, ILIAC VASC, OR BYPASS GRAFTS, COMPLETE STUDY",1584.0,871.2,245.64,1370.16,53
CPT,93979,"HC UNILAT/LTD, DUPLEX SCAN AORTA, INF VENA CAVA, ILIAC VASC/BYPASS GRAFTS",571.5,314.325,108.06,834.0,477
CPT,93980,"HC DUPLEX SCAN ARTERIAL INFLOW AND VENOUS OUTFLOW PENILE VESSELS, COMPLETE",549.0,301.95,108.06,834.0,212
CPT,93981,"HC DUPLEX SCAN ART INFLOW VEN OUTFLOW PENILE VESSELS, FOLLOW UP/LTD",647.0,355.85,108.06,834.0,53
CPT,93985,HC DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL BI STD,842.0,463.1,245.64,834.0,53
CPT,93986,HC DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL UNI STD,862.0,474.1,108.06,834.0,159
CPT,93990,HC DUPLEX SCAN HEMODIALYSIS ACCESS,691.0,380.05,108.06,834.0,265
CPT,93998,HC DX DUPLEX STUDY OF BILAT NECK & CHEST VESSELS FOR SOFT TISSUE SWELLING,96.0,52.8,24.89,83.04,53
CPT,94002,HC VENT MGMT INPT INITIAL DAY,936.0,514.8,280.8,809.64,53
CPT,94003,HC VENT MGMT INPT SUBSEQ DAY,936.0,514.8,280.8,809.64,53
CPT,94004,VENT MGMT NF PER DAY,,,43.31,44.61,15
CPT,94005,HOME VENT MGMT SUPERVISION,,,84.36,86.89,15
CPT,94010,HC SPIROMETRY,476.0,261.8,142.8,748.0,53
CPT,94010,HC SPIROMETRY W DEVICE INSTRUCTION,404.0,222.2,121.2,748.0,53
CPT,94010,HC SPIROMETRY WO BD BEDSIDE,520.0,286.0,156.0,748.0,53
CPT,94010,"HC SPIROMETRY, INCL GRPH RECORD, TOTAL-TIMED VITAL CAPACITY,EXPIR FLOW RATE",500.25,275.14,142.65,748.0,318
CPT,94011,SPIROMETRY UP TO 2 YRS OLD,,,158.99,163.76,15
CPT,94012,SPIRMTRY W/BRNCHDIL INF-2 YR,,,316.44,325.94,15
CPT,94013,MEAS LUNG VOL THRU 2 YRS,,,539.2,555.37,15
CPT,94014,PATIENT RECORDED SPIROMETRY,,,405.5,417.67,15
CPT,94015,HC PATIENT-INIT SPIROMETRIC RECORDING W TEACHING,512.0,281.6,153.6,748.0,53
CPT,94016,REVIEW PATIENT SPIROMETRY,,,22.61,23.28,15
CPT,94060,HC SPIROMETRY W BD,848.0,466.4,254.4,748.0,159
CPT,94070,HC METHACHOLINE CHALLENGE,791.0,435.05,237.3,748.0,53
CPT,94070,HC METHACOLINE CHALLENGE W HH NEBULIZER,921.0,506.55,276.3,796.67,53
CPT,94070,HC METHACOLINE CHALLENGE W HH NEBULIZER SPIROMETRY,955.0,525.25,286.5,826.08,53
CPT,94150,HC VITAL CAPACITY,211.0,116.05,63.3,748.0,53
CPT,94200,HC MAX VOLUNT VENT,226.0,124.3,60.36,748.0,53
CPT,94375,RESPIRATORY FLOW VOLUME LOOP,,,316.44,325.94,15
CPT,94450,BREATHING RESPONSE HYPOXIA,,,158.99,163.76,15
CPT,94452,HAST W/I&R PHYS/QHP,,,130.99,134.92,15
CPT,94453,HAST W/SUPPL OXYGEN TITRJ,,,130.99,134.92,15
CPT,94610,INTRAPULM SURFACTANT ADMN,,,206.68,212.89,15
CPT,94617,"HC EXERCISE TEST BRONCHSPASM, INCL PRE/POST-SPIROMET & PULSE OX, W/ EKG REC",1004.0,552.2,130.99,868.46,53
CPT,94618,"HC BASIC 6 MIN WALK, PULM STRESS TEST,INCL MEAS HEART RATE,OXIMT,OXY TITR",439.0,241.45,130.99,748.0,689
CPT,94619,"HC EXERCISE TEST BRONCHSPASM, INCL PRE/POST-SPIROMET & PULSE OX, WO EKG REC",395.0,217.25,60.36,748.0,53
CPT,94621,"HC CARDPULM EXER TEST, INCL MEAS MIN VENT, CO2 PROD, O2 UPTAKE, EKG RECORD",2410.0,1325.5,316.44,2084.65,53
CPT,94625,"HC OUTPATIENT PULMONARY REHAB, W/O CONT OX MONITORING PER SESSION",327.0,179.85,60.36,346.0,53
CPT,94626,PHY/QHP OP PULM RHB W/MNTR,,,60.36,62.17,15
CPT,94640,HC EZPAP TREATMENT INITIAL,404.0,222.2,121.2,684.0,53
CPT,94640,HC EZPAP TREATMENT SUBSEQ,137.0,75.35,41.1,684.0,53
CPT,94640,HC HHN TREATMENT INITIAL PER DAY,358.5,197.175,75.0,684.0,371
CPT,94640,HC HHN TREATMENT SUBSEQ PER DAY,105.0,57.75,31.5,684.0,212
CPT,94640,HC IPPB TREATMENT INITIAL PER DAY,404.0,222.2,121.2,684.0,53
CPT,94640,HC IPPB TREATMENT SUBSEQ PER DAY,137.0,75.35,41.1,684.0,53
CPT,94640,HC MDI TREATMENT INITIAL PER DAY,404.0,222.2,121.2,684.0,53
CPT,94640,HC MDI TREATMENT SUBSEQ PER DAY,137.0,75.35,41.1,684.0,53
CPT,94640,"HC PRESS/NON-PRESS INHALATION TX FOR ACUTE AIRWAY OBSTRUCTION, THER/DX",468.0,257.4,140.4,684.0,53
CPT,94640,HC SPUTUM INDUCTION INITIAL,404.0,222.2,121.2,684.0,106
CPT,94640,HC SPUTUM INDUCTION SUBSQ,137.0,75.35,41.1,684.0,53
CPT,94642,HC AEROSOL INHALATION TREATMENT,451.0,248.05,135.3,684.0,53
CPT,94644,HC CONT INHALATION TX W AEROSOL 1ST HR,255.0,140.25,76.5,684.0,53
CPT,94645,HC CONT INHALATION TX W AEROSOL EA ADDL HR,88.0,48.4,15.58,684.0,53
CPT,94660,HC CPAP BIPAP INITIATION HOME UNIT,325.0,178.75,97.5,684.0,53
CPT,94660,HC NIV CPAP BIPAP INITIATION INITIAL,820.0,451.0,206.68,709.3,53
CPT,94660,HC NIV CPAP BIPAP INITIATION SUBSEQ,260.0,143.0,78.0,684.0,53
CPT,94662,APC,,,671.81,691.96,15
CPT,94664,HC DEMO EVAL PATIENT USE INHALER-BREATHING DEVICE,268.0,147.4,80.4,684.0,371
CPT,94667,HC ACAPELLA INITIAL,250.0,137.5,75.0,684.0,53
CPT,94667,HC AEROBIKA INITIAL,250.0,137.5,75.0,684.0,53
CPT,94667,HC CHEST PHYSIOTHERAPY INITIAL,250.0,137.5,75.0,684.0,53
CPT,94667,HC CHEST PHYSIOTHERAPY W PD INITIAL,250.0,137.5,75.0,684.0,53
CPT,94667,HC CHEST PHYSIOTHERAPY W VEST INITIAL,250.0,137.5,75.0,684.0,53
CPT,94667,HC INSUFFLATION-EXSUFFLATION INITIAL,250.0,137.5,75.0,684.0,53
CPT,94667,HC INTENSIVE CHEST PHYSIOTHERAPY INITIAL,250.0,137.5,75.0,684.0,53
CPT,94667,HC INTRAPULM PERCUSS PEP INITIAL,250.0,137.5,75.0,684.0,53
CPT,94668,HC ACAPELLA SUBSEQ,69.0,37.95,20.7,684.0,53
CPT,94668,HC CHEST PHYSIOTHERAPY SUBSEQ,69.0,37.95,20.7,684.0,53
CPT,94668,HC CHEST PHYSIOTHERAPY W PD SUBSEQ,69.0,37.95,20.7,684.0,53
CPT,94668,HC CHEST PHYSIOTHERAPY W VEST SUBSEQ,69.0,37.95,20.7,684.0,53
CPT,94668,HC INSUFFLATION-EXSUFFLATION SUBSEQ,69.0,37.95,20.7,684.0,53
CPT,94668,HC INTENSIVE CHEST PHYSIOTHERAPY SUBSEQ,69.0,37.95,20.7,684.0,53
CPT,94668,HC INTRAPULM PERCUSS PEP SUBSEQ,69.0,37.95,20.7,684.0,53
CPT,94669,MECHANICAL CHEST WALL OSCILL,,,206.68,212.89,15
CPT,94680,HC O2 UPTAKE EXPIRED GAS ANALYSIS DIRECT SIMPLE,549.0,301.95,158.99,748.0,53
CPT,94681,HC O2 UPTAKE EXPIRED GAS ANALYSIS INCL CO2 OUTPUT,889.0,488.95,266.7,768.99,53
CPT,94690,"HC OXYGEN UPTAKE, EXPIRED GAS ANALYSIS, REST, INDIRECT",158.0,86.9,47.4,748.0,159
CPT,94726,HC PLETHYSMOGRAPHY LUNG VOL W WO AIRWAY RESIST,798.0,438.9,239.4,748.0,212
CPT,94727,HC GAS DILUT WASHOUT LNG VOL W WO DISTRIB VENT&VOL,534.0,293.7,158.99,748.0,53
CPT,94728,AIRWY RESIST BY OSCILLOMETRY,,,158.99,163.76,15
CPT,94729,HC DIFFUSING CAPACITY CARBON MONOXIDE-MEMBRANE,558.0,306.9,51.86,748.0,212
CPT,94760,"HC NONINVASIVE EAR/PULSE OXIMETRY FOR OXYGEN SATURATION, SINGLE DETERM",81.25,44.69,3.2,748.0,1113
CPT,94761,"HC NONINVASIVE EAR/PULSE OXIMETRY FOR OXYGEN SATURATION, MULTIPLE DETERM",189.5,104.23,3.51,748.0,106
CPT,94762,"HC NONINVASIVE EAR/PULSE OXIMETRY FOR OXYGEN SATURATION, CONTINOUS OVERNITE",546.0,300.3,158.99,748.0,106
CPT,94762,HC PULSE OXIMETRY OVERNIGHT_INPT,384.0,211.2,115.2,748.0,53
CPT,94772,CIRCADIAN RESPIR PATTERN REC,,,539.2,555.37,15
CPT,94775,PED HOME APNEA MNTR ATT ONLY,,,158.99,163.76,15
CPT,94776,PED HOME APNEA MNTR DL&ALYS,,,158.99,163.76,15
CPT,94780,CARS/BD TST INFT-12MO 60 MIN,,,39.89,41.08,15
CPT,94781,CARS/BD TST INFT-12MO +30MIN,,,20.16,20.76,15
CPT,94799,HC CARBOGEN TREATMENT,217.0,119.35,65.1,748.0,53
CPT,94799,"HC ETCO2 NON-VENT, UNLIST PULMONARY SERVICE/PX",324.0,178.2,97.2,748.0,53
CPT,94799,HC MAX INSP EXP PRESSURES,61.0,33.55,18.3,748.0,159
CPT,94799,HC OPTIFLOW / AEROSOL DAILY,179.0,98.45,53.7,748.0,53
CPT,94799,HC PATIENT ASSESS TDP INITIAL,61.0,33.55,18.3,748.0,53
CPT,94799,HC PATIENT ASSESS TDP SUBSEQ,61.0,33.55,18.3,748.0,53
CPT,94799,HC RAPID RESPONSE CALL,217.0,119.35,65.1,748.0,212
CPT,94799,HC SPUTUM COLLECTION BY BRONCHIAL ALVEOLAR LAVAGE,250.0,137.5,75.0,684.0,53
CPT,94799,HC SPUTUM SPECIMEN COLLECTION,102.0,56.1,30.6,684.0,106
CPT,95004,"HC PERC TESTS W/ ALLERG EXTRACTS, IMMED TYP REACT, SPECIFY NUMBER TESTS",14.0,7.7,4.2,1064.89,53
CPT,95012,NITRIC OXIDE EXP GAS DETER,,,39.89,41.08,15
CPT,95017,ALL TSTG PERQ&IQ W/VENOMS,,,24.89,25.63,15
CPT,95018,ALL TSTG PERQ&IQ DRUGS/BIOL,,,39.89,41.08,15
CPT,95024,IQ TESTS W/ALLERGENIC XTRCS,,,60.36,62.17,15
CPT,95027,IQ TSTS SEQL&INCRL AIRBORNE,,,24.89,25.63,15
CPT,95028,IQ TSTS ALLERGY DELAYED RXN,,,39.89,41.08,15
CPT,95044,PATCH/APPLICATION TESTS,,,1033.87,1064.89,15
CPT,95052,PHOTO PATCH TESTS,,,60.36,62.17,15
CPT,95056,HC PHOTOSENSITIVITY TESTS,243.0,133.65,34.0,210.2,53
CPT,95060,OPH MUCOUS MEMBRANE TESTS,,,130.99,134.92,15
CPT,95065,DIR NSL MUCOUS MEMBRANE TEST,,,39.89,41.08,15
CPT,95070,INHLJ BRNCL CHALLENGE TSTG,,,539.2,555.37,15
CPT,95076,INGEST CHALLENGE INI 120 MIN,,,539.2,555.37,15
CPT,95079,INGEST CHALLENGE ADDL 60 MIN,,,80.77,83.2,15
CPT,95115,IMMUNOTHERAPY ONE INJECTION,,,46.89,48.29,15
CPT,95117,IMMUNOTHERAPY INJECTIONS,,,46.89,48.29,15
CPT,95144,ANTIGEN THERAPY SERVICES,,,46.89,48.29,15
CPT,95145,ANTIGEN THERAPY SERVICES,,,46.89,48.29,15
CPT,95146,ANTIGEN THERAPY SERVICES,,,46.89,48.29,15
CPT,95147,ANTIGEN THERAPY SERVICES,,,72.32,74.49,15
CPT,95148,ANTIGEN THERAPY SERVICES,,,72.32,74.49,15
CPT,95149,ANTIGEN THERAPY SERVICES,,,72.32,74.49,15
CPT,95165,ANTIGEN THERAPY SERVICES,,,46.89,48.29,15
CPT,95170,ANTIGEN THERAPY SERVICES,,,46.89,48.29,15
CPT,95180,RAPID DESENSITIZATION,,,405.5,417.67,15
CPT,95199,UNLISTED ALL/IMMLG SVC/PX,,,24.89,25.63,15
CPT,95249,"HC AMB CONTIN GLUCOSE MONITORING, MINIMUM 72 HRS, PATIENT PROVIDED EQUIP",232.5,127.875,60.36,603.0,159
CPT,95250,"HC AMB CONT GLUC MONIT INTERST TISS FLD MIN 72 HRS, PHYS/OTH QHP PROV EQUIP",319.0,175.45,95.7,603.0,159
CPT,95251,CONT GLUC MNTR ANALYSIS I&R,,,32.05,33.01,15
CPT,95700,HC EEG CONTINUOUS RECORDING W/VIDEO BY TECH MIN 8 CHANNELS,780.0,429.0,158.99,936.0,53
CPT,95705,EEG W/O VID 2-12 HR UNMNTR,,,316.44,325.94,15
CPT,95706,"HC EEG, WO VID, BY TECH, 2-12 HRS, INTERMIT MONIT & MAINT",773.0,425.15,231.9,936.0,53
CPT,95707,EEG W/O VID 2-12HR CONT MNTR,,,316.44,325.94,15
CPT,95708,EEG WO VID EA 12-26HR UNMNTR,,,539.2,555.37,15
CPT,95709,"HC EEG, WO VID, BY TECH, EA INCREM 12-26 HRS, INTERMIT MONIT & MAINT",1702.0,936.1,510.6,1472.23,53
CPT,95710,EEG W/O VID EA 12-26HR CONT,,,539.2,555.37,15
CPT,95711,VEEG 2-12 HR UNMONITORED,,,316.44,325.94,15
CPT,95712,VEEG 2-12 HR INTMT MNTR,,,316.44,325.94,15
CPT,95713,VEEG 2-12 HR CONT MNTR,,,539.2,555.37,15
CPT,95714,VEEG EA 12-26 HR UNMNTR,,,539.2,555.37,15
CPT,95715,VEEG EA 12-26HR INTMT MNTR,,,539.2,555.37,15
CPT,95716,VEEG EA 12-26HR CONT MNTR,,,1033.87,1064.89,15
CPT,95717,EEG PHYS/QHP 2-12 HR W/O VID,,,98.91,101.88,15
CPT,95718,EEG PHYS/QHP 2-12 HR W/VEEG,,,124.29,128.01,15
CPT,95719,EEG PHYS/QHP EA INCR W/O VID,,,148.83,153.29,15
CPT,95720,EEG PHY/QHP EA INCR W/VEEG,,,191.22,196.96,15
CPT,95721,EEG PHY/QHP>36<60 HR W/O VID,,,191.42,197.16,15
CPT,95722,EEG PHY/QHP>36<60 HR W/VEEG,,,231.94,238.9,15
CPT,95723,EEG PHY/QHP>60<84 HR W/O VID,,,234.79,241.84,15
CPT,95724,EEG PHY/QHP>60<84 HR W/VEEG,,,294.25,303.08,15
CPT,95725,EEG PHY/QHP>84 HR W/O VID,,,269.46,277.55,15
CPT,95726,EEG PHY/QHP>84 HR W/VEEG,,,374.81,386.06,15
CPT,95782,POLYSOM <6 YRS 4/> PARAMTRS,,,1033.87,4229.0,22
CPT,95783,POLYSOM <6 YRS CPAP/BILVL,,,1033.87,4229.0,22
CPT,95800,SLP STDY UNATTENDED,,,158.99,4229.0,22
CPT,95801,SLP STDY UNATND W/ANAL,,,60.36,4229.0,22
CPT,95803,"HC ACTIGRAPHY TESTING, RECORDING, ANALYSIS, I&R, 3 DAYS OR MORE",268.0,147.4,60.36,603.0,53
CPT,95803,"HC ACTIGRAPHY TESTING, RECORDING, ANALYSIS, I&R, LESS THAN 3 DAYS",268.0,147.4,60.36,603.0,53
CPT,95805,HC MULTIPLE SLEEP LATENCY TEST,4407.0,2423.85,539.2,4229.0,53
CPT,95806,HC SLEEP STUDY UNATTENDED RESPIRATORY EFFORT,765.0,420.75,158.99,4229.0,106
CPT,95807,SLEEP STUDY ATTENDED,,,539.2,4229.0,22
CPT,95808,POLYSOM ANY AGE 1-3> PARAM,,,1033.87,4229.0,22
CPT,95810,HC POLYSOMNOGRAPHY STUDY,6272.0,3449.6,1033.87,5425.28,53
CPT,95810,HC POLYSOMNOGRAPHY STUDY < 6 HRS,6272.0,3449.6,1033.87,5425.28,53
CPT,95811,HC POLYSOMNOGRAPY W CPAP OR BIPAP,6720.0,3696.0,1033.87,5812.8,53
CPT,95811,HC POLYSOMNOGRAPY W CPAP OR BIPAP LESS THAN 6 HRS,6720.0,3696.0,1033.87,5812.8,53
CPT,95812,"HC CERIBELL, EEG EXTENDED MONITORING, 41-60 MIN",961.0,528.55,288.3,936.0,2226
CPT,95812,HC EEG 41-60 MINUTES,1235.0,679.25,316.44,1068.28,106
CPT,95813,"HC CERIBELL, EEG EXTENDED MONITORING, 61-119 MIN",1058.0,581.9,316.44,936.0,2173
CPT,95813,"HC EEG EXTENDED MONITORING, 61-119 MIN",1454.0,799.7,316.44,1257.71,106
CPT,95816,"HC CERIBELL, EEG, INCL RECORDING AWAKE AND DROWSY",594.0,326.7,178.2,936.0,2173
CPT,95816,HC EEG AWAKE AND DROWSY,1280.0,704.0,316.44,1107.2,106
CPT,95816,HC EEG PORTABLE BEDSIDE,1495.0,822.25,316.44,1293.18,53
CPT,95819,HC EEG AWAKE AND ASLEEP,1946.0,1070.3,316.44,1683.29,106
CPT,95822,HC EEG RECORDING IN COMA OR SLEEP,1166.0,641.3,316.44,1008.59,53
CPT,95824,EEG CEREBRAL DEATH ONLY,,,539.2,555.37,15
CPT,95829,HC SURG ELECTROCORTICOGRAM,3998.0,2198.9,530.0,3458.27,53
CPT,95830,INSERT ELECTRODES FOR EEG,,,611.63,629.98,15
CPT,95836,HC ELECTROCORTICOGRAM IMPL BRAIN NEUROSTIM PULSE GEN/TRANS,134.0,73.7,37.89,603.0,53
CPT,95851,RANGE OF MOTION MEASUREMENTS,,,22.62,23.3,15
CPT,95852,RANGE OF MOTION MEASUREMENTS,,,19.14,19.72,15
CPT,95857,HC TENSILON TEST,806.0,443.3,241.8,697.19,106
CPT,95860,HC MUSCLE TEST ONE LIMB,745.0,409.75,130.99,1147.0,159
CPT,95861,HC MUSCLE TEST 2 LIMBS,928.0,510.4,130.99,1147.0,53
CPT,95863,NEEDLE EMG 3 EXTREMITIES,,,158.99,163.76,15
CPT,95864,NEEDLE EMG 4 EXTREMITIES,,,158.99,163.76,15
CPT,95865,HC MUSCLE TEST LARYNX,241.0,132.55,72.3,1147.0,53
CPT,95866,NEEDLE EMG HEMIDIAPHRAGM,,,158.99,163.76,15
CPT,95867,HC MUSCLE TEST CRAN NERV UNILAT,519.0,285.45,155.7,1147.0,53
CPT,95868,HC MUSCLE TEST CRAN NERVE BILAT,805.0,442.75,241.5,1147.0,53
CPT,95869,HC MUSCLE TEST THOR PARASPINAL,370.0,203.5,111.0,1147.0,53
CPT,95870,HC MUSCLE TEST NONPARASPINAL,379.0,208.45,113.7,1147.0,159
CPT,95872,HC MUSCLE TEST ONE FIBER,914.0,502.7,158.99,1147.0,53
CPT,95873,GUIDE NERV DESTR ELEC STIM,,,63.46,65.37,15
CPT,95874,HC NDL EMG GUIDED CHEMODENERVATION,280.0,154.0,68.41,1147.0,159
CPT,95875,LIMB EXERCISE TEST,,,158.99,163.76,15
CPT,95885,HC NDL EMG EA EXTREM W NERVE CONDUCTION LTD,615.0,338.25,55.69,1147.0,159
CPT,95886,HC NDL EMG EA EXTREM W NERVE CONDUCTION COMPL,591.0,325.05,87.26,1147.0,159
CPT,95887,HC NDL EMG NON-EXTREM MUSCLES W NERVE CONDUCTION,456.0,250.8,75.91,1147.0,53
CPT,95905,MOTOR &/ SENS NRVE CNDJ TEST,,,405.5,417.67,15
CPT,95907,HC NERVE CONDUCTION STUDIES 1-2 STUDIES,505.0,277.75,151.5,1147.0,159
CPT,95908,HC NERVE CONDUCTION STUDIES 3-4 STUDIES,1088.0,598.4,316.44,1147.0,159
CPT,95909,HC NERVE CONDUCTION STUDIES 5-6 STUDIES,1348.0,741.4,316.44,1166.02,159
CPT,95910,HC NERVE CONDUCTION STUDIES 7-8 STUDIES,1348.0,741.4,316.44,1166.02,159
CPT,95911,HC NERVE CONDUCTION STUDIES 9-10 STUDIES,2183.0,1200.65,539.2,1888.3,159
CPT,95912,HC NERVE CONDUCTION STUDIES 11-12 STUDIES,1761.0,968.55,528.3,1523.27,159
CPT,95913,"HC NERVE CONDUCTION STUDIES, 13 OR MORE STUDIES",1761.0,968.55,528.3,1523.27,159
CPT,95919,QUAN PUPLMTRY PHY/QHP UNI/BI,,,130.99,134.92,15
CPT,95921,HC AUTONOMIC NERV FUNCTION_ CARDIOVAGEL INNERVAT,423.0,232.65,126.9,1147.0,53
CPT,95922,HC VASOMOTOR ADRENERGIC INNERV_VALSALVA W TILT,474.0,260.7,130.99,1147.0,53
CPT,95923,HC QSART 4 SITES W TST,1522.0,837.1,130.99,1316.53,53
CPT,95923,HC QSART 4 SITES WO TST,1522.0,837.1,130.99,1316.53,53
CPT,95923,HC QSART > 4 SITES W TST,1522.0,837.1,130.99,1316.53,53
CPT,95923,HC QSART > 4 SITES WO TST,1522.0,837.1,130.99,1316.53,53
CPT,95923,HC THERMOREGULATORY SWEAT W TST ALONE,1522.0,837.1,130.99,1316.53,53
CPT,95924,HC AUTO NRV FUNCT PARASYMP & SYMP 5 MIN PASS TILT,1122.0,617.1,316.44,1147.0,53
CPT,95925,HC SHORT-LATENCY SOMATOSENSORY EVP STUDY UPR LIMBS,1343.0,738.65,316.44,1161.7,53
CPT,95926,HC SHORT-LATENCY SOMATOSENSORY EVP STUDY LWR LIMBS,1310.0,720.5,316.44,1147.0,53
CPT,95927,HC SHORT-LATENCY SOMATOSENSORY EVP STUDY TRNK HEAD,885.0,486.75,265.5,1147.0,53
CPT,95928,HC C MOTOR EVOKED UPPR LIMBS,2800.0,1540.0,645.0,2422.0,53
CPT,95929,HC C MOTOR EVOKED LWR LIMBS,1789.0,983.95,536.7,1547.49,53
CPT,95930,"HC VEP CHECKERBOARD/FLASH TEST, CNS EXCEPT GLAUCOMA, W INTERP-RPT",838.0,460.9,251.4,1147.0,159
CPT,95933,HC BLINK REFLEX TEST,295.0,162.25,60.36,1147.0,53
CPT,95937,HC NEUROMUSCULAR JUNCTION TEST,600.0,330.0,158.99,1147.0,53
CPT,95938,HC SHORT-LATENCY SOMATOSENS EVP UPR & LWR LIMBS,1854.0,1019.7,539.2,1603.71,53
CPT,95939,HC CTR MOTR EVP TRANSCRNL MOTR STIM UPR & LWR LIMB,3268.0,1797.4,645.0,2826.82,53
CPT,95940,HC CONT INTRAOP NEUROPHYS MONITOR IN OPERATING ROOM EACH 15 MIN,213.0,117.15,29.74,1147.0,53
CPT,95954,EEG MONITORING/GIVING DRUGS,,,539.2,555.37,15
CPT,95955,HC EEG DURING SURG,1909.0,1049.95,168.79,1651.29,53
CPT,95957,EEG DIGITAL ANALYSIS,,,270.15,278.25,15
CPT,95958,HC EEG MONITORING FUNCTION TEST,2575.0,1416.25,530.0,2227.38,53
CPT,95961,HC FUNCT CORTICAL MAP ELECTRD STIM BRAIN INIT HR PHYS ATTEND DBS W MONIT,2575.0,1416.25,530.0,2227.38,53
CPT,95961,HC FUNCT CORTICAL MAP ELECTRD STIM BRAIN INIT HR PHYS ATTEND GRID,2575.0,1416.25,530.0,2227.38,53
CPT,95962,HC ELECTRD STIM BRAIN EA ADDL HR PHYSICIAN ATTEND,428.0,235.4,128.4,936.0,53
CPT,95965,HC MEG SPONTANEOUS,18134.0,9973.7,1033.87,16018.0,53
CPT,95966,HC MEG EVOKED SINGLE,4534.0,2493.7,1033.87,16018.0,53
CPT,95967,HC MEG EVOKED EACH ADDL,3968.0,2182.4,1190.4,16018.0,38
CPT,95970,HC ANALYZE NEUROSTIM NO PROG,718.0,394.9,130.99,621.07,212
CPT,95971,"HC ELC ANLY NSTIM PLS GEN, SIMPLE SP CRD PERPH, W INTRAOP/SUBSEQ PROG",514.0,282.7,93.28,603.0,159
CPT,95972,"HC ELC ANLY NSTIM PLS GEN, COMPLEX SP CRD PERPH, W INTRAOP/SUBSEQ PROG",771.0,424.05,93.28,666.92,212
CPT,95976,"HC ELECTR ANALYS IMPL NEURSTIM PLS GEN/TRNSMIT, W/ SIMPLE CRANIAL NERVE",552.0,303.6,37.89,603.0,106
CPT,95977,"HC ELECTR ANALYS IMPL NEURSTIM PLS GEN/TRNSMIT, W/ COMPLX CRANIAL NERVE",743.0,408.65,93.28,642.7,106
CPT,95980,IO ANAL GAST N-STIM INIT,,,38.95,40.12,15
CPT,95981,HC ELC ANLY NSTM PLS GEN GASTRIC SUBSEQ WO REPRG,291.0,160.05,60.36,603.0,53
CPT,95982,HC ELC ANLY NSTM PLS GEN GASTRIC SUBSEQ W REPRG,91.0,50.05,27.3,603.0,53
CPT,95983,"HC ELECTR ANALYS IMPL NEURSTIM PLS GEN/TRNSMIT, W/ BRAIN, FIRST 15 MIN",314.0,172.7,93.28,603.0,53
CPT,95984,"HC ELECTR ANALYS IMPL NEURSTIM PLS GEN/TRNSMIT, W/ BRAIN, EA AD 15 MIN (AD)",231.0,127.05,39.63,603.0,53
CPT,95990,SPIN/BRAIN PUMP REFIL & MAIN,,,337.06,3533.0,21
CPT,95991,SPIN/BRAIN PUMP REFIL & MAIN,,,299.97,3533.0,21
CPT,95992,HC CANALITH REPOSITIONING PROC,237.5,130.625,39.75,384.0,424
CPT,95999,"HC NON-EEG TECH, EEG CONT RECORD, SETUP, EDUC, TAKEDOWN, MIN 8 CHANNELS",347.0,190.85,104.1,936.0,2173
CPT,95999,HC QUANTITATIVE EMG,189.0,103.95,56.7,1147.0,53
CPT,96000,MOTION ANALYSIS VIDEO/3D,,,539.2,555.37,15
CPT,96001,MOTION TEST W/FT PRESS MEAS,,,1033.87,1064.89,15
CPT,96002,DYNAMIC SURFACE EMG,,,316.44,325.94,15
CPT,96004,PHYS REVIEW OF MOTION TESTS,,,97.87,100.8,15
CPT,96041,GENETIC COUNSELING SVC EA 30,,,47.17,48.59,15
CPT,96105,HC TELEHEALTH SLP ASSESS APHASIA PER HOUR,489.0,268.95,90.99,422.99,159
CPT,96110,DEVELOPMENTAL SCREEN W/SCORE,,,10.63,10.95,15
CPT,96112,DEVEL TST PHYS/QHP 1ST HR,,,158.99,163.76,15
CPT,96113,DEVEL TST PHYS/QHP EA ADDL,,,51.88,53.44,15
CPT,96116,NUBHVL XM PHYS/QHP 1ST HR,,,316.44,325.94,15
CPT,96121,NUBHVL XM PHY/QHP EA ADDL HR,,,71.22,73.36,15
CPT,96125,COGNITIVE TEST BY HC PRO,,,96.7,99.6,15
CPT,96127,BRIEF EMOTIONAL/BEHAV ASSMT,,,39.89,41.08,15
CPT,96130,PSYCL TST EVAL PHYS/QHP 1ST,,,316.44,325.94,15
CPT,96131,PSYCL TST EVAL PHYS/QHP EA,,,81.16,83.6,15
CPT,96132,NRPSYC TST EVAL PHYS/QHP 1ST,,,539.2,555.37,15
CPT,96133,NRPSYC TST EVAL PHYS/QHP EA,,,91.38,94.12,15
CPT,96136,PSYCL/NRPSYC TST PHY/QHP 1ST,,,130.99,134.92,15
CPT,96137,PSYCL/NRPSYC TST PHY/QHP EA,,,34.8,35.84,15
CPT,96138,PSYCL/NRPSYC TECH 1ST,,,405.5,417.67,15
CPT,96139,PSYCL/NRPSYC TST TECH EA,,,31.99,32.95,15
CPT,96146,PSYCL/NRPSYC TST AUTO RESULT,,,24.89,25.63,15
CPT,96156,HC HEALTH BEHAVIOR ASSESSMENT/RE-ASSESSMENT,213.0,117.15,63.9,184.25,212
CPT,96156,HC TELEHEALTH HEALTH BEHAVIOR ASSESSMENT/RE-ASSESSMENT,192.0,105.6,57.6,166.08,106
CPT,96158,HC HEALTH BEHAVIOR IVNTJ INDIV FACE TO FACE 1ST 30 MIN,200.0,110.0,60.0,173.0,212
CPT,96159,HC HEALTH BEHAVIOR IVNTJ INDIV FACE TO FACE EA ADDL 15 MIN,76.0,41.8,22.8,65.74,212
CPT,96160,PT-FOCUSED HLTH RISK ASSMT,,,30.27,31.18,15
CPT,96161,CAREGIVER HEALTH RISK ASSMT,,,30.27,31.18,15
CPT,96164,HLTH BHV IVNTJ GRP 1ST 30,,,30.27,31.18,15
CPT,96165,HLTH BHV IVNTJ GRP EA ADDL,,,4.8,4.94,15
CPT,96167,HC HEALTH BEHAVIOR INTERVENTION FAM W/PT FACE TO FACE 1ST 30 MIN,335.0,184.25,30.27,289.78,212
CPT,96168,HC HEALTH BEHAVIOR INTERVENTION FAM W/PT FACE TO FACE EA ADD 15 MIN,168.0,92.4,25.19,145.32,212
CPT,96170,HC HEALTH BEHAVIOR INTERVENTION FAM W/O PT FACE TO FACE 1ST 30 MIN,209.0,114.95,62.7,180.79,212
CPT,96171,HC HEALTH BEHAVIOR INTERVENTION FAM W/O PT FACE TO FACE EA ADDL 15,104.0,57.2,26.15,89.96,212
CPT,96202,MLT FAM GRP BHV TRAIN 1ST 60,,,22.68,23.36,15
CPT,96203,MLT FAM GRP BHV TRAIN EA ADD,,,5.74,5.91,15
CPT,96360,"HC HYDRATION IV INFUSION, INITIAL, 31-60 MIN",538.0,295.9,153.0,733.0,3763
CPT,96361,"HC HYDRATION IV INFUSION, EACH ADDITIONAL HOUR (ADD ON CODE)",194.0,106.7,46.89,733.0,3763
CPT,96365,"HC ARGININE-GHRH STIM, THER/PROPH/DX IV INFUS, INITIAL, UP TO 1 HR",707.0,388.85,212.1,733.0,53
CPT,96365,"HC SALINE SUPPRESS, THER, PROPH, OR DX IV INFUSION, INITIAL, UP TO 1 HOUR",707.0,388.85,212.1,733.0,53
CPT,96365,"HC THER, PROPH, OR DX IV INFUSION, INITIAL, UP TO 1 HOUR",557.0,306.35,167.1,733.0,53
CPT,96365,"HC THER/PROPH/DX IV INFUS, INITIAL UP TO 1 HR",557.0,306.35,167.1,733.0,53
CPT,96365,"HC THER/PROPH/DX IV INFUS, INITIAL, UP TO 1 HOUR",564.5,310.475,167.1,733.0,3816
CPT,96366,"HC THER, PROPH, OR DX IV INFUSION, EACH ADDITIONAL HOUR (ADD ON CODE)",218.0,119.9,46.89,733.0,53
CPT,96366,"HC THER/PROPH/DX IV INFUS, EACH ADDITIONAL HOUR (ADD ON CODE)",218.0,119.9,46.89,733.0,3657
CPT,96367,"HC THER/PROPH/DX IV INFUS, ADL SEQUENTL INFUS NEW DRG/SUBST,UP TO 1HR (ADD)",262.0,144.1,72.32,733.0,3604
CPT,96368,"HC THER/PROPH/DX IV INFUS, CONCURRENT INFUSION (ADD ON CODE)",208.0,114.4,17.68,733.0,3604
CPT,96369,"HC SUBCUTANOUS INFUS FOR THER/PROPH, INITIAL, UP TO 1 HR, INCL PUMP SET-UP",660.0,363.0,198.0,733.0,2332
CPT,96370,"HC SUBCUTANOUS INFUS FOR THER/PROPH, EACH ADDITIONAL HOUR (ADD ON CODE)",160.0,88.0,46.89,733.0,2332
CPT,96371,"HC SUBCUTANOUS INFUS FOR THER/PROPH, ADDITIONAL PUMP INFUSION SITE (ADD)",171.0,94.05,51.3,733.0,159
CPT,96372,HC THER/PROPH/DX INJ SUBQ OR IM AVEED,322.0,177.1,72.32,733.0,53
CPT,96372,"HC THER/PROPH/DX INJ, SUBCUTANEOUS OR INTRAMUSCULAR",140.0,77.0,35.4,733.0,4929
CPT,96372,HC THER/PROPH/DX INJECTION SUBQ/IM - PROTON,115.0,63.25,34.5,733.0,53
CPT,96372,"HC WATER DEPREV, THER, PROPH, OR DX INJECTION, SUBCUTANEOUS OR IM",362.0,199.1,72.32,733.0,53
CPT,96373,"HC THER/PROPH/DX INJ, INTRA-ARTERIAL",418.0,229.9,125.4,733.0,2226
CPT,96374,"HC CALCITONIN STIM, THER/PROPH/DX INJ, IV PUSH, SINGL/INIT SUBST/DRUG",350.0,192.5,105.0,733.0,53
CPT,96374,"HC COSYNTROPIN STIM, THER/PROPH/DX INJ, IV PUSH, SINGL/INIT SUBST/DRUG",410.0,225.5,123.0,733.0,53
CPT,96374,"HC CRH STIM, THER/PROPH/DX INJ, IV PUSH, SINGL/INIT SUBST/DRUG",450.0,247.5,135.0,733.0,53
CPT,96374,"HC GLUCAGON STIM, THER/PROPH/DX INJ, IV PUSH, SINGL/INIT SUBST/DRUG",410.0,225.5,123.0,733.0,53
CPT,96374,"HC THER/PROPH/DX INJ, IV PUSH, SINGLE OR INITIAL SUBSTANCE/DRUG",324.0,178.2,97.2,733.0,3975
CPT,96374,"HC THER/PROPH/DX INJ, IV PUSH, SINGLE/1ST SBST/DRUG - PROTON",315.0,173.25,94.5,733.0,53
CPT,96375,"HC THER/PROPH/DX INJ, EACH ADDL SEQUENTL IV PUSH",180.0,99.0,46.89,733.0,53
CPT,96375,"HC THER/PROPH/DX INJ, EACH ADDL SEQUENTL IV PUSH NEW SUBST/DRUG (ADD)",180.0,99.0,46.89,733.0,3657
CPT,96375,"HC THER/PROPH/DX INJ, IV PUSH EACH NEW SBST/DRUG (ADD) - PROTON",175.0,96.25,46.89,733.0,53
CPT,96376,"HC THER/PROPH/DX INJ, EACH ADDL SEQUENTL IV PUSH SAME SUBST/DRUG (ADD)",204.0,112.2,61.2,733.0,2394
CPT,96376,"HC THER/PROPH/DX INJ, IV PUSH EACH SAME SBST/DRUG (ADD) - PROTON",198.0,108.9,59.4,733.0,38
CPT,96377,HC APPLICATION ON-BODY INJECTOR FOR TIMED SUBCUTANEOUS INJ,131.0,72.05,39.3,733.0,424
CPT,96379,UNL THER/PROP/DIAG INJ/INF,,,46.89,48.29,15
CPT,96380,ADMN RSV MONOC ANTB IM CNSL,,,21.49,22.14,15
CPT,96381,ADMN RSV MONOC ANTB IM NJX,,,18.3,18.85,15
CPT,96401,"HC CHEMO ADMIN, SUBCUTANEOUS/INTRAMUSCULAR, NON-HORMONAL ANTI-NEOPLASTIC",440.0,242.0,72.32,1608.0,3127
CPT,96402,"HC CHEMO ADMIN, SUBCUTANEOUS/INTRAMUSCULAR, HORMONAL ANTI-NEOPLASTIC",367.5,202.125,72.32,1608.0,3180
CPT,96405,"HC CHEMO ADMIN, INTRALESIONAL, UP TO AND INCLUDING 7 LESIONS",183.0,100.65,54.3,1608.0,265
CPT,96406,"HC CHEMO ADMIN, INTRALESIONAL, MORE THAN 7 LESIONS",979.0,538.45,214.1,1608.0,212
CPT,96409,"HC CHEMO ADMIN, IV, PUSH, SINGLE OR INITIAL SUBSTANCE/DRUG",748.5,411.675,222.0,1608.0,2968
CPT,96411,"HC CHEMO ADMIN, IV, PUSH, EACH ADDITIONAL SUBSTANCE/DRUG (ADD ON)",464.5,255.475,72.32,1608.0,2968
CPT,96413,"HC CHEMO ADMIN, IV INFUS, UP TO 1 HOUR, SINGLE/INITIAL SUBSTANCE/DRUG",981.5,539.825,249.0,1608.0,2968
CPT,96415,"HC CHEMO ADMIN, IV INFUS, EACH ADDITIONAL HOUR (ADD ON CODE)",458.5,252.175,72.32,1608.0,2968
CPT,96416,"HC CHEMO ADMIN, IV INFUS, INITIATE PROLONG(MORE TH 8 HRS), REQ PORT/IMP PMP",795.5,437.525,146.7,1608.0,2809
CPT,96417,"HC CHEMO ADMIN, IV INFUS, EA ADL SEQUENTL (DIFF SUBST/DRG), UP TO 1HR (ADD)",555.5,305.525,72.32,1608.0,2968
CPT,96420,"HC CHEMOTHERAPY ADMIN, INTRA-ARTERIAL, PUSH TECHNIQUE",599.0,329.45,179.7,1608.0,106
CPT,96422,"HC CHEMOTHERAPY ADMIN, INTRA-ARTERIAL, PUSH TECHNIQUE, UP TO 1 HOUR",830.0,456.5,249.0,1608.0,53
CPT,96423,CHEMO IA INFUSE EACH ADDL HR,,,46.89,48.29,15
CPT,96425,CHEMOTHERAPY INFUSION METHOD,,,337.06,347.18,15
CPT,96440,CHMOTX ADMN PLRL CAV THRCNTS,,,337.06,347.18,15
CPT,96446,HC CHEMO ADMIN INTO PERITONEAL CAVITY VIA IMPLANTED PORT/CATHETER,810.0,445.5,243.0,1608.0,53
CPT,96450,"HC CHEMOTHERAPY ADMIN, INTO CNS, REQUIRING AND INCLUDING SPINAL PUNCTURE",1830.0,1006.5,337.06,1608.0,477
CPT,96521,HC REFILL AND MAINT PORTABLE PUMP,731.0,402.05,214.1,1608.0,424
CPT,96522,"HC REFILL AND MAINT IMPLANTABLE PUMP/RESERVOIR FOR DRUG DELIV, SYSTEMIC",686.0,377.3,205.8,799.0,2809
CPT,96523,HC IRRIGATION IMPLANTED VAD FOR DRUG DELIVERY SYSTEM,223.5,122.925,60.36,799.0,1166
CPT,96542,"HC CHEMOTHER INJ, SUBARACHN/INTRAVENT VIA SUBCUT RESERV, SGL/MULT AGNT",518.0,284.9,155.4,1608.0,212
CPT,96547,INTRAOP HIPEC PX 1ST 60 MIN,,,315.39,3533.0,21
CPT,96548,NTRAOP HIPEC PX EA ADD 30MIN,,,144.86,3533.0,21
CPT,96549,"HC IP ONLY, CHEMO ADMIN IV INFUSION CONCURRENT",154.5,84.975,45.6,1608.0,689
CPT,96567,PDT DSTR PRMLG LES SKN,,,201.92,3533.0,21
CPT,96570,PHOTODYNMC TX 30 MIN ADD-ON,,,48.13,3533.0,21
CPT,96571,PHOTODYNAMIC TX ADDL 15 MIN,,,22.86,3533.0,21
CPT,96573,PDT DSTR PRMLG LES PHYS/QHP,,,201.92,3533.0,21
CPT,96574,DBRDMT PRMLG LES W/PDT,,,201.92,4258.0,22
CPT,96900,HC ACTINOTHERAPY UV LIGHT,89.0,48.95,26.7,799.0,53
CPT,96902,MCRSCP XM HAIR PLUCK/CLIPPED,,,20.29,20.9,15
CPT,96904,WHOLE BODY PHOTOGRAPHY,,,61.4,63.24,15
CPT,96910,HC PHOTOCHEMOTHERAPY WITH UV-B,150.0,82.5,45.0,799.0,53
CPT,96912,HC PHOTOCHEMOTHERAPY WITH UV-A,135.0,74.25,40.5,799.0,53
CPT,96913,PHOTOCHEMOTX SEV DERMATOSES,,,406.0,418.18,15
CPT,96920,EXCIMER LSR PSRIASIS<250SQCM,,,201.92,4258.0,16
CPT,96921,EXCIMER LSR PSRIASIS 250-500,,,201.92,4258.0,16
CPT,96922,EXCIMER LSR PSRIASIS>500SQCM,,,406.0,4258.0,16
CPT,96931,RCM IMG ACQUISJ&I&R 1ST LES,,,155.08,159.73,15
CPT,96932,RCM IMG ACQUISJ ONLY 1ST LES,,,114.64,118.08,15
CPT,96933,RCM I&R ONLY 1ST LESION,,,40.44,41.65,15
CPT,96934,RCM IMG ACQUISJ&I&R EA ADDL,,,109.72,113.01,15
CPT,96935,RCM IMG ACQUISJ ONLY EA ADDL,,,70.58,72.7,15
CPT,96936,RCM I&R ONLY EA ADDL LESION,,,39.14,40.32,15
CPT,96999,UNLISTED SPEC DERM SVC/PX,,,201.92,207.98,15
CPT,97010,HOT OR COLD PACKS THERAPY,,,6.07,6.25,15
CPT,97012,HC MECHANICAL TRACTION THERAPY 15 MIN,197.0,108.35,13.77,384.0,106
CPT,97012,HC MECHANICAL TRACTION THERAPY 30 MIN,270.0,148.5,13.77,384.0,106
CPT,97012,HC MECHANICAL TRACTION THERAPY 45 MIN,343.0,188.65,13.77,384.0,106
CPT,97012,HC MECHANICAL TRACTION THERAPY 60 MIN,418.0,229.9,13.77,384.0,106
CPT,97014,"HC AT, ELECTRICAL STIMULATION UNATTENDED",132.0,72.6,11.81,114.18,53
CPT,97014,"HC OT, ELECTRICAL STIMULATION UNATTENDED 15 MIN",136.0,74.8,11.81,384.0,265
CPT,97014,"HC OT, ELECTRICAL STIMULATION UNATTENDED 30 MIN",212.0,116.6,11.81,384.0,212
CPT,97014,"HC OT, ELECTRICAL STIMULATION UNATTENDED 45 MIN",251.0,138.05,11.81,384.0,212
CPT,97014,"HC PT, ELECTRICAL STIMULATION UNATTENDED 15 MIN",136.0,74.8,11.81,384.0,424
CPT,97014,"HC PT, ELECTRICAL STIMULATION UNATTENDED 30 MIN",212.0,116.6,11.81,384.0,371
CPT,97014,"HC PT, ELECTRICAL STIMULATION UNATTENDED 45 MIN",251.0,138.05,11.81,384.0,371
CPT,97016,"HC AT, VASOPNEUMATIC DEVICE THERAPY",166.0,91.3,11.19,143.59,53
CPT,97016,HC VASOPNEUMATIC DEVICE THERAPY 15 MIN_OT,136.0,74.8,11.19,384.0,106
CPT,97016,HC VASOPNEUMATIC DEVICE THERAPY 15 MIN_PT,136.0,74.8,11.19,384.0,265
CPT,97016,HC VASOPNEUMATIC DEVICE THERAPY 30 MIN_OT,248.0,136.4,11.19,384.0,106
CPT,97016,HC VASOPNEUMATIC DEVICE THERAPY 30 MIN_PT,248.0,136.4,11.19,384.0,265
CPT,97018,HC PARAFFIN BATH THERAPY_OT,96.0,52.8,5.76,384.0,53
CPT,97018,HC PARAFFIN BATH THERAPY_PT,96.0,52.8,5.76,384.0,106
CPT,97022,HC FLUIDOTHERAPY 15 MIN,201.0,110.55,14.89,384.0,106
CPT,97024,DIATHERMY EG MICROWAVE,,,6.69,6.89,15
CPT,97026,INFRARED THERAPY,,,6.38,6.57,15
CPT,97028,ULTRAVIOLET THERAPY,,,7.65,7.88,15
CPT,97032,"HC AT, ELECTRICAL STIMULATION MANUAL, EACH 15 MIN",205.0,112.75,13.77,177.33,53
CPT,97032,"HC OT, ELECTRICAL STIMULATION ATTENDED, EACH 15 MIN",175.0,96.25,13.77,384.0,318
CPT,97032,"HC PT, ELECTRICAL STIMULATION ATTENDED, EACH 15 MIN",175.0,96.25,13.77,384.0,371
CPT,97033,"HC AT, IONTOPHORESIS, EACH 15 MIN",184.0,101.2,18.11,159.16,53
CPT,97033,HC IONTOPHORESIS EACH 15 MIN_OT,222.0,122.1,18.11,384.0,106
CPT,97033,HC IONTOPHORESIS EACH 15 MIN_PT,222.0,122.1,18.11,384.0,212
CPT,97034,APP MDLTY 1+CNTRST BTH EA 15,,,13.09,13.48,15
CPT,97035,"HC AT, ULTRASOUND THERAPY, EACH 15 MIN",168.0,92.4,13.4,145.32,53
CPT,97035,"HC OT, ULTRASOUND THERAPY, EACH 15 MIN",157.0,86.35,13.4,384.0,318
CPT,97035,"HC PT, ULTRASOUND THERAPY, EACH 15 MIN",157.0,86.35,13.4,384.0,371
CPT,97036,APP MDLTY 1+HUBBRD TNK EA 15,,,33.0,33.99,15
CPT,97037,APPL MODALITY 1+LLLT PO PAIN,,,39.89,41.08,15
CPT,97110,"HC AT, THERAPEUTIC EXERCISES, EACH 15 MIN",184.0,101.2,27.97,159.16,53
CPT,97110,"HC OT, THERAPEUTIC EXERCISES, EACH 15 MIN",173.0,95.15,27.97,384.0,318
CPT,97110,"HC PT, THERAPEUTIC EXERCISES, EACH 15 MIN",173.0,95.15,27.97,384.0,530
CPT,97110,"HC TELEHEALTH AT, THERAPEUTIC EXERCISES, EACH 15 MIN",163.0,89.65,27.97,141.0,53
CPT,97110,"HC TELEHEALTH PT, THERAPEUTIC EXERCISES, EACH 15 MIN",152.0,83.6,27.97,384.0,371
CPT,97110,HC TELEHEALTH THERAPEUTIC EXERCISES EACH 15 MIN_OT,152.0,83.6,27.97,384.0,212
CPT,97112,"HC AT, NEUROMUSCULAR RE-EDUCATION, EACH 15 MIN",192.0,105.6,31.14,166.08,53
CPT,97112,"HC OT, NEUROMUSCULAR RE-EDUCATION, EACH 15 MIN",182.0,100.1,31.14,384.0,318
CPT,97112,"HC PT, NEUROMUSCULAR RE-EDUCATION, EACH 15 MIN",182.0,100.1,31.14,384.0,477
CPT,97112,HC TELEHEALTH  NEUROMUSCULAR RE-EDUCATION EACH 15 MIN OT,141.0,77.55,31.14,384.0,212
CPT,97112,"HC TELEHEALTH AT, NEUROMUSCULAR RE-EDUCATION, EACH 15 MIN",148.0,81.4,31.14,128.02,53
CPT,97112,"HC TELEHEALTH PT, NEUROMUSCULAR RE-EDUCATION, EACH 15 MIN",141.0,77.55,31.14,384.0,371
CPT,97113,HC AQUATIC THERAPY EXERCISES EACH 15 MIN,174.0,95.7,35.44,384.0,318
CPT,97116,"HC AT, GAIT TRAINING THERAPY, EACH 15 MIN",150.0,82.5,27.97,129.75,53
CPT,97116,HC GAIT TRAINING THERAPY EACH 15 MIN,162.0,89.1,27.97,384.0,530
CPT,97116,"HC TELEHEALTH AT, GAIT TRAINING THERAPY, EACH 15 MIN",129.0,70.95,27.97,111.59,53
CPT,97116,HC TELEHEALTH GAIT TRAINING THERAPY EACH 15 MIN,138.0,75.9,27.97,384.0,371
CPT,97124,MASSAGE THERAPY,,,28.76,29.63,15
CPT,97129,"HC OT, THER INTERV FOCUS ON COGNITIV FUNCTION, DIRECT ONE-ON-ONE 1ST 15 MIN",147.0,80.85,21.23,384.0,265
CPT,97129,"HC ST, THER INTERV FOCUS ON COGNITIV FUNCTION, DIRECT ONE-ON-ONE 1ST 15 MIN",147.0,80.85,21.23,384.0,212
CPT,97129,HC TELEHEALTH THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,128.0,70.4,21.23,384.0,159
CPT,97130,"HC OT, THER INTERV FOCUS ON COGNITIV FUNCT, DIRECT ONE-ON-ONE EA ADL 15 MIN",140.0,77.0,20.28,384.0,265
CPT,97130,"HC ST, THER INTERV FOCUS ON COGNITIV FUNCT, DIRECT ONE-ON-ONE EA ADL 15 MIN",140.0,77.0,20.28,384.0,212
CPT,97130,HC TELEHEALTH THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES,122.0,67.1,20.28,384.0,159
CPT,97140,"HC AT, MANUAL THERAPY, EACH 15 MIN",185.0,101.75,26.4,160.03,53
CPT,97140,"HC OT, MANUAL THERAPY, EACH 15 MIN",173.0,95.15,26.4,384.0,318
CPT,97140,"HC PT, MANUAL THERAPY, EACH 15 MIN",173.0,95.15,26.4,384.0,530
CPT,97150,HC GROUP THERAPY 15 MIN_OT,20.0,11.0,6.0,384.0,159
CPT,97150,HC GROUP THERAPY 15 MIN_PT,20.0,11.0,6.0,384.0,212
CPT,97150,HC GROUP THERAPY 30 MIN_OT,40.0,22.0,12.0,384.0,159
CPT,97150,HC GROUP THERAPY 30 MIN_PT,40.0,22.0,12.0,384.0,212
CPT,97150,HC GROUP THERAPY 45 MIN_OT,60.0,33.0,16.92,384.0,159
CPT,97150,HC GROUP THERAPY 45 MIN_PT,60.0,33.0,16.92,384.0,212
CPT,97150,HC GROUP THERAPY 60 MIN_OT,83.0,45.65,16.92,384.0,159
CPT,97150,HC GROUP THERAPY 60 MIN_PT,83.0,45.65,16.92,384.0,212
CPT,97151,BHV ID ASSMT BY PHYS/QHP,,,94.0,96.82,15
CPT,97152,BHV ID SUPRT ASSMT BY 1 TECH,,,94.0,96.82,15
CPT,97153,ADAPTIVE BEHAVIOR TX BY TECH,,,94.0,96.82,15
CPT,97154,GRP ADAPT BHV TX BY TECH,,,30.27,31.18,15
CPT,97155,ADAPT BEHAVIOR TX PHYS/QHP,,,163.27,168.17,15
CPT,97156,FAM ADAPT BHV TX GDN PHY/QHP,,,30.27,31.18,15
CPT,97157,MULT FAM ADAPT BHV TX GDN,,,30.27,31.18,15
CPT,97158,GRP ADAPT BHV TX BY PHY/QHP,,,30.27,31.18,15
CPT,97161,"HC PHYSICAL THERAPY EVALUATION, LOW COMPLEXITY",331.0,182.05,95.13,384.0,530
CPT,97161,"HC TELEHEALTH PHYSICAL THERAPY EVALUATION, LOW COMPLEXITY",249.0,136.95,74.7,384.0,371
CPT,97162,"HC PHYSICAL THERAPY EVALUATION, MODERATE COMPLEXITY",428.0,235.4,95.13,384.0,530
CPT,97162,"HC TELEHEALTH PHYSICAL THERAPY EVALUATION, MODERATE COMPLEXITY",338.0,185.9,95.13,384.0,371
CPT,97163,"HC PHYSICAL THERAPY EVALUATION, HIGH COMPLEXITY",548.0,301.4,95.13,474.02,530
CPT,97163,"HC TELEHEALTH PHYSICAL THERAPY EVALUATION, HIGH COMPLEXITY",478.0,262.9,95.13,413.47,371
CPT,97164,HC RE-EVALUATION PHYSICAL THERAPY ESTABLISHED PLAN OF CARE,227.0,124.85,65.63,384.0,530
CPT,97164,HC TELEHEALTH RE-EVALUATION PHYSICAL THERAPY ESTABLISHED PLAN OF CARE,254.0,139.7,65.63,384.0,371
CPT,97165,"HC OCCUPATIONAL THERAPY EVALUATION, LOW COMPLEXITY",369.0,202.95,97.6,384.0,424
CPT,97165,"HC TELEHEALTH OCCUPATIONAL THERAPY EVALUATION, LOW COMPLEXITY",276.0,151.8,82.8,384.0,212
CPT,97166,"HC OCCUPATIONAL THERAPY EVALUATION, MODERATE COMPLEXITY",433.0,238.15,97.6,384.0,424
CPT,97166,"HC TELEHEALTH OCCUPATIONAL THERAPY EVALUATION, MODERATE COMPLEXITY",343.0,188.65,97.6,384.0,212
CPT,97167,"HC OCCUPATIONAL THERAPY EVALUATION, HIGH COMPLEXITY",546.0,300.3,97.6,472.29,424
CPT,97167,"HC TELEHEALTH OCCUPATONAL THERAPY EVALUATION, HIGH COMPLEXITY",514.0,282.7,97.6,444.61,212
CPT,97168,HC RE-EVALUATION OCCUPATIONAL THERAPY ESTABLISHED PLAN OF CARE,230.0,126.5,67.28,384.0,424
CPT,97168,HC TELEHEALTH RE-EVALUATION OCCUPATIONAL THERAPY ESTABLISHED PLAN OF CARE,259.0,142.45,67.28,384.0,212
CPT,97169,"HC ATHLETIC TRAINING EVALUATION, LOW COMPLEXITY",322.0,177.1,96.6,278.53,38
CPT,97170,"HC ATHLETIC TRAINING EVALUATION, MODERATE COMPLEXITY",496.0,272.8,148.8,429.04,38
CPT,97171,"HC ATHLETIC TRAINING EVALUATION, HIGH COMPLEXITY",577.0,317.35,173.1,499.11,38
CPT,97172,HC RE-EVALUATION ATHLETIC TRAINING ESTABLISHED PLAN CARE,234.0,128.7,70.2,202.41,38
CPT,97530,"HC AT, THERAPEUTIC ACTIVITIES, EACH 15 MIN",161.0,88.55,33.53,139.27,53
CPT,97530,"HC OT, THERAPEUTIC ACTIVITIES, EACH 15 MIN",156.0,85.8,33.53,384.0,318
CPT,97530,"HC PT, THERAPEUTIC ACTIVITIES, EACH 15 MIN",156.0,85.8,33.53,384.0,477
CPT,97530,"HC TELEHEALTH AT, THERAPEUTIC ACTIVITIES, EACH 15 MIN",124.0,68.2,33.53,107.26,53
CPT,97530,"HC TELEHEALTH PT, THERAPEUTIC ACTIVITIES, EACH 15 MIN",118.0,64.9,33.53,384.0,371
CPT,97530,HC TELEHEALTH THERAPEUTIC ACTIVITIES EACH 15 MIN_OT,118.0,64.9,33.53,384.0,212
CPT,97533,HC SENSORY INTEGRATION EACH 15 MIN,160.0,88.0,48.0,384.0,265
CPT,97535,"HC OT, SELF CARE/HOME MGMT TRAINING, EACH 15 MIN",151.0,83.05,31.07,384.0,424
CPT,97535,"HC PT, SELF CARE/HOME MGMT TRAINING, EACH 15 MIN",151.0,83.05,31.07,384.0,318
CPT,97535,HC SELF CARE MGMT TRAINING EACH 15 MIN_ST,151.0,83.05,31.07,384.0,53
CPT,97535,"HC TELEHEALTH OT, SELF CARE/HOME MGMT TRAINING, EACH 15 MIN",113.0,62.15,31.07,384.0,212
CPT,97535,"HC TELEHEALTH PT, SELF CARE/HOME MGMT TRAINING, EACH 15 MIN",212.0,116.6,31.07,384.0,53
CPT,97537,COMMUNITY/WORK REINTEGRATION,,,30.8,31.73,15
CPT,97542,"HC PT, WHEELCHAIR MGMT, EACH 15 MIN",111.0,61.05,29.87,384.0,265
CPT,97542,HC WHEELCHAIR MGMT TRAINING EACH 15 MIN_OT,111.0,61.05,29.87,384.0,159
CPT,97545,HC WORK HARDENING-CONDITIONING INITIAL 2 HRS_OT,318.0,174.9,95.4,384.0,38
CPT,97545,HC WORK HARDENING-CONDITIONING INITIAL 2 HRS_PT,284.0,156.2,85.2,384.0,114
CPT,97546,HC WORK HARDENING-CONDITIONING ADDL HR,186.0,102.3,55.8,384.0,38
CPT,97550,"HC OT, CAREGIVER TRAINING WO PATIENT PRESENT, FACE TO FACE, INIT 30 MINUTES",327.0,179.85,50.62,384.0,265
CPT,97550,"HC PT, CAREGIVER TRAINING WO PATIENT PRESENT, FACE TO FACE, INIT 30 MINUTES",327.0,179.85,50.62,384.0,371
CPT,97550,"HC ST, CAREGIVER TRAINING WO PATIENT PRESENT, FACE TO FACE, INIT 30 MINUTES",327.0,179.85,50.62,384.0,159
CPT,97551,"HC OT, CAREGIVER TRAINING WO PATIENT PRESENT, FACE TO FACE, EA ADDL 15 MIN",163.0,89.65,25.0,384.0,265
CPT,97551,"HC PT, CAREGIVER TRAINING WO PATIENT PRESENT, FACE TO FACE, EA ADDL 15 MIN",163.0,89.65,25.0,384.0,371
CPT,97551,"HC ST, CAREGIVER TRAINING WO PATIENT PRESENT, FACE TO FACE, EA ADDL 15 MIN",163.0,89.65,25.0,384.0,159
CPT,97552,"HC OT, GRP CAREGIV TRAINING WO PAT PRESENT, FACE TO FACE, W/ MULT CAREGIV",51.0,28.05,15.3,384.0,265
CPT,97552,"HC PT, GRP CAREGIV TRAINING WO PAT PRESENT, FACE TO FACE, W/ MULT CAREGIV",51.0,28.05,15.3,384.0,371
CPT,97552,"HC ST, GRP CAREGIV TRAINING WO PAT PRESENT, FACE TO FACE, W/ MULT CAREGIV",51.0,28.05,15.3,384.0,159
CPT,97597,"HC DEBRIDE WND CARE ADVANCED, 1ST 20 SQ CM/LESS_RN",603.0,331.65,180.9,4258.0,106
CPT,97597,"HC DEBRIDE WND CARE MAJOR, 1ST 20 SQ CM/LESS_RN",566.0,311.3,169.8,4258.0,106
CPT,97597,"HC DEBRIDE WND CARE MINOR, 1ST 20 SQ CM/LESS_RN",487.0,267.85,146.1,4258.0,106
CPT,97597,"HC DEBRIDE WND CARE MODERATE, 1ST 20 SQ CM/LESS_RN",525.0,288.75,157.5,4258.0,106
CPT,97597,"HC DEBRIDE, OPEN WOUND, FIRST 20 SQ CM/LESS, PER SESS, TOT WND(S) SURF AREA",624.5,343.475,171.0,4258.0,583
CPT,97597,"HC OT ADVANCED, DEBRIDE, OPEN WND, PER SESS, TOT WND SA, 1ST 20 SQ CM/LESS",518.0,284.9,155.4,448.07,212
CPT,97597,"HC OT MAJOR, DEBRIDE, OPEN WND, PER SESS, TOT WND SA, 1ST 20 SQ CM/LESS",486.0,267.3,145.8,420.39,212
CPT,97597,"HC OT MINOR, DEBRIDE, OPEN WND, PER SESS, TOT WND SA, 1ST 20 SQ CM/LESS",418.0,229.9,125.4,384.0,212
CPT,97597,"HC OT MODERATE, DEBRIDE, OPEN WND, PER SESS, TOT WND SA, 1ST 20 SQ CM/LESS",451.0,248.05,135.3,390.12,212
CPT,97597,"HC PT ADVANCED, DEBRIDE, OPEN WND, PER SESS, TOT WND SA, 1ST 20 SQ CM/LESS",518.0,284.9,155.4,448.07,265
CPT,97597,"HC PT MAJOR, DEBRIDE, OPEN WND, PER SESS, TOT WND SA, 1ST 20 SQ CM/LESS",486.0,267.3,145.8,420.39,318
CPT,97597,"HC PT MINOR, DEBRIDE, OPEN WND, PER SESS, TOT WND SA, 1ST 20 SQ CM/LESS",418.0,229.9,125.4,384.0,318
CPT,97597,"HC PT MODERATE, DEBRIDE, OPEN WND, PER SESS, TOT WND SA, 1ST 20 SQ CM/LESS",451.0,248.05,135.3,390.12,318
CPT,97598,HC DEBRIDE WND CARE ADVANCED EA ADDL 20 CM_OT,534.0,293.7,41.16,461.91,53
CPT,97598,HC DEBRIDE WND CARE ADVANCED EA ADDL 20 CM_RN,585.0,321.75,41.16,3533.0,53
CPT,97598,HC DEBRIDE WND CARE MAJOR EA ADDL 20 CM_OT,503.0,276.65,41.16,435.1,53
CPT,97598,HC DEBRIDE WND CARE MAJOR EA ADDL 20 CM_RN,551.0,303.05,41.16,3533.0,53
CPT,97598,HC DEBRIDE WND CARE MINOR EA ADDL 20 CM_OT,430.0,236.5,41.16,384.0,53
CPT,97598,HC DEBRIDE WND CARE MINOR EA ADDL 20 CM_PT,430.0,236.5,41.16,384.0,106
CPT,97598,HC DEBRIDE WND CARE MINOR EA ADDL 20 CM_RN,471.0,259.05,41.16,3533.0,53
CPT,97598,HC DEBRIDE WND CARE MODERATE EA ADDL 20 CM_OT,462.0,254.1,41.16,399.63,53
CPT,97598,HC DEBRIDE WND CARE MODERATE EA ADDL 20 CM_RN,507.0,278.85,41.16,3533.0,53
CPT,97598,"HC DEBRIDE, OPEN WOUND, EA AD 20 SQ CM/PART, PER SESS, TOT WND(S) SURF AREA",626.5,344.575,41.16,3533.0,371
CPT,97598,"HC PT ADVANCED, DEBRIDE, OPEN WND, PER SESS, TOT WND SA,EA AD 20 SQ CM (AD)",534.0,293.7,41.16,461.91,265
CPT,97598,"HC PT MAJOR, DEBRIDE, OPEN WND, PER SESS, TOT WND SA,EA AD 20 SQ CM (AD)",503.0,276.65,41.16,435.1,265
CPT,97598,"HC PT MODERATE, DEBRIDE, OPEN WND, PER SESS, TOT WND SA,EA AD 20 SQ CM (AD)",462.0,254.1,41.16,399.63,265
CPT,97602,"HC OT ADVANCED, REM DEVITALZ TISS FROM WND(S), NON-SEL, W/O ANES, PER SESS",374.0,205.7,112.2,384.0,212
CPT,97602,"HC OT MAJOR, REM DEVITALZ TISS FROM WND(S), NON-SEL, W/O ANES, PER SESS",336.0,184.8,100.8,384.0,212
CPT,97602,"HC OT MINOR, REM DEVITALZ TISS FROM WND(S), NON-SEL, W/O ANES, PER SESS",274.0,150.7,82.2,384.0,212
CPT,97602,"HC OT MODERATE, REM DEVITALZ TISS FROM WND(S), NON-SEL, W/O ANES, PER SESS",299.0,164.45,89.7,384.0,212
CPT,97602,"HC PT ADVANCED, REM DEVITALZ TISS FROM WND(S), NON-SEL, W/O ANES, PER SESS",374.0,205.7,112.2,384.0,265
CPT,97602,"HC PT MAJOR, REM DEVITALZ TISS FROM WND(S), NON-SEL, W/O ANES, PER SESS",336.0,184.8,100.8,384.0,318
CPT,97602,"HC PT MINOR, REM DEVITALZ TISS FROM WND(S), NON-SEL, W/O ANES, PER SESS",274.0,150.7,82.2,384.0,318
CPT,97602,"HC PT MODERATE, REM DEVITALZ TISS FROM WND(S), NON-SEL, W/O ANES, PER SESS",299.0,164.45,89.7,384.0,318
CPT,97602,"HC REM DEVITALZ TISS FROM WND(S), NON-SEL, W/O ANES, PER SESS",357.5,196.625,105.6,4258.0,583
CPT,97602,"HC RN ADVANCED, REM DEVITALZ TISS FROM WND(S), NON-SEL, W/O ANES, PER SESS",363.0,199.65,108.9,4258.0,106
CPT,97602,"HC RN MAJOR, REM DEVITALZ TISS FROM WND(S), NON-SEL, W/O ANES, PER SESS",326.0,179.3,97.8,4258.0,106
CPT,97602,"HC RN MINOR, REM DEVITALZ TISS FROM WND(S), NON-SEL, W/O ANES, PER SESS",266.0,146.3,79.8,4258.0,106
CPT,97602,"HC RN MODERATE, REM DEVITALZ TISS FROM WND(S), NON-SEL, W/O ANES, PER SESS",290.0,159.5,87.0,4258.0,106
CPT,97605,"HC NEG PRESS WND THERAPY, USE DME, TOT WND(S) SURF AREA LESS TH/EQ TO 50 CM",444.0,244.2,133.2,384.06,371
CPT,97606,"HC NEG PRESS WND THERAPY, USE DME, TOT WND(S) SURF AREA GREATER THAN 50 CM",925.5,509.025,274.8,808.78,424
CPT,97607,"HC NEG PRESS WND THERAPY, NON-DME, TOT WND SURF AREA LESS TH/EQ TO 50 SQ CM",938.75,516.315,277.35,824.35,424
CPT,97608,"HC NEG PRESS WND THERAPY, NON-DME, TOT WND SURF AREA GREATER THAN 50 SQ CM",909.5,500.23,272.85,786.72,159
CPT,97610,HC LOW FREQUENCY NON-CONTACT NON-THERMAL US PER DAY,502.0,276.1,150.6,799.0,106
CPT,97750,"HC AT, PHYSICAL PERFORM TEST/MEASURE, W WRITTEN RPT, EACH 15 MIN",166.0,91.3,32.31,143.59,53
CPT,97750,"HC OT, PHYSICAL PERFORMANCE TEST OR MEASUREMENT, EACH 15 MIN",164.0,90.2,32.31,384.0,106
CPT,97750,"HC PT, PHYSICAL PERFORMANCE TEST OR MEASUREMENT, EACH 15 MIN",164.0,90.2,32.31,384.0,265
CPT,97750,"HC TELEHEALTH OT, PHYSICAL PERFORMANCE TEST OR MEASUREMENT, EACH 15 MIN",126.0,69.3,32.31,384.0,212
CPT,97750,"HC TELEHEALTH PT, PHYSICAL PERFORMANCE TEST OR MEASUREMENT, EACH 15 MIN",126.0,69.3,32.31,384.0,371
CPT,97755,"HC OT, ASST TECHNOLOGY ASSESSMENT, W/ WRITTEN RPT, EA 15 MINS",93.0,51.15,27.9,384.0,53
CPT,97755,"HC PT, ASST TECHNOLOGY ASSESSMENT, W/ WRITTEN RPT, EA 15 MINS",93.0,51.15,27.9,384.0,53
CPT,97760,"HC OT, ORTHO(S) MGMT-TRAIN UP/LOW EXTRM AND/OR TRNK, INIT ENCNTR, EA 15 MIN",199.0,109.45,44.45,384.0,318
CPT,97760,"HC PT, ORTHO(S) MGMT-TRAIN UP/LOW EXTRM AND/OR TRNK, INIT ENCNTR, EA 15 MIN",199.0,109.45,44.45,384.0,371
CPT,97760,HC TELEHEALTH ORTHOTICS FIT TRAINING EACH 15 MIN_OT,167.0,91.85,44.45,384.0,212
CPT,97760,"HC TELEHEALTH PT, ORTHO MGMT-TRAIN UP/LOW EXTRM/TRNK, INIT ENCNTR, EA 15MIN",167.0,91.85,44.45,384.0,371
CPT,97761,"HC OT, PROSTH(S) TRAIN, UP/LOW EXTREM, INIT ENCOUNTER, EA 15 MIN",171.0,94.05,39.19,384.0,265
CPT,97761,"HC PT, PROSTH(S) TRAIN, UP/LOW EXTREM, INIT ENCOUNTER, EA 15 MIN",171.0,94.05,39.19,384.0,371
CPT,97761,HC TELEHEALTH PROSTHETIC TRAINIING EACH 15 MIN_OT,130.0,71.5,39.0,384.0,212
CPT,97761,"HC TELEHEALTH PT, PROSTH(S) TRAIN, UP/LOW EXTREM, INIT ENCOUNTER, EA 15 MIN",130.0,71.5,39.0,384.0,371
CPT,97763,"HC OT, ORTHOTIC(S)/PROSTH MGMT UP/LOW EXTREM AND/OR TRNK, SUBSEQ, EA 15 MIN",205.0,112.75,48.45,384.0,318
CPT,97763,"HC PT, ORTHOTIC(S)/PROSTH MGMT UP/LOW EXTREM AND/OR TRNK, SUBSEQ, EA 15 MIN",205.0,112.75,48.45,384.0,371
CPT,97802,HC MED NUTRITION THER INIT INDIV EA 15 MIN,122.0,67.1,34.59,266.0,53
CPT,97803,HC MED NUTRITION THER RE-ASSESS EA 15 MIN,90.0,49.5,27.0,266.0,53
CPT,97804,HC MED NUTRITION THER GROUP EA 30 MIN,41.0,22.55,12.3,266.0,53
CPT,97810,HC ACUPUNCTURE PREPAY SELF,32.0,17.6,9.6,27.68,53
CPT,97811,ACUP 1/> W/O ESTIM EA ADD 15,,,24.49,25.22,15
CPT,97813,HC ACUPUNCTURE PREPAY SELF W ELECT STIM,32.0,17.6,9.6,27.68,53
CPT,97814,ACUP 1/> W/ESTIM EA ADDL 15,,,27.6,28.42,15
CPT,98000,SYNCH AUDIO-VIDEO NEW SF 15,,,47.95,49.39,15
CPT,98001,SYNCH AUDIO-VIDEO NEW LOW 30,,,78.83,81.19,15
CPT,98002,SYNCH AUDIO-VIDEO NEW MOD 45,,,125.75,129.52,15
CPT,98003,SYNCH AUDIO-VIDEO NEW HI 60,,,166.85,171.85,15
CPT,98004,SYNCH AUDIO-VIDEO EST SF 10,,,37.0,38.11,15
CPT,98005,SYNCH AUDIO-VIDEO EST LOW 20,,,64.78,66.72,15
CPT,98006,SYNCH AUDIO-VIDEO EST MOD 30,,,95.07,97.92,15
CPT,98007,SYNCH AUDIO-VIDEO EST HI 40,,,126.37,130.16,15
CPT,98008,SYNCH AUDIO-ONLY NEW SF 15,,,45.64,47.01,15
CPT,98009,SYNCH AUDIO-ONLY NEW LOW 30,,,75.45,77.71,15
CPT,98010,SYNCH AUDIO-ONLY NEW MOD 45,,,116.83,120.33,15
CPT,98011,SYNCH AUDIO-ONLY NEW HIGH 60,,,152.49,157.06,15
CPT,98012,SYNCH AUDIO-ONLY EST SF 10,,,33.84,34.85,15
CPT,98013,SYNCH AUDIO-ONLY EST LOW 20,,,59.27,61.05,15
CPT,98014,SYNCH AUDIO-ONLY EST MOD 30,,,86.06,88.64,15
CPT,98015,SYNCH AUDIO-ONLY EST HIGH 40,,,125.44,129.2,15
CPT,98016,BRIEF COMUNICAJ TECH-BSD SVC,,,15.18,15.64,15
CPT,98925,"HC OSTEOPATHIC MANIPULATIVE TREATMENT, 1-2 BODY REGIONS",60.0,33.0,18.0,51.9,53
CPT,98926,OSTEOPATH MANJ 3-4 REGIONS,,,25.71,26.48,15
CPT,98927,OSTEOPATH MANJ 5-6 REGIONS,,,25.71,26.48,15
CPT,98928,OSTEOPATH MANJ 7-8 REGIONS,,,25.71,26.48,15
CPT,98929,OSTEOPATH MANJ 9-10 REGIONS,,,25.71,26.48,15
CPT,98940,CHIROPRACT MANJ 1-2 REGIONS,,,25.71,26.48,15
CPT,98941,CHIROPRACT MANJ 3-4 REGIONS,,,25.71,26.48,15
CPT,98942,CHIROPRACTIC MANJ 5 REGIONS,,,25.71,26.48,15
CPT,98943,CHIROPRACT MANJ XTRSPINL 1/>,,,23.87,24.58,15
CPT,98960,HC OUTPT NUTRITION EDUC 30 MIN,177.0,97.35,28.69,266.0,53
CPT,98961,EDU&TRN PT SLF-MGMT NQHP 2-4,,,13.73,14.14,15
CPT,98962,EDU&TRN PT SLF-MGMT NQHP 5-8,,,10.01,10.31,15
CPT,98966,PH1 ASSMT&MGMT NQHP 5-10,,,12.53,12.9,15
CPT,98967,PH1 ASSMT&MGMT NQHP 11-20,,,23.2,23.89,15
CPT,98968,PH1 ASSMT&MGMT NQHP 21-30,,,32.21,33.18,15
CPT,98970,NQHP OL DIG ASSMT&MGMT 5-10,,,10.98,11.31,15
CPT,98971,NQHP OL DIG ASSMT&MGMT 11-20,,,20.44,21.05,15
CPT,98972,NQHP OL DIG ASSMT&MGMT 21+,,,31.31,32.25,15
CPT,98975,RTM 1ST SET-UP&PT EDUCAJ EQP,,,130.96,134.89,15
CPT,98976,RTM DEV SPLY RESP SYS 16-30D,,,37.89,39.03,15
CPT,98977,RTM DEV SPLY MSCSKL 16-30 D,,,37.89,39.03,15
CPT,98978,RTM DEV SPLY CBT 16-30 D,,,37.89,39.03,15
CPT,98980,RTM TX MGMT 1ST 20 MIN,,,48.03,49.47,15
CPT,98981,RTM TX MGMT EA ADDL 20 MIN,,,37.49,38.62,15
CPT,99000,SPECIMEN HANDLING OFFICE-LAB,,,5.27,6.5,6
CPT,99001,HC SPECIMEN HANDLING,83.0,45.65,6.26,73.53,76
CPT,99091,COLLJ & INTERPJ DATA EA 30 D,,,49.64,51.13,15
CPT,99151,MOD SED SAME PHYS/QHP <5 YRS,,,55.5,57.16,15
CPT,99152,MOD SED SAME PHYS/QHP 5/>YRS,,,46.17,47.56,15
CPT,99153,MOD SED SAME PHYS/QHP EA,,,10.74,11.06,15
CPT,99155,MOD SED OTH PHYS/QHP <5 YRS,,,74.54,76.78,15
CPT,99156,MOD SED OTH PHYS/QHP 5/>YRS,,,67.16,69.17,15
CPT,99157,MOD SED OTHER PHYS/QHP EA,,,52.04,53.6,15
CPT,99170,ANOGENITAL EXAM CHILD W IMAG,,,204.43,210.56,15
CPT,99173,VISUAL ACUITY SCREEN,,,2.89,2.98,15
CPT,99174,OCULAR INSTRUMNT SCREEN BIL,,,5.68,5.85,15
CPT,99175,INDUCTION OF VOMITING,,,27.66,28.49,15
CPT,99177,OCULAR INSTRUMNT SCREEN BIL,,,4.44,4.57,15
CPT,99183,HYPERBARIC OXYGEN THERAPY,,,95.29,98.15,15
CPT,99184,HYPOTHERMIA ILL NEONATE,,,196.65,202.54,15
CPT,99188,APP TOPICAL FLUORIDE VARNISH,,,10.91,11.24,15
CPT,99195,HC THERAPEUTIC PHLEBOTOMY,346.5,190.575,102.0,799.0,848
CPT,99202,OFFICE O/P NEW SF 15 MIN,,,66.74,68.74,15
CPT,99203,OFFICE O/P NEW LOW 30 MIN,,,103.31,106.41,15
CPT,99204,OFFICE O/P NEW MOD 45 MIN,,,155.08,159.73,15
CPT,99205,OFFICE O/P NEW HI 60 MIN,,,204.46,210.59,15
CPT,99211,HC FACILITY E&M LEVEL 1,158.5,87.175,21.72,148.78,2240
CPT,99211,"HC LACTATION, FACILITY E&M LEVEL 1",145.0,79.75,21.72,125.43,40
CPT,99211,"HC PHARMACIST, FACILITY E&M LEVEL 1",145.0,79.75,21.72,125.43,40
CPT,99211,"HC TRU, FACILITY E&M LEVEL 1",172.0,94.6,21.72,148.78,40
CPT,99212,HC FACILITY E&M LEVEL 2,212.0,116.60000000000001,46.0,230.09,2280
CPT,99212,"HC PHARMACIST, FACILITY E&M LEVEL 2",158.0,86.9,46.0,136.67,40
CPT,99212,"HC TRU, FACILITY E&M LEVEL 2",266.0,146.3,46.0,230.09,40
CPT,99213,HC FACILITY E&M LEVEL 3,262.5,144.375,46.0,294.1,2240
CPT,99213,"HC PHARMACIST, FACILITY E&M LEVEL 3",185.0,101.75,46.0,160.03,40
CPT,99213,"HC TRU, FACILITY E&M LEVEL 3",340.0,187.0,46.0,294.1,40
CPT,99214,HC FACILITY E&M LEVEL 4,335.5,184.52499999999998,46.0,375.41,2200
CPT,99214,"HC PHARMACIST, FACILITY E&M LEVEL 4",237.0,130.35,46.0,205.01,40
CPT,99214,"HC TRU, FACILITY E&M LEVEL 4",434.0,238.7,46.0,375.41,40
CPT,99215,HC FACILITY E&M LEVEL 5,417.5,229.625,46.0,439.42,2200
CPT,99215,"HC PHARMACIST, FACILITY E&M LEVEL 5",327.0,179.85,46.0,282.86,40
CPT,99215,"HC TRU, FACILITY E&M LEVEL 5",508.0,279.4,46.0,439.42,40
CPT,99221,1ST HOSP IP/OBS SF/LOW 40,,,74.98,77.22,15
CPT,99222,1ST HOSP IP/OBS MODERATE 55,,,119.27,122.85,15
CPT,99223,1ST HOSP IP/OBS HIGH 75,,,159.24,164.02,15
CPT,99231,SBSQ HOSP IP/OBS SF/LOW 25,,,44.97,46.32,15
CPT,99232,SBSQ HOSP IP/OBS MODERATE 35,,,72.63,74.81,15
CPT,99233,SBSQ HOSP IP/OBS HIGH 50,,,108.86,112.13,15
CPT,99234,HOSP IP/OBS SM DT SF/LOW 45,,,89.31,91.99,15
CPT,99235,HOSP IP/OBS SAME DATE MOD 70,,,145.76,150.13,15
CPT,99236,HOSP IP/OBS SAME DATE HI 85,,,190.29,196.0,15
CPT,99238,HOSP IP/OBS DSCHRG MGMT 30/<,,,74.57,76.81,15
CPT,99239,HOSP IP/OBS DSCHRG MGMT >30,,,105.62,108.79,15
CPT,99242,OFF/OP CONSLTJ NEW/EST SF 20,,,69.63,71.72,15
CPT,99243,OFF/OP CNSLTJ NEW/EST LOW 30,,,104.7,107.84,15
CPT,99244,OFF/OP CNSLTJ NEW/EST MOD 40,,,149.4,153.88,15
CPT,99245,OFF/OP CONSLTJ NEW/EST HI 55,,,194.85,200.7,15
CPT,99252,IP/OBS CONSLTJ NEW/EST SF 35,,,65.47,67.44,15
CPT,99253,IP/OBS CNSLTJ NEW/EST LOW 45,,,92.09,94.85,15
CPT,99254,IP/OBS CNSLTJ NEW/EST MOD 60,,,127.77,131.6,15
CPT,99255,IP/OBS CONSLTJ NEW/EST HI 80,,,171.79,176.94,15
CPT,99281,HC LEVEL 1 EMERGENCY DEPARTMENT VISIT,315.0,173.25,89.48,943.0,53
CPT,99281,HC SANE EXAM - BRIEF CONSULT,315.0,173.25,89.48,943.0,53
CPT,99282,HC LEVEL 2 EMERGENCY DEPARTMENT VISIT,766.5,421.58,160.93,1835.0,53
CPT,99283,HC LEVEL 3 EMERGENCY DEPARTMENT VISIT,2033.0,1118.15,281.38,3923.0,53
CPT,99284,HC LEVEL 4 EMERGENCY DEPARTMENT VISIT,2730.0,1501.5,432.72,5302.0,53
CPT,99284,HC SANE EXAM - INTERMEDIATE,1292.0,710.6,426.36,5302.0,53
CPT,99285,HC LEVEL 5 EMERGENCY DEPARTMENT VISIT,3060.0,1683.0,623.03,6730.0,53
CPT,99285,HC SANE EXAM - COMPREHENSIVE,1786.0,982.3,589.38,6730.0,53
CPT,99291,"HC ED CRITICAL CARE, E&M, FIRST 30-74 MINUTES",2940.0,1617.0,856.26,7067.0,53
CPT,99292,"HC ED CRITICAL CARE, E&M, EACH ADDITIONAL 30 MINUTES (ADD ON CODE)",1260.0,693.0,109.39,7067.0,53
CPT,99304,1ST NF CARE SF/LOW MDM 25,,,73.95,76.17,15
CPT,99305,1ST NF CARE MODERATE MDM 35,,,123.13,126.83,15
CPT,99306,1ST NF CARE HIGH MDM 50,,,168.19,173.24,15
CPT,99307,SBSQ NF CARE SF MDM 10,,,37.0,38.11,15
CPT,99308,SBSQ NF CARE LOW MDM 20,,,68.91,70.98,15
CPT,99309,SBSQ NF CARE MODERATE MDM 30,,,99.72,102.71,15
CPT,99310,SBSQ NF CARE HIGH MDM 45,,,141.93,146.19,15
CPT,99315,NF DSCHRG MGMT 30 MIN/LESS,,,75.28,77.54,15
CPT,99316,NF DSCHRG MGMT 30 MIN+,,,120.65,124.27,15
CPT,99341,HOME/RES VST NEW SF MDM 15,,,46.09,47.47,15
CPT,99342,HOME/RES VST NEW LOW MDM 30,,,73.31,75.51,15
CPT,99344,HOME/RES VST NEW MOD MDM 60,,,131.69,135.65,15
CPT,99345,HOME/RES VST NEW HIGH MDM 75,,,185.76,191.33,15
CPT,99347,HOME/RES VST EST SF MDM 20,,,42.23,43.5,15
CPT,99348,HOME/RES VST EST LOW MDM 30,,,71.35,73.5,15
CPT,99349,HOME/RES VST EST MOD MDM 40,,,117.48,121.0,15
CPT,99350,HOME/RES VST EST HIGH MDM 60,,,170.61,175.72,15
CPT,99358,PROLONG SERVICE W/O CONTACT,,,82.73,85.21,15
CPT,99359,PROLONG SERV W/O CONTACT ADD,,,35.21,36.27,15
CPT,99360,PHYSICIAN STANDBY SERVICES,,,54.01,55.63,15
CPT,99366,TEAM CONF W/PAT BY HC PROF,,,37.79,38.92,15
CPT,99367,TEAM CONF W/O PAT BY PHYS,,,49.53,51.02,15
CPT,99368,TEAM CONF W/O PAT BY HC PRO,,,32.39,33.36,15
CPT,99374,HOME HEALTH CARE SUPERVISION,,,63.46,65.37,15
CPT,99375,HOME HEALTH CARE SUPERVISION,,,95.01,97.86,15
CPT,99377,HOSPICE CARE SUPERVISION,,,63.46,65.37,15
CPT,99378,HOSPICE CARE SUPERVISION,,,95.01,97.86,15
CPT,99379,NURSING FAC CARE SUPERVISION,,,63.46,65.37,15
CPT,99380,NURSING FAC CARE SUPERVISION,,,95.01,97.86,15
CPT,99381,INIT PM E/M NEW PAT INFANT,,,102.0,105.06,15
CPT,99382,INIT PM E/M NEW PAT 1-4 YRS,,,106.69,109.89,15
CPT,99383,PREV VISIT NEW AGE 5-11,,,110.85,114.18,15
CPT,99384,PREV VISIT NEW AGE 12-17,,,124.28,128.01,15
CPT,99385,PREV VISIT NEW AGE 18-39,,,120.77,124.39,15
CPT,99386,PREV VISIT NEW AGE 40-64,,,139.19,143.37,15
CPT,99387,INIT PM E/M NEW PAT 65+ YRS,,,151.3,155.84,15
CPT,99391,PER PM REEVAL EST PAT INFANT,,,91.5,94.24,15
CPT,99392,PREV VISIT EST AGE 1-4,,,97.36,100.28,15
CPT,99393,PREV VISIT EST AGE 5-11,,,97.36,100.28,15
CPT,99394,PREV VISIT EST AGE 12-17,,,106.21,109.39,15
CPT,99395,PREV VISIT EST AGE 18-39,,,108.97,112.24,15
CPT,99396,PREV VISIT EST AGE 40-64,,,115.78,119.26,15
CPT,99397,PER PM REEVAL EST PAT 65+ YR,,,124.9,128.65,15
CPT,99401,PREV MED CNSL INDIV APPRX 15,,,35.66,36.73,15
CPT,99402,PREV MED CNSL INDIV APPRX 30,,,58.24,59.98,15
CPT,99403,PREV MED CNSL INDIV APPRX 45,,,79.66,82.05,15
CPT,99404,PREV MED CNSL INDIV APPRX 60,,,102.23,105.3,15
CPT,99406,"HC SMOKING/TOBACCO USE CESSATION COUNSEL VISIT, INTERMEDIATE, 3-10 MINUTES",37.5,20.63,11.25,266.0,371
CPT,99407,HC LVL 2 SMOKING CESSATION,37.5,20.63,11.25,266.0,53
CPT,99407,"HC SMOKING/TOBACCO USE CESSATION COUNSEL VISIT, INTENSV, GT THAN 10 MINUTES",37.5,20.63,11.25,266.0,212
CPT,99408,HC SBIRT (SCREENING BRIEF INTERVENTION & REFERRAL FOR TREATMENT) 15-30 MIN,90.0,49.5,27.0,799.0,106
CPT,99409,HC SBIRT (SCREENING BRIEF INTERVENTION & REFERRAL FOR TX) MORE THAN 30 MIN,205.0,112.75,61.06,799.0,106
CPT,99411,PREVENTIVE COUNSELING GROUP,,,18.27,18.82,15
CPT,99412,PREVENTIVE COUNSELING GROUP,,,22.85,23.54,15
CPT,99415,PROLNG CLIN STAFF SVC 1ST HR,,,18.99,19.56,15
CPT,99416,PROLNG CLIN STAFF SVC EA ADD,,,8.77,9.04,15
CPT,99417,PROLNG OP E/M EACH 15 MIN,,,28.52,29.37,15
CPT,99418,PROLNG IP/OBS E/M EA 15 MIN,,,36.53,37.63,15
CPT,99421,OL DIG E/M SVC 5-10 MIN,,,13.87,14.29,15
CPT,99422,OL DIG E/M SVC 11-20 MIN,,,27.13,27.94,15
CPT,99423,OL DIG E/M SVC 21+ MIN,,,43.33,44.63,15
CPT,99424,PRIN CARE MGMT PHYS 1ST 30,,,76.98,79.29,15
CPT,99425,PRIN CARE MGMT PHYS EA ADDL,,,56.52,58.21,15
CPT,99426,"HC PRIN CARE MGMT, SGL HI-RISK DIS, 1ST 30 MIN CLIN STAFF, PER CAL MO",208.0,114.4,46.0,179.92,120
CPT,99427,"HC PRIN CARE MGMT, SGL HI-RISK DIS, EA AD 30 MIN CLIN STAFF, PER CAL MO(AD)",104.0,57.2,46.0,89.96,120
CPT,99437,CHRNC CARE MGMT PHYS EA ADDL,,,55.28,56.94,15
CPT,99439,"HC CHRONIC CARE MGMT SVC, EA AD 20 MIN CLIN STAFF, PER CAL MO (AD)",104.0,57.2,44.12,89.96,120
CPT,99446,NTRPROF PH1/NTRNET/EHR 5-10,,,16.29,16.77,15
CPT,99447,NTRPROF PH1/NTRNET/EHR 11-20,,,32.88,33.87,15
CPT,99448,NTRPROF PH1/NTRNET/EHR 21-30,,,49.06,50.53,15
CPT,99449,NTRPROF PH1/NTRNET/EHR 31/>,,,66.07,68.05,15
CPT,99451,NTRPROF PH1/NTRNET/EHR 5/>,,,31.74,32.69,15
CPT,99452,NTRPROF PH1/NTRNET/EHR RFRL,,,32.36,33.33,15
CPT,99453,REM MNTR PHYSIOL PARAM SETUP,,,130.96,134.89,15
CPT,99454,REM MNTR PHYSIOL PARAM 16-30,,,37.89,39.03,15
CPT,99457,RPM TX MGMT 1ST 20 MIN,,,45.85,47.23,15
CPT,99458,RPM TX MGMT EA ADDL 20 MIN,,,36.88,37.98,15
CPT,99459,PELVIC EXAMINATION,,,19.81,20.41,15
CPT,99460,INIT NB EM PER DAY HOSP,,,130.96,134.89,15
CPT,99461,INIT NB EM PER DAY NON-FAC,,,84.95,87.5,15
CPT,99462,SBSQ NB EM PER DAY HOSP,,,36.99,38.1,15
CPT,99463,SAME DAY NB DISCHARGE,,,130.96,134.89,15
CPT,99464,ATTENDANCE AT DELIVERY,,,66.31,68.3,15
CPT,99465,NB RESUSCITATION,,,664.98,684.93,15
CPT,99466,PED CRIT CARE TRANSPORT,,,211.72,218.07,15
CPT,99467,PED CRIT CARE TRANSPORT ADDL,,,106.28,109.46,15
CPT,99468,NEONATE CRIT CARE INITIAL,,,816.46,840.96,15
CPT,99469,NEONATE CRIT CARE SUBSQ,,,353.38,363.98,15
CPT,99471,PED CRITICAL CARE INITIAL,,,706.67,727.87,15
CPT,99472,PED CRITICAL CARE SUBSQ,,,362.05,372.91,15
CPT,99473,SELF-MEAS BP PT EDUCAJ/TRAIN,,,24.89,25.63,15
CPT,99474,SELF-MEAS BP 2 READG BID 30D,,,15.84,16.31,15
CPT,99475,PED CRIT CARE AGE 2-5 INIT,,,510.77,526.1,15
CPT,99476,PED CRIT CARE AGE 2-5 SUBSQ,,,309.06,318.33,15
CPT,99477,INIT DAY HOSP NEONATE CARE,,,309.68,318.97,15
CPT,99478,"SBSQ IC VLBW INF<1,500 GM",,,121.53,125.17,15
CPT,99479,"SBSQ IC LBW INF 1,500-2,500",,,110.44,113.75,15
CPT,99480,"SBSQ IC INF PBW 2,501-5,000",,,106.28,109.46,15
CPT,99483,ASSMT & CARE PLN PT COG IMP,,,94.0,96.82,15
CPT,99484,CARE MGMT SVC BHVL HLTH COND,,,30.27,31.18,15
CPT,99485,SUPRV INTERFACILTY TRANSPORT,,,67.64,69.67,15
CPT,99486,SUPRV INTERFAC TRNSPORT ADDL,,,58.59,60.34,15
CPT,99487,"HC COMPLEX CHRONIC CARE MGMT SVC, 1ST 60 MIN CLIN STAFF, PER CAL MO",371.0,204.05,46.0,320.92,120
CPT,99489,"HC COMPLEX CHRONIC CARE MGMT SVC, EA AD 30 MIN CLIN STAFF, PER CAL MO (AD)",185.0,101.75,46.0,160.03,120
CPT,99490,"HC CHRONIC CARE MGMT SVC, 1ST 20 MIN CLIN STAFF, PER CAL MO",208.0,114.4,46.0,179.92,120
CPT,99491,CHRNC CARE MGMT PHYS 1ST 30,,,78.69,81.05,15
CPT,99492,1ST PSYC COLLAB CARE MGMT,,,94.0,96.82,15
CPT,99493,SBSQ PSYC COLLAB CARE MGMT,,,94.0,96.82,15
CPT,99494,1ST/SBSQ PSYC COLLAB CARE,,,53.88,55.5,15
CPT,99495,"HC TRANSITIONAL CARE MGMT SVC, MOD COMPLEXITY, W/N 14 DAYS OF DISCHG",238.5,131.18,46.0,206.3,120
CPT,99496,"HC TRANSITIONAL CARE MGMT SVC, HIGH COMPLEXITY, W/N 7 CAL DAYS OF DISCHG",238.5,131.18,46.0,206.3,120
CPT,99497,HC ADVANCED CARE PLANNING FIRST 30 MIN WITH HEALTH CARE PROFESSIONAL,205.0,112.75,61.5,799.0,53
CPT,99498,HC ADVANCED CARE PLANNING ADDITIONAL 30 MIN WITH HC PROFESSIONAL (ADD-ON),205.0,112.75,61.5,799.0,53
EAPG,0002,SUPERFICIAL NEEDLE BIOPSY AND ASPIRATION,,,347.49,364.86,14
EAPG,0003,"LEVEL I SKIN INCISION AND DRAINAGE, DEBRIDEMENT, DESTRUCTION, OTHER RELATED PX",,,90.36,94.88,14
EAPG,0004,"LEVEL II SKIN INCISION AND DRAINAGE, DEBRIDEMENT, DESTRUCTION, OTHER RELATED PX",,,575.47,604.24,14
EAPG,0005,NAIL PROCEDURES,,,34.37,36.09,14
EAPG,0009,"LEVEL I SKIN EXCISIONS, BIOPSIES, AND REPAIRS",,,223.42,234.59,14
EAPG,0010,"LEVEL II SKIN EXCISIONS, BIOPSIES, AND REPAIRS",,,642.13,674.24,14
EAPG,0011,"LEVEL III SKIN EXCISIONS, BIOPSIES, AND REPAIRS",,,931.3,977.87,14
EAPG,0016,SIMPLE WOUND REPAIR AND TREATMENT,,,98.37,103.29,14
EAPG,0017,INTERMEDIATE WOUND REPAIR AND TREATMENT,,,202.81,212.95,14
EAPG,0018,COMPLEX WOUND REPAIR AND TREATMENT,,,529.37,555.84,14
EAPG,0019,MOHS MICROGRAPHIC SURGERY,,,484.11,508.32,14
EAPG,0020,"BREAST BIOPSIES, EXCISIONS, AND OTHER RELATED PROCEDURES",,,686.93,721.28,14
EAPG,0021,LEVEL I MASTECTOMY AND RECONSTRUCTIVE BREAST PROCEDURES,,,1706.9,1792.25,14
EAPG,0022,LEVEL II MASTECTOMY AND RECONSTRUCTIVE BREAST PROCEDURES,,,3861.57,4054.65,14
EAPG,0023,LEVEL I FOREARM AND WRIST PROCEDURES,,,896.81,941.65,14
EAPG,0024,LEVEL II FOREARM AND WRIST PROCEDURES,,,2877.52,3021.4,14
EAPG,0025,LEVEL I SHOULDER AND UPPER ARM PROCEDURES,,,2497.83,2622.72,14
EAPG,0026,LEVEL I KNEE AND LOWER LEG PROCEDURES,,,1700.55,1785.58,14
EAPG,0027,LEVEL I HIP AND FEMUR PROCEDURES,,,1997.92,2097.82,14
EAPG,0028,LEVEL I SPINE PROCEDURES,,,2594.51,2724.24,14
EAPG,0029,LEVEL II SPINE PROCEDURES,,,5211.01,5471.56,14
EAPG,0033,LEVEL I HAND PROCEDURES,,,690.3,724.82,14
EAPG,0034,LEVEL II HAND PROCEDURES,,,1127.47,1183.84,14
EAPG,0035,LEVEL I FOOT PROCEDURES,,,1131.34,1187.91,14
EAPG,0036,LEVEL II FOOT PROCEDURES,,,2998.16,3148.07,14
EAPG,0037,LEVEL I ARTHROSCOPY,,,1124.12,1180.33,14
EAPG,0038,LEVEL II ARTHROSCOPY,,,2917.16,3063.02,14
EAPG,0039,CAST APPLICATION OR REPLACEMENT,,,102.39,107.51,14
EAPG,0040,MINOR SPLINT AND STRAPPING APPLICATION,,,38.43,40.35,14
EAPG,0041,CLOSED TREATMENT FX AND DISLOCATION,,,251.92,264.52,14
EAPG,0043,OPEN OR PERCUTANEOUS TREATMENT OF FRACTURES,,,2815.39,2956.16,14
EAPG,0044,BONE OR JOINT MANIPULATION UNDER ANESTHESIA,,,524.66,550.89,14
EAPG,0046,LEVEL I ARTHROPLASTY,,,1835.54,1927.32,14
EAPG,0047,LEVEL II ARTHROPLASTY,,,4882.91,5127.06,14
EAPG,0049,"LEVEL I JOINT, TENDON, OR LIGAMENT INJECTION PROCEDURES",,,128.36,134.78,14
EAPG,0050,"LEVEL II JOINT, TENDON, OR LIGAMENT INJECTION PROCEDURES",,,230.99,242.54,14
EAPG,0051,"MUSCULOSKELETAL EXCISIONS, BIOPSIES, AND DRAINAGE PROCEDURES",,,944.76,992.0,14
EAPG,0052,LEVEL II KNEE AND LOWER LEG PROCEDURES,,,3987.43,4186.8,14
EAPG,0053,SPINE INJECTIONS AND OTHER RELATED PROCEDURES,,,395.06,414.81,14
EAPG,0054,FIXATION DEVICE INSERTION OR REPLACEMENT PROCEDURES,,,1238.99,1300.94,14
EAPG,0055,LEVEL II HIP AND FEMUR PROCEDURES,,,5844.03,6136.23,14
EAPG,0056,SKIN AND CONNECTIVE TISSUE GRAFTING AND FLAP PROCEDURES,,,1003.1,1053.26,14
EAPG,0057,LEVEL III SPINE PROCEDURES,,,8527.52,8953.9,14
EAPG,0058,LEVEL II SHOULDER AND UPPER ARM PROCEDURES,,,4916.43,5162.25,14
EAPG,0059,ARTERIOVENOUS FISTULA CREATION OR REVISION FOR HEMODIALYSIS,,,1862.31,1955.43,14
EAPG,0060,PULMONARY FUNCTION TESTS,,,54.81,57.55,14
EAPG,0062,LEVEL I ENDOSCOPY OF THE UPPER AIRWAY,,,303.05,318.2,14
EAPG,0063,LEVEL II ENDOSCOPY OF THE UPPER AIRWAY,,,989.66,1039.14,14
EAPG,0064,LEVEL I LOWER AIRWAY ENDOSCOPY,,,948.22,995.63,14
EAPG,0066,PULMONARY REHABILITATIVE SERVICES,,,17.8,18.69,14
EAPG,0067,VENTILATION ASSISTANCE AND MANAGEMENT,,,617.22,648.08,14
EAPG,0068,"THORACENTESIS, RELATED BIOPSY AND PLEURAL DRAINAGE PROCEDURES",,,522.98,549.13,14
EAPG,0069,LEVEL I THORACIC AND CHEST PROCEDURES,,,1196.98,1256.83,14
EAPG,0070,LEVEL II THORACIC AND CHEST PROCEDURES,,,2642.16,2774.27,14
EAPG,0071,LEVEL II LOWER AIRWAY ENDOSCOPY,,,2006.53,2106.86,14
EAPG,0072,TRACHEOSTOMY AND RELATED TRACHEAL PROCEDURES,,,1155.86,1213.65,14
EAPG,0073,DIAPHRAGMATIC PROCEDURES AND RELATED HERNIA REPAIR,,,3430.42,3601.94,14
EAPG,0074,"REVISION, REPLACEMENT OR REMOVAL OF CARDIAC DEVICE COMPONENT",,,787.06,826.41,14
EAPG,0075,LEVEL I CENTRAL VENOUS ACCESS PROCEDURES,,,609.61,640.09,14
EAPG,0076,"REVISION, REPAIR OR REMOVAL OF CENTRAL VENOUS ACCESS DEVICE",,,382.28,401.39,14
EAPG,0077,LEVEL I PERIPHERAL ENDOVASCULAR AND TRANSCATHETER PROCEDURES,,,1985.25,2084.51,14
EAPG,0078,"LEVEL I PERIPHERAL VASCULAR REPAIR, LIGATION OR RECONSTRUCTION",,,1101.54,1156.62,14
EAPG,0079,LEVEL II PERIPHERAL ENDOVASCULAR AND TRANSCATHETER PROCEDURES,,,3400.57,3570.6,14
EAPG,0080,EXERCISE TOLERANCE TESTS,,,88.48,92.9,14
EAPG,0081,ECHOCARDIOGRAPHY,,,243.06,255.21,14
EAPG,0082,COMPREHENSIVE CARDIAC ELECTROPHYSIOLOGIC PROCEDURES WITH ABLATION,,,8807.21,9247.57,14
EAPG,0083,LEVEL II CENTRAL VENOUS ACCESS PROCEDURES,,,1112.34,1167.96,14
EAPG,0084,CARDIAC CATHETERIZATION PROCEDURES,,,1281.54,1345.62,14
EAPG,0085,LEVEL III PERIPHERAL ENDOVASCULAR AND TRANSCATHETER PROCEDURES,,,5685.01,5969.26,14
EAPG,0086,PACEMAKER AND OTHER CARDIOVASCULAR DEVICE INSERTION AND REPLACEMENT,,,4097.33,4302.2,14
EAPG,0087,REMOVAL OR REVISION OF PACEMAKERS AND OTHER CARDIOVASCULAR DEVICES,,,3732.4,3919.02,14
EAPG,0090,LEVEL I VARICOSE VEIN AND RELATED PROCEDURES,,,321.16,337.22,14
EAPG,0091,"LEVEL II PERIPHERAL VASCULAR REPAIR, LIGATION OR RECONSTRUCTION",,,2099.52,2204.5,14
EAPG,0092,RESUSCITATION,,,384.07,403.27,14
EAPG,0093,CARDIOVERSION,,,336.25,353.06,14
EAPG,0094,CARDIAC REHABILITATION,,,77.68,81.56,14
EAPG,0096,CARDIAC ELECTROPHYSIOLOGIC PROCEDURES INCLUDING PACING AND RECORDING,,,3530.03,3706.53,14
EAPG,0097,AICD AND RELATED CARDIAC DEVICE INSERTION OR REPLACEMENT,,,11600.2,12180.21,14
EAPG,0099,LEVEL I PERCUTANEOUS CORONARY AND INTRACARDIAC INTERVENTIONAL PROCEDURES,,,4424.09,4645.29,14
EAPG,0103,LEVEL II VARICOSE VEIN AND RELATED PROCEDURES,,,1369.04,1437.49,14
EAPG,0104,MAJOR OPEN CORONARY ARTERY PROCEDURES INCLUDING CABG,,,8331.45,8748.02,14
EAPG,0105,MAJOR OPEN CARDIAC AND CARDIAC VALVE PROCEDURES,,,5807.39,6097.76,14
EAPG,0106,MAJOR OPEN ABDOMINAL AND THORACIC VASCULAR PROCEDURES,,,4426.16,4647.47,14
EAPG,0107,CHOLECYSTECTOMY AND RELATED BILIARY PROCEDURES,,,1882.8,1976.94,14
EAPG,0108,OTHER INTRA-ABDOMINAL AND INTRAPERITONEAL SURGICAL PROCEDURES,,,1951.55,2049.13,14
EAPG,0109,ANCILLARY DRUG ADMINISTRATION,,,26.73,28.07,14
EAPG,0110,PHARMACOTHERAPY BY EXTENDED INFUSION,,,265.49,278.76,14
EAPG,0111,PHARMACOTHERAPY EXCEPT BY EXTENDED INFUSION,,,146.85,154.19,14
EAPG,0113,LEVEL I BLOOD PRODUCT EXCHANGE SERVICES,,,224.97,236.22,14
EAPG,0114,LEVEL II BLOOD PRODUCT EXCHANGE SERVICES,,,834.38,876.1,14
EAPG,0115,DEEP LYMPH STRUCTURE PROCEDURES,,,1717.68,1803.56,14
EAPG,0116,LEVEL I ALLERGY TESTS,,,16.56,17.39,14
EAPG,0118,NUTRITION THERAPY,,,106.85,112.19,14
EAPG,0119,CAR T-CELL IMMUNOTHERAPY PREPARATION SERVICES,,,381.48,400.55,14
EAPG,0120,CAR T-CELL IMMUNOTHERAPY,,,19852.87,20845.51,14
EAPG,0121,LEVEL II PERCUTANEOUS CORONARY AND INTRACARDIAC INTERVENTIONAL PROCEDURES,,,7551.69,7929.27,14
EAPG,0122,PERCUTANEOUS INTRA-ABDOMINAL OR INTRATHORACIC VASCULAR PROCEDURES,,,8019.41,8420.38,14
EAPG,0123,PERIPHERAL VASCULAR BYPASS PROCEDURES,,,2546.44,2673.76,14
EAPG,0124,BONE MARROW BIOPSIES,,,972.93,1021.58,14
EAPG,0125,LEVEL I ESOPHAGEAL AND GASTRIC SURGICAL PROCEDURES,,,1751.26,1838.82,14
EAPG,0126,LEVEL II ESOPHAGEAL AND GASTRIC SURGICAL PROCEDURES,,,1925.66,2021.94,14
EAPG,0127,LEVEL I SMALL AND LARGE INTESTINE SURGICAL PROCEDURES,,,1064.68,1117.91,14
EAPG,0128,LEVEL II SMALL AND LARGE INTESTINE SURGICAL PROCEDURES,,,2097.21,2202.07,14
EAPG,0129,ESOPHAGOGASTRIC RESTRICTIVE PROCEDURES AND GASTRIC FUNDOPLICATION,,,2705.26,2840.52,14
EAPG,0130,MINOR GASTROINTESTINAL PROCEDURES INCLUDING TUBE INSERTION OR PLACEMENT,,,185.79,195.08,14
EAPG,0134,LEVEL I UPPER GI ENDOSCOPY,,,520.22,546.23,14
EAPG,0135,LEVEL II UPPER GI ENDOSCOPY,,,1097.94,1152.84,14
EAPG,0136,LEVEL I LOWER GI ENDOSCOPY,,,516.96,542.81,14
EAPG,0137,LEVEL II LOWER GI ENDOSCOPY,,,1092.71,1147.35,14
EAPG,0138,LEVEL I ERCP AND RELATED ENDOSCOPIC PROCEDURES,,,1394.5,1464.23,14
EAPG,0141,LEVEL I ANAL AND RECTAL PROCEDURES,,,761.8,799.89,14
EAPG,0142,LEVEL II ANAL AND RECTAL PROCEDURES,,,1191.06,1250.61,14
EAPG,0150,ABDOMINAL PARACENTESIS AND RELATED PERITONEAL DRAINAGE PROCEDURES,,,381.22,400.28,14
EAPG,0151,LEVEL I HEPATOBILIARY AND PANCREAS PROCEDURES,,,1189.15,1248.61,14
EAPG,0152,LEVEL II HEPATOBILIARY AND PANCREAS PROCEDURES,,,2947.11,3094.47,14
EAPG,0153,LEVEL II ERCP AND RELATED ENDOSCOPIC PROCEDURES,,,2331.8,2448.39,14
EAPG,0154,LEVEL III UPPER GI ENDOSCOPY,,,2124.51,2230.74,14
EAPG,0155,LEVEL III BLOOD PRODUCT EXCHANGE SERVICES,,,2163.65,2271.83,14
EAPG,0156,OCULAR IMAGING AND RELATED SERVICES,,,30.12,31.63,14
EAPG,0157,REPRODUCTIVE PATHOLOGY TESTS,,,55.18,57.94,14
EAPG,0158,PATHOLOGY CONSULTATION AND INTERPRETATION,,,49.6,52.08,14
EAPG,0159,MINOR UROLOGY SERVICES,,,43.42,45.59,14
EAPG,0161,URINARY STUDIES AND PROCEDURES,,,207.14,217.5,14
EAPG,0166,LEVEL I URETHRAL PROCEDURES,,,1560.42,1638.44,14
EAPG,0167,LEVEL II URETHRAL PROCEDURES,,,3076.82,3230.66,14
EAPG,0168,DIALYSIS PROCEDURES,,,459.28,482.24,14
EAPG,0170,LEVEL I KIDNEY AND URETERAL PROCEDURES,,,771.37,809.94,14
EAPG,0171,LEVEL II KIDNEY AND URETERAL PROCEDURES,,,1516.14,1591.95,14
EAPG,0172,LEVEL III KIDNEY AND URETERAL PROCEDURES,,,3611.34,3791.91,14
EAPG,0173,LEVEL I BLADDER AND URETERAL PROCEDURES,,,814.0,854.7,14
EAPG,0174,LEVEL II BLADDER AND URETERAL PROCEDURES,,,2169.82,2278.31,14
EAPG,0175,LEVEL III BLADDER AND URETERAL PROCEDURES,,,2594.3,2724.02,14
EAPG,0176,LEVEL I PROSTATE PROCEDURES,,,888.42,932.84,14
EAPG,0177,MINOR DERMATOLOGY SERVICES,,,17.93,18.83,14
EAPG,0178,ANTEPARTUM PROCEDURES,,,306.16,321.47,14
EAPG,0179,ECTOPIC PREGNANCY PROCEDURES,,,1845.94,1938.24,14
EAPG,0180,TESTICULAR AND EPIDIDYMAL PROCEDURES,,,1489.88,1564.37,14
EAPG,0182,INSERTION OF PENILE PROSTHESIS,,,7036.54,7388.37,14
EAPG,0183,LEVEL I PENILE PROCEDURES,,,1022.14,1073.25,14
EAPG,0184,LEVEL II PROSTATE PROCEDURES,,,2342.09,2459.19,14
EAPG,0187,LEVEL II PENILE PROCEDURES,,,1745.41,1832.68,14
EAPG,0188,LEVEL I PERINEAL AND VAGINAL GYNECOLOGICAL PROCEDURES,,,1318.95,1384.9,14
EAPG,0189,LEVEL II PERINEAL AND VAGINAL GYNECOLOGICAL PROCEDURES,,,2973.61,3122.29,14
EAPG,0190,ARTIFICIAL FERTILIZATION,,,278.56,292.49,14
EAPG,0191,LEVEL I FETAL PROCEDURES,,,102.28,107.39,14
EAPG,0192,LEVEL II FETAL PROCEDURES,,,529.03,555.48,14
EAPG,0194,ABORTION AND MISCARRIAGE TREATMENT AND PROCEDURES,,,929.75,976.24,14
EAPG,0195,VAGINAL DELIVERY PROCEDURES,,,1241.26,1303.32,14
EAPG,0202,CESAREAN DELIVERY PROCEDURES,,,1372.69,1441.32,14
EAPG,0203,GLOBAL ANTEPARTUM AND POSTPARTUM VISITS,,,114.08,119.78,14
EAPG,0204,LEVEL I HYSTERECTOMY AND MYOMECTOMY PROCEDURES,,,2154.08,2261.78,14
EAPG,0205,OBSTETRICAL PROCEDURES,,,920.85,966.89,14
EAPG,0206,LEVEL II HYSTERECTOMY AND MYOMECTOMY PROCEDURES,,,3030.55,3182.08,14
EAPG,0207,LEVEL I OTHER UTERINE AND ADNEXA GYNECOLOGICAL PROCEDURES,,,1227.78,1289.17,14
EAPG,0208,LEVEL II OTHER UTERINE AND ADNEXA GYNECOLOGICAL PROCEDURES,,,2261.12,2374.18,14
EAPG,0209,OTHER GYNECOLOGICAL PROCEDURES,,,270.78,284.32,14
EAPG,0210,EXTENDED EEG STUDIES,,,248.49,260.91,14
EAPG,0211,ELECTROENCEPHALOGRAM,,,192.83,202.47,14
EAPG,0212,ELECTROCONVULSIVE THERAPY,,,249.23,261.69,14
EAPG,0213,NERVE AND MUSCLE TESTS,,,69.43,72.9,14
EAPG,0214,LEVEL I NERVOUS SYSTEM INJECTIONS INCLUDING CRANIAL TAP,,,207.58,217.96,14
EAPG,0217,LEVEL I PERIPHERAL NERVE PROCEDURES,,,704.93,740.18,14
EAPG,0218,LEVEL II PERIPHERAL NERVE PROCEDURES,,,2548.04,2675.44,14
EAPG,0220,LEVEL II NERVOUS SYSTEM INJECTIONS INCLUDING CRANIAL TAP,,,759.85,797.84,14
EAPG,0222,SLEEP STUDIES ATTENDED,,,397.15,417.01,14
EAPG,0223,LEVEL I NEUROSTIMULATOR AND RELATED DEVICE IMPLANTATION,,,3227.89,3389.28,14
EAPG,0224,LEVEL II NEUROSTIMULATOR AND RELATED DEVICE IMPLANTATION,,,10032.14,10533.75,14
EAPG,0225,OTHER INTRACRANIAL NEUROSURGERY PROCEDURES,,,1904.41,1999.63,14
EAPG,0226,SLEEP STUDIES UNATTENDED,,,79.35,83.32,14
EAPG,0227,LEVEL I CRANIOFACIAL BONE PROCEDURES,,,1372.19,1440.8,14
EAPG,0228,LEVEL II CRANIOFACIAL BONE PROCEDURES,,,2591.57,2721.15,14
EAPG,0229,MINOR AUDIOMETRY TESTS AND AUDIOLOGY SCREENING SERVICES,,,16.96,17.81,14
EAPG,0230,MINOR OPHTHALMOLOGICAL PROCEDURES AND DIAGNOSTIC SERVICES,,,152.09,159.69,14
EAPG,0233,CATARACT AND OTHER INTRAOCULAR LENS PROCEDURES,,,894.81,939.55,14
EAPG,0234,LEVEL I ANTERIOR CHAMBER EYE PROCEDURES,,,546.6,573.93,14
EAPG,0235,LEVEL II ANTERIOR CHAMBER EYE PROCEDURES,,,1760.24,1848.25,14
EAPG,0237,"LEVEL I INTRAVITREAL, RETINAL AND OTHER POSTERIOR CHAMBER EYE PROCEDURES",,,531.28,557.84,14
EAPG,0238,"LEVEL II INTRAVITREAL, RETINAL AND OTHER POSTERIOR CHAMBER EYE PROCEDURES",,,1674.01,1757.71,14
EAPG,0239,EXTRAOCULAR MUSCLE PROCEDURES,,,1134.67,1191.4,14
EAPG,0241,OCULAR RECONSTRUCTIVE PROCEDURES W OR W/O OCULAR DEVICE,,,1573.25,1651.91,14
EAPG,0244,CLASS II THERAPEUTIC RADIOPHARMACEUTICALS,,,211.96,222.56,14
EAPG,0245,CLASS III THERAPEUTIC RADIOPHARMACEUTICALS,,,7074.16,7427.87,14
EAPG,0246,CLASS IV THERAPEUTIC RADIOPHARMACEUTICALS,,,18704.49,19639.71,14
EAPG,0247,LEVEL I CORNEAL AND OTHER ANTERIOR SURFACE EYE PROCEDURES,,,297.88,312.77,14
EAPG,0248,LEVEL II CORNEAL AND OTHER ANTERIOR SURFACE EYE PROCEDURES,,,1695.69,1780.47,14
EAPG,0249,"MINOR EAR, NOSE, MOUTH AND THROAT PROCEDURES",,,95.93,100.73,14
EAPG,0250,COCHLEAR DEVICE IMPLANTATION,,,12602.26,13232.37,14
EAPG,0251,OTORHINOLARYNGOLOGIC FUNCTION TESTS,,,71.05,74.6,14
EAPG,0252,"LEVEL I EAR, NOSE, MOUTH AND THROAT PROCEDURES",,,736.5,773.33,14
EAPG,0253,"LEVEL II EAR, NOSE, MOUTH AND THROAT PROCEDURES",,,1401.57,1471.65,14
EAPG,0254,"LEVEL III EAR, NOSE, MOUTH AND THROAT PROCEDURES",,,1796.07,1885.87,14
EAPG,0255,"LEVEL IV EAR, NOSE, MOUTH AND THROAT PROCEDURES",,,2309.03,2424.48,14
EAPG,0256,TONSIL AND ADENOID PROCEDURES,,,1117.78,1173.67,14
EAPG,0257,AUDIOMETRY,,,41.31,43.38,14
EAPG,0258,"LEVEL I EYELID, LACRIMAL AND CONJUNCTIVAL PROCEDURES",,,711.99,747.59,14
EAPG,0259,"LEVEL II EYELID, LACRIMAL AND CONJUNCTIVAL PROCEDURES",,,895.1,939.86,14
EAPG,0260,CASE MANAGEMENT AND CARE PLANNING SERVICES,,,66.25,69.56,14
EAPG,0261,ESRD MONTHLY CASE MANAGEMENT,,,281.12,295.18,14
EAPG,0262,CLEFT LIP AND PALATE REPAIR,,,1391.79,1461.38,14
EAPG,0263,THYROID AND PARATHYROID PROCEDURES,,,2272.66,2386.29,14
EAPG,0264,MAJOR CRANIOTOMY AND CRANIECTOMY SURGICAL PROCEDURES,,,2086.07,2190.37,14
EAPG,0265,PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,,,7185.18,7544.44,14
EAPG,0266,OPEN INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,,,2426.41,2547.73,14
EAPG,0267,OTHER CRANIOTOMY PROCEDURES INCLUDING CRANIOPLASTY,,,3163.55,3321.73,14
EAPG,0268,CRANIAL AND SPINAL SHUNT PROCEDURES,,,2918.27,3064.18,14
EAPG,0269,LEVEL II ANCILLARY THERAPEUTIC SERVICES,,,18.3,19.22,14
EAPG,0270,OCCUPATIONAL THERAPY,,,132.2,138.81,14
EAPG,0271,PHYSICAL THERAPY,,,120.66,126.69,14
EAPG,0272,SPEECH THERAPY AND EVALUATION,,,145.07,152.32,14
EAPG,0276,PROCEDURES FOR REVISION OR REMOVAL OF NEUROSTIMULATOR DEVICES,,,1651.64,1734.22,14
EAPG,0277,LEVEL I VASCULAR RADIOLOGICAL PROCEDURES,,,584.41,613.63,14
EAPG,0278,INJECTION(S) FOR RADIOLOGICAL IMAGING,,,179.07,188.02,14
EAPG,0279,LEVEL II VASCULAR RADIOLOGICAL PROCEDURES,,,900.83,945.87,14
EAPG,0280,LEVEL III VASCULAR RADIOLOGICAL PROCEDURES,,,2410.51,2531.04,14
EAPG,0282,MAGNETIC RESONANCE ANGIOGRAPHY,,,264.52,277.75,14
EAPG,0284,MYELOGRAPHY AND DISCOGRAPHY IMAGING PROCEDURES,,,288.39,302.81,14
EAPG,0286,MAMMOGRAPHY AND OTHER RELATED PROCEDURES,,,24.25,25.46,14
EAPG,0288,LEVEL I DIAGNOSTIC ULTRASOUND,,,56.46,59.28,14
EAPG,0289,LEVEL II DIAGNOSTIC ULTRASOUND,,,85.52,89.8,14
EAPG,0290,PET SCANS,,,722.54,758.67,14
EAPG,0291,BONE DENSITY AND RELATED PROCEDURES,,,39.07,41.02,14
EAPG,0293,MAGNETIC RESONANCE IMAGING WITHOUT CONTRAST,,,124.1,130.31,14
EAPG,0295,MAGNETIC RESONANCE IMAGING WITH CONTRAST,,,208.73,219.17,14
EAPG,0297,MAGNETOCEPHALOGRAPHY,,,1720.51,1806.54,14
EAPG,0299,LEVEL I COMPUTED TOMOGRAPHY,,,55.12,57.88,14
EAPG,0300,LEVEL II COMPUTED TOMOGRAPHY,,,166.05,174.35,14
EAPG,0301,COMPUTED TOMOGRAPHY- OTHER,,,118.43,124.35,14
EAPG,0302,COMPUTED TOMOGRAPHIC ANGIOGRAPHY,,,204.61,214.84,14
EAPG,0304,MINOR SPECIMEN COLLECTION SERVICES,,,1.32,1.39,14
EAPG,0305,LEVEL I SURGICAL PATHOLOGY TESTS,,,16.86,17.7,14
EAPG,0306,LEVEL II SURGICAL PATHOLOGY TESTS,,,83.11,87.27,14
EAPG,0308,LEVEL III PATHOLOGY TESTS,,,86.22,90.53,14
EAPG,0309,ADAPTIVE BEHAVIORAL HEALTH TREATMENT SERVICES,,,23.06,24.21,14
EAPG,0310,DEVELOPMENTAL AND NEUROPSYCHOLOGICAL TESTING,,,317.97,333.87,14
EAPG,0312,BEHAVIORAL AND SUBSTANCE ABUSE PARTIAL HOSPITALIZATION PROGRAM,,,272.55,286.18,14
EAPG,0315,COUNSELLING OR INDIVIDUAL BRIEF PSYCHOTHERAPY,,,67.21,70.57,14
EAPG,0316,INDIVIDUAL COMPREHENSIVE PSYCHOTHERAPY,,,75.62,79.4,14
EAPG,0317,FAMILY PSYCHOTHERAPY,,,80.23,84.24,14
EAPG,0318,GROUP PSYCHOTHERAPY,,,130.43,136.95,14
EAPG,0319,ACTIVITY THERAPY,,,81.76,85.85,14
EAPG,0320,BEHAVIORAL HEALTH - CASE MANAGEMENT AND TREATMENT PLAN DEVELOPMENT,,,49.36,51.83,14
EAPG,0321,CRISIS INTERVENTION,,,117.35,123.22,14
EAPG,0322,MEDICATION ADMINISTRATION AND OBSERVATION,,,17.9,18.8,14
EAPG,0323,BEHAVIORAL HEALTH ASSESSMENT,,,124.22,130.43,14
EAPG,0324,SCREENING FOR BEHAVIORAL CHANGE OR RISK ASSESSMENT,,,11.55,12.13,14
EAPG,0325,PREVENTION COUNSELING,,,33.92,35.62,14
EAPG,0327,INTENSIVE OUTPATIENT PSYCHIATRIC TREATMENT,,,170.52,179.05,14
EAPG,0328,"DAY REHABILITATION, HALF DAY",,,166.52,174.85,14
EAPG,0329,"DAY REHABILITATION, FULL DAY",,,248.11,260.52,14
EAPG,0331,LEVEL I DIAGNOSTIC NUCLEAR MEDICINE,,,191.12,200.68,14
EAPG,0332,LEVEL II DIAGNOSTIC NUCLEAR MEDICINE,,,471.05,494.6,14
EAPG,0333,BEHAVIORAL HEALTH RESIDENTIAL TREATMENT,,,275.66,289.44,14
EAPG,0335,CLASS I BRACHYTHERAPY SOURCES,,,134.37,141.09,14
EAPG,0336,CLASS II BRACHYTHERAPY SOURCES,,,1705.19,1790.45,14
EAPG,0337,CLASS III BRACHYTHERAPY SOURCES,,,6275.34,6589.11,14
EAPG,0340,THERAPEUTIC NUCLEAR MEDICINE,,,125.32,131.59,14
EAPG,0343,LEVEL I RADIATION THERAPY,,,92.83,97.47,14
EAPG,0346,RADIOSURGERY,,,2699.32,2834.29,14
EAPG,0347,LEVEL II RADIATION THERAPY,,,246.17,258.48,14
EAPG,0348,LEVEL III RADIATION THERAPY,,,723.08,759.23,14
EAPG,0350,ADJUNCTIVE DENTAL SERVICES,,,122.92,129.07,14
EAPG,0352,LEVEL I PERIODONTICS,,,481.29,505.35,14
EAPG,0353,"LEVEL I PROSTHODONTICS, FIXED",,,54.24,56.95,14
EAPG,0354,"LEVEL II PROSTHODONTICS, FIXED",,,202.89,213.03,14
EAPG,0355,"LEVEL III PROSTHODONTICS, FIXED",,,251.01,263.56,14
EAPG,0356,"LEVEL I PROSTHODONTICS, REMOVABLE",,,109.93,115.43,14
EAPG,0357,"LEVEL II PROSTHODONTICS, REMOVABLE",,,135.91,142.71,14
EAPG,0358,"LEVEL III PROSTHODONTICS, REMOVABLE",,,161.87,169.96,14
EAPG,0359,LEVEL I MAXILLOFACIAL PROSTHETICS,,,809.33,849.8,14
EAPG,0360,LEVEL II MAXILLOFACIAL PROSTHETICS,,,1739.14,1826.1,14
EAPG,0361,LEVEL I DENTAL RESTORATIONS,,,1137.32,1194.19,14
EAPG,0362,LEVEL II DENTAL RESTORATIONS,,,1517.66,1593.54,14
EAPG,0363,LEVEL III DENTAL RESTORATIONS,,,1448.57,1521.0,14
EAPG,0364,LEVEL I ENDODONTICS,,,74.5,78.23,14
EAPG,0365,LEVEL II ENDODONTICS,,,134.0,140.7,14
EAPG,0366,LEVEL III ENDODONTICS,,,159.63,167.61,14
EAPG,0367,LEVEL I ORAL SURGERY PROCEDURES,,,650.0,682.5,14
EAPG,0368,LEVEL II ORAL SURGERY PROCEDURES,,,1002.29,1052.4,14
EAPG,0369,LEVEL III ORAL SURGERY PROCEDURES,,,1511.78,1587.37,14
EAPG,0371,LEVEL I ORTHODONTICS,,,715.91,751.71,14
EAPG,0372,SEALANT,,,26.39,27.71,14
EAPG,0373,LEVEL I DENTAL IMAGING,,,19.57,20.55,14
EAPG,0374,LEVEL II DENTAL IMAGING,,,74.75,78.49,14
EAPG,0375,DENTAL ANESTHESIA,,,22.31,23.43,14
EAPG,0376,DIAGNOSTIC DENTAL PROCEDURES,,,67.01,70.36,14
EAPG,0377,PREVENTIVE DENTAL PROCEDURES,,,70.37,73.89,14
EAPG,0378,LEVEL II PERIODONTICS,,,713.78,749.47,14
EAPG,0379,LEVEL II ORTHODONTICS,,,787.52,826.9,14
EAPG,0380,ANESTHESIA,,,11.29,11.85,14
EAPG,0381,LEVEL I DENTAL IMPLANTS,,,687.09,721.44,14
EAPG,0382,LEVEL II DENTAL IMPLANTS,,,755.81,793.6,14
EAPG,0384,LEVEL III CHEMISTRY TESTS,,,28.98,30.43,14
EAPG,0385,"LEVEL I COMPLEX LABORATORY, MOLECULAR PATHOLOGY AND GENETIC TESTS",,,18.6,19.53,14
EAPG,0386,"LEVEL II COMPLEX LABORATORY, MOLECULAR PATHOLOGY AND GENETIC TESTS",,,68.38,71.8,14
EAPG,0387,"LEVEL III COMPLEX LABORATORY, MOLECULAR PATHOLOGY AND GENETIC TESTS",,,152.4,160.02,14
EAPG,0388,LEVEL III MICROBIOLOGY TESTS,,,76.85,80.69,14
EAPG,0389,LEVEL II CONVENTIONAL RADIOLOGY,,,60.18,63.19,14
EAPG,0390,LEVEL I PATHOLOGY TESTS,,,2.1,2.21,14
EAPG,0391,LEVEL II PATHOLOGY TESTS,,,16.96,17.81,14
EAPG,0392,PAP SMEARS,,,8.71,9.15,14
EAPG,0393,LEVEL II BLOOD AND TISSUE TYPING TESTS,,,26.3,27.62,14
EAPG,0394,LEVEL I IMMUNOLOGY TESTS,,,4.81,5.05,14
EAPG,0395,LEVEL II IMMUNOLOGY TESTS,,,17.4,18.27,14
EAPG,0396,LEVEL I MICROBIOLOGY TESTS,,,4.22,4.43,14
EAPG,0397,LEVEL II MICROBIOLOGY TESTS,,,24.86,26.1,14
EAPG,0398,LEVEL I ENDOCRINOLOGY TESTS,,,5.66,5.94,14
EAPG,0399,LEVEL II ENDOCRINOLOGY TESTS,,,14.86,15.6,14
EAPG,0400,LEVEL I CHEMISTRY TESTS,,,5.14,5.4,14
EAPG,0401,LEVEL II CHEMISTRY TESTS,,,11.98,12.58,14
EAPG,0402,BASIC CHEMISTRY TESTS,,,2.32,2.44,14
EAPG,0403,ORGAN OR DISEASE ORIENTED PANELS,,,3.85,4.04,14
EAPG,0404,TOXICOLOGY TESTS,,,5.19,5.45,14
EAPG,0405,THERAPEUTIC DRUG MONITORING,,,5.17,5.43,14
EAPG,0406,LEVEL I CLOTTING TESTS,,,1.9,2.0,14
EAPG,0407,LEVEL II CLOTTING TESTS,,,10.96,11.51,14
EAPG,0408,LEVEL I HEMATOLOGY TESTS,,,2.54,2.67,14
EAPG,0410,URINALYSIS,,,1.26,1.32,14
EAPG,0412,ANCILLARY RESPIRATORY THERAPY AND OTHER PULMONARY TESTS AND SERVICES,,,30.04,31.54,14
EAPG,0413,CARDIOGRAM,,,13.46,14.13,14
EAPG,0414,LEVEL I IMMUNIZATION,,,13.17,13.83,14
EAPG,0415,LEVEL II IMMUNIZATION,,,63.66,66.84,14
EAPG,0417,MINOR FEMALE REPRODUCTIVE PROCEDURES,,,113.05,118.7,14
EAPG,0418,AMBULATORY PATIENT MONITORING AND RELATED ASSESSMENTS,,,30.39,31.91,14
EAPG,0419,ANCILLARY OPHTHALMOLOGY OR OPTOMETRY SERVICES,,,41.47,43.54,14
EAPG,0420,"ELECTRONIC ANALYSIS FOR CARDIAC, NEUROLOGICAL AND OTHER DEVICES",,,71.33,74.9,14
EAPG,0423,VASCULAR ACCESS BY NEEDLE OR CATHETER,,,347.98,365.38,14
EAPG,0427,BIOFEEDBACK AND OTHER TRAINING,,,50.24,52.75,14
EAPG,0428,"PATIENT EDUCATION, INDIVIDUAL",,,35.77,37.56,14
EAPG,0429,"PATIENT EDUCATION, GROUP",,,22.15,23.26,14
EAPG,0431,CLASS II CHEMOTHERAPY DRUGS,,,22.67,23.8,14
EAPG,0432,CLASS III CHEMOTHERAPY DRUGS,,,58.24,61.15,14
EAPG,0433,CLASS IV CHEMOTHERAPY DRUGS,,,61.16,64.22,14
EAPG,0434,CLASS V CHEMOTHERAPY DRUGS,,,177.93,186.83,14
EAPG,0436,CLASS II PHARMACOTHERAPY,,,55.27,58.03,14
EAPG,0437,CLASS III PHARMACOTHERAPY,,,62.17,65.28,14
EAPG,0438,CLASS IV PHARMACOTHERAPY,,,98.93,103.88,14
EAPG,0439,CLASS V PHARMACOTHERAPY,,,248.9,261.35,14
EAPG,0440,CLASS VI PHARMACOTHERAPY,,,259.9,272.9,14
EAPG,0441,CLASS VI CHEMOTHERAPY DRUGS,,,316.24,332.05,14
EAPG,0443,CLASS VII CHEMOTHERAPY DRUGS,,,573.65,602.33,14
EAPG,0444,CLASS VII PHARMACOTHERAPY,,,495.38,520.15,14
EAPG,0448,EXPANDED HOURS ACCESS,,,21.1,22.16,14
EAPG,0450,OBSERVATION,,,445.07,467.32,14
EAPG,0458,ALLERGY THERAPY,,,12.21,12.82,14
EAPG,0459,VACCINE ADMINISTRATION,,,20.65,21.68,14
EAPG,0460,CLASS VIII COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY,,,643.86,676.05,14
EAPG,0461,CLASS IX COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY,,,901.02,946.07,14
EAPG,0462,CLASS X COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY,,,2226.29,2337.6,14
EAPG,0463,CLASS XI COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY,,,2481.24,2605.3,14
EAPG,0464,CLASS XII COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY,,,3945.08,4142.33,14
EAPG,0465,CLASS XIII COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY,,,8642.1,9074.21,14
EAPG,0466,CLASS XIV COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY,,,12423.67,13044.85,14
EAPG,0470,OBSTETRICAL ULTRASOUND,,,51.77,54.36,14
EAPG,0471,LEVEL I CONVENTIONAL RADIOLOGY,,,28.79,30.23,14
EAPG,0472,ULTRASOUND GUIDANCE,,,56.08,58.88,14
EAPG,0473,CT GUIDANCE,,,41.53,43.61,14
EAPG,0474,RADIOLOGICAL GUIDANCE FOR THERAPEUTIC OR DIAGNOSTIC PROCEDURES,,,105.85,111.14,14
EAPG,0475,MRI GUIDANCE,,,108.41,113.83,14
EAPG,0476,LEVEL I RADIATION TREATMENT PREPARATION AND PLANNING,,,61.84,64.93,14
EAPG,0477,LEVEL II RADIATION TREATMENT PREPARATION AND PLANNING,,,92.05,96.65,14
EAPG,0478,LEVEL III RADIATION TREATMENT PREPARATION AND PLANNING,,,547.9,575.3,14
EAPG,0483,RADIATION THERAPY MANAGEMENT,,,202.57,212.7,14
EAPG,0485,CORNEAL TISSUE PROCESSING,,,1405.11,1475.37,14
EAPG,0486,LEVEL I BLOOD AND TISSUE TYPING TESTS,,,1.87,1.96,14
EAPG,0488,MINOR DEVICE EVALUATION AND INTERROGATION,,,18.57,19.5,14
EAPG,0493,LEVEL I ANCILLARY THERAPEUTIC SERVICES,,,14.52,15.25,14
EAPG,0494,COMPLEX BLOOD COLLECTION SERVICES,,,36.97,38.82,14
EAPG,0497,TELEHEALTH FACILITATION,,,6.1,6.41,14
EAPG,0499,"BLOOD PROCESSING, STORAGE AND RELATED SERVICES",,,44.53,46.76,14
EAPG,0518,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,,,111.56,117.14,14
EAPG,0519,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM,,,70.2,73.71,14
EAPG,0520,SPINAL DIAGNOSES AND INJURIES,,,78.62,82.55,14
EAPG,0521,NERVOUS SYSTEM MALIGNANCY,,,71.93,75.53,14
EAPG,0522,DEGENERATIVE NERVOUS SYSTEM DIAGNOSES EXC MULT SCLEROSIS,,,68.35,71.77,14
EAPG,0523,MULTIPLE SCLEROSIS AND OTHER DEMYELINATING DISEASES,,,61.54,64.62,14
EAPG,0524,OTHER CENTRAL NERVOUS SYSTEM DIAGNOSES,,,82.91,87.06,14
EAPG,0526,TRANSIENT ISCHEMIA,,,135.53,142.31,14
EAPG,0527,"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DIAGNOSES",,,68.9,72.35,14
EAPG,0528,ANOXIC AND OTHER SEVERE BRAIN DAMAGE OR COMA,,,94.58,99.31,14
EAPG,0529,SEIZURE,,,103.06,108.21,14
EAPG,0530,HEADACHES OTHER THAN MIGRAINE,,,87.99,92.39,14
EAPG,0531,MIGRAINE,,,64.29,67.5,14
EAPG,0532,HEAD TRAUMA WITH OR WITHOUT LOC/COMA LESS THAN 1 HR,,,113.84,119.53,14
EAPG,0533,AFTEREFFECTS OF CEREBROVASCULAR ACCIDENT,,,79.97,83.97,14
EAPG,0534,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION W/O INFARC,,,63.34,66.51,14
EAPG,0535,CVA AND PRECEREBRAL OCCLUSION W INFARCT,,,124.54,130.77,14
EAPG,0536,CEREBRAL PALSY,,,79.13,83.09,14
EAPG,0537,"MALFUNCTION, REACTION, COMPLICATION OF NEUROLOGICAL DEVICE OR PROC",,,91.61,96.19,14
EAPG,0538,HEAD TRAUMA WITH LOC/COMA MORE THEN 1 HR,,,260.23,273.24,14
EAPG,0539,INTRACRANIAL HEMORRHAGE,,,143.69,150.87,14
EAPG,0545,"PERIPHERAL, CRANIAL, AND AUTONOMIC NERVE INJURIES",,,81.29,85.35,14
EAPG,0548,PERIPHERAL AND OTHER VASCULAR RELATED INJURIES,,,111.45,117.02,14
EAPG,0550,ACUTE MAJOR EYE INFECTIONS,,,71.67,75.25,14
EAPG,0551,CATARACTS,,,56.59,59.42,14
EAPG,0552,GLAUCOMA,,,69.18,72.64,14
EAPG,0553,OTHER OPHTHALMIC SYSTEM DIAGNOSES,,,79.44,83.41,14
EAPG,0555,CONJUNCTIVITIS,,,62.23,65.34,14
EAPG,0556,OCULAR AND PERIOCULAR MALIGNANCY,,,81.7,85.79,14
EAPG,0557,OTHER EYE INFECTION DIAGNOSES,,,52.21,54.82,14
EAPG,0558,"MALFUNCTION, REACTION, OR COMPLICATION OF OCULAR DEVICE OR PROCEDURE",,,66.76,70.1,14
EAPG,0560,"EAR, NOSE, MOUTH, THROAT, CRANIAL AND FACIAL MALIGNANCIES",,,84.44,88.66,14
EAPG,0561,VERTIGO AND OTHER LABYRINTH DISORDERS,,,115.62,121.4,14
EAPG,0562,INFECTIONS OF UPPER RESPIRATORY TRACT AND OTITIS MEDIA,,,92.83,97.47,14
EAPG,0563,DENTAL AND ORAL DIAGNOSES AND INJURIES,,,69.7,73.19,14
EAPG,0564,"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIOFACIAL DIAGNOSES",,,80.16,84.17,14
EAPG,0566,"MALFUNCTION, REACTION, OR COMPLICATION OF OTOLARYNGOLOGIC DEVICE OR PROCEDURE",,,76.8,80.64,14
EAPG,0570,CYSTIC FIBROSIS - PULMONARY DISEASE,,,149.33,156.8,14
EAPG,0571,RESPIRATORY MALIGNANCY,,,77.77,81.66,14
EAPG,0572,BRONCHIOLITIS AND RSV PNEUMONIA,,,199.65,209.63,14
EAPG,0574,CHRONIC OBSTRUCTIVE PULMONARY DISEASE,,,134.56,141.29,14
EAPG,0575,ASTHMA,,,108.93,114.38,14
EAPG,0576,OTHER RESPIRATORY SYSTEM DIAGNOSES,,,101.12,106.18,14
EAPG,0579,STATUS ASTHMATICUS,,,176.08,184.88,14
EAPG,0580,MAJOR CHEST AND RESPIRATORY TRAUMA,,,210.81,221.35,14
EAPG,0581,PULMONARY INFECTION DIAGNOSES INCLUDING PNEUMONIA,,,164.5,172.73,14
EAPG,0582,INTERSTITIAL AND ALVEOLAR LUNG DIAGNOSES,,,103.35,108.52,14
EAPG,0583,"MALFUNCTION, REACTION, OR COMPLICATION OF PULMONARY DEVICE OR PROCEDURE",,,162.03,170.13,14
EAPG,0584,ACUTE BRONCHITIS,,,133.42,140.09,14
EAPG,0585,"AFTERCARE, OPEN WOUNDS AND OTHER TRAUMATIC INJURIES",,,61.12,64.18,14
EAPG,0586,PULMONARY EMBOLISM,,,104.53,109.76,14
EAPG,0587,RESPIRATORY FAILURE,,,246.7,259.04,14
EAPG,0589,"MALFUNCTION, REACTION, OR COMPLICATION OF CARDIOVASCULAR DEVICE OR PROC",,,128.99,135.44,14
EAPG,0591,ACUTE MYOCARDIAL INFARCTION,,,250.02,262.52,14
EAPG,0592,OTHER CARDIOVASCULAR SYSTEM DIAGNOSES,,,98.69,103.62,14
EAPG,0594,HEART FAILURE,,,104.69,109.92,14
EAPG,0595,CARDIAC ARREST OR OTHER CAUSES OF MORTALITY,,,94.25,98.96,14
EAPG,0596,PERIPHERAL AND OTHER VASCULAR DIAGNOSES,,,76.3,80.12,14
EAPG,0597,PHLEBITIS,,,134.14,140.85,14
EAPG,0598,ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,,,69.07,72.52,14
EAPG,0599,HYPERTENSION,,,72.18,75.79,14
EAPG,0600,CARDIAC STRUCTURAL AND VALVULAR DIAGNOSES,,,65.82,69.11,14
EAPG,0601,CARDIAC ARRHYTHMIA AND CONDUCTION DIAGNOSES,,,101.85,106.94,14
EAPG,0602,ATRIAL FIBRILLATION,,,79.09,83.04,14
EAPG,0604,CHEST PAIN,,,215.12,225.88,14
EAPG,0605,SYNCOPE AND COLLAPSE,,,163.95,172.15,14
EAPG,0607,CARDIOMYOPATHY DIAGNOSES,,,64.28,67.49,14
EAPG,0608,ACUTE AND SUBACUTE ENDOCARDITIS,,,73.12,76.78,14
EAPG,0610,CONTUSIONS TO EXTERNAL ORGANS OTHER THAN HEAD TRAUMA,,,132.74,139.38,14
EAPG,0616,DIVERTICULITIS AND DIVERTICULOSIS,,,110.12,115.63,14
EAPG,0617,GASTROINTESTINAL HEMORRHAGE AND RELATED POSTPROCEDURAL HEMORRHAGE DIAGNOSES,,,164.07,172.27,14
EAPG,0618,INTESTINAL OBSTRUCTION DIAGNOSES,,,160.65,168.68,14
EAPG,0619,GASTROINTESTINAL AND PERITONEAL INFECTION DIAGNOSES,,,128.2,134.61,14
EAPG,0620,DIGESTIVE MALIGNANCY,,,92.45,97.07,14
EAPG,0621,PEPTIC ULCER AND GASTRITIS,,,158.78,166.72,14
EAPG,0623,ESOPHAGITIS AND OTHER ESOPHAGEAL DIAGNOSES,,,85.03,89.28,14
EAPG,0624,OTHER GASTROINTESTINAL SYSTEM DIAGNOSES,,,96.87,101.71,14
EAPG,0626,INFLAMMATORY BOWEL DISEASE,,,68.82,72.26,14
EAPG,0627,"NON-BACTERIAL GASTROENTERITIS, NAUSEA AND VOMITING",,,110.23,115.74,14
EAPG,0628,ABDOMINAL PAIN,,,126.24,132.55,14
EAPG,0629,"MALFUNCTION, REACTION AND COMPLICATION OF GI DEVICE OR PROCEDURE",,,175.08,183.83,14
EAPG,0630,CONSTIPATION,,,101.91,107.01,14
EAPG,0631,HERNIA,,,79.37,83.34,14
EAPG,0632,IRRITABLE BOWEL SYNDROME,,,58.94,61.89,14
EAPG,0633,ALCOHOLIC LIVER DISEASE,,,94.87,99.61,14
EAPG,0634,MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,,,109.2,114.66,14
EAPG,0635,PANCREAS DIAGNOSES EXCEPT MALIGNANCY,,,115.09,120.84,14
EAPG,0636,HEPATITIS WITHOUT COMA,,,88.74,93.18,14
EAPG,0637,GALLBLADDER AND BILIARY TRACT DIAGNOSES,,,110.74,116.28,14
EAPG,0638,CHOLECYSTITIS,,,152.86,160.5,14
EAPG,0639,OTHER HEPATOBILIARY SYSTEM DIAGNOSES,,,96.18,100.99,14
EAPG,0641,HEPATIC COMA AND MAJOR ACUTE LIVER DIAGNOSES,,,87.04,91.39,14
EAPG,0642,GASTROINTESTINAL VASCULAR INSUFFICIENCY,,,112.7,118.34,14
EAPG,0647,"FRACTURES, DISLOCATIONS, OTHER INJURIES - UPPER EXTREMITY INCLUDING SHOULDER",,,146.16,153.47,14
EAPG,0648,"FRACTURES, DISLOCATIONS AND SPRAINS OF THE SKULL, CRANIUM AND FACE",,,168.82,177.26,14
EAPG,0649,OTHER PATHOLOGICAL FRACTURES W/O MUSCULOSKELETAL MALIGNANCY,,,146.14,153.45,14
EAPG,0650,"FRACTURES, DISLOCATIONS, OTHER INJURIES - LOWER EXTREMITY INCLUDING FEMUR",,,145.72,153.01,14
EAPG,0651,"FRACTURES, DISLOCATIONS, SPRAINS AND OTHER INJURIES OF THE PELVIS AND HIP",,,184.58,193.81,14
EAPG,0652,OTHER INJURIES AND DISORDERS OF THE MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE,,,73.87,77.56,14
EAPG,0653,MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FX DUE TO MALIGNANCY,,,97.94,102.84,14
EAPG,0654,"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",,,80.07,84.07,14
EAPG,0655,CONNECTIVE TISSUE DIAGNOSES,,,65.92,69.22,14
EAPG,0656,"FRACTURES, DISLOCATIONS, OTHER INJURIES OF THE NECK, UPPER BACK AND CHEST",,,164.2,172.41,14
EAPG,0657,"FRACTURES, DISLOCATIONS, SPRAINS AND OTHER INJURIES OF THE LOWER BACK",,,92.14,96.75,14
EAPG,0658,SCIATICA AND LOW BACK PAIN,,,83.14,87.3,14
EAPG,0659,"MALFUNCTION, REACTION, COMPLIC OF ORTHOPEDIC DEVICE OR PROCEDURE",,,102.53,107.66,14
EAPG,0660,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,,,88.98,93.43,14
EAPG,0662,OSTEOPOROSIS,,,67.77,71.16,14
EAPG,0663,PAIN RELATED DIAGNOSES,,,71.76,75.35,14
EAPG,0670,NON-PRESSURE CHRONIC SKIN ULCERS,,,67.52,70.9,14
EAPG,0671,MAJOR SKIN DIAGNOSES,,,64.06,67.26,14
EAPG,0672,MALIGNANT BREAST DIAGNOSES,,,70.37,73.89,14
EAPG,0673,CELLULITIS AND OTHER BACTERIAL SKIN INFECTIONS,,,103.26,108.42,14
EAPG,0674,"OPEN WOUNDS, PUNCTURES AND OTHER OPEN TRAUMATIC INJURIES",,,88.7,93.14,14
EAPG,0675,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DIAGNOSES",,,56.78,59.62,14
EAPG,0676,PRESSURE ULCERS,,,70.08,73.58,14
EAPG,0690,"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DIAGNOSES",,,87.71,92.1,14
EAPG,0691,INBORN ERRORS OF METABOLISM,,,61.72,64.81,14
EAPG,0692,OTHER ENDOCRINE SYSTEM DIAGNOSES,,,73.9,77.6,14
EAPG,0694,ELECTROLYTE DISORDERS,,,130.9,137.45,14
EAPG,0695,OBESITY,,,56.11,58.92,14
EAPG,0696,THYROID AND PARATHYROID DIAGNOSES,,,67.67,71.05,14
EAPG,0710,DIABETES WITH OPHTHALMIC MANIFESTATIONS,,,94.83,99.57,14
EAPG,0711,DIABETES WITH OTHER MANIFESTATIONS AND COMPLICATIONS,,,84.0,88.2,14
EAPG,0712,DIABETES WITH NEUROLOGIC MANIFESTATIONS,,,65.73,69.02,14
EAPG,0713,DIABETES WITHOUT COMPLICATIONS,,,61.13,64.19,14
EAPG,0714,DIABETES WITH RENAL MANIFESTATIONS,,,67.8,71.19,14
EAPG,0715,DIABETES WITH VASCULAR COMPLICATIONS INCLUDING FOOT AND OTHER SKIN ULCERS,,,68.13,71.54,14
EAPG,0720,CHRONIC KIDNEY DISEASE,,,74.4,78.12,14
EAPG,0721,KIDNEY AND URINARY TRACT MALIGNANCY,,,70.95,74.5,14
EAPG,0722,NEPHRITIS AND NEPHROSIS,,,82.6,86.73,14
EAPG,0723,COMPLEX KIDNEY AND URINARY TRACT INFECTIONS,,,134.09,140.79,14
EAPG,0724,URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,,,80.25,84.26,14
EAPG,0725,"MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PROC",,,132.17,138.78,14
EAPG,0726,"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",,,84.0,88.2,14
EAPG,0727,ACUTE LOWER URINARY TRACT INFECTIONS,,,125.98,132.28,14
EAPG,0729,ACUTE KIDNEY INJURY,,,178.44,187.36,14
EAPG,0740,MALE REPRODUCTIVE SYSTEM MALIGNANCY,,,73.95,77.65,14
EAPG,0741,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES,,,80.97,85.02,14
EAPG,0743,PROSTATITIS,,,71.18,74.74,14
EAPG,0744,MALE REPRODUCTIVE SYSTEM INFECTIONS,,,74.15,77.86,14
EAPG,0750,FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,,,80.56,84.59,14
EAPG,0751,FEMALE REPRODUCTIVE SYSTEM INFECTIONS,,,92.78,97.42,14
EAPG,0752,OTHER FEMALE REPRODUCTIVE SYSTEM AND MENSTRUAL DIAGNOSES,,,71.62,75.2,14
EAPG,0760,LABOR AND DELIVERY RELATED DIAGNOSES,,,127.1,133.46,14
EAPG,0761,POSTPARTUM AND POST ABORTION DIAGNOSES,,,115.49,121.26,14
EAPG,0762,PRETERM LABOR DIAGNOSES,,,203.47,213.64,14
EAPG,0763,ABORTION RELATED DIAGNOSES,,,186.69,196.02,14
EAPG,0764,FALSE LABOR,,,112.87,118.51,14
EAPG,0765,OTHER ANTEPARTUM COMPLICATION DIAGNOSES,,,139.88,146.87,14
EAPG,0766,ROUTINE PRENATAL CARE,,,87.42,91.79,14
EAPG,0767,COMPLICATIONS OF TREATMENT AFFECTING PREGNANCY,,,212.5,223.13,14
EAPG,0768,ANTEPARTUM ENCOUNTERS FOR NON-ROUTINE AND ABNORMAL FINDINGS,,,129.23,135.69,14
EAPG,0770,NORMAL NEONATE,,,73.24,76.9,14
EAPG,0771,NEONATAL DIAGNOSES,,,124.63,130.86,14
EAPG,0777,SUPERFICIAL INJURY TO SKIN AND SUBCUTANEOUS TISSUE,,,102.45,107.57,14
EAPG,0780,OTHER HEMATOLOGICAL DIAGNOSES,,,103.26,108.42,14
EAPG,0781,COAGULATION AND PLATELET DISORDERS AND CONGENITAL FACTOR DEFICIENCIES,,,75.43,79.2,14
EAPG,0783,SICKLE CELL ANEMIA CRISIS,,,157.87,165.76,14
EAPG,0785,"ANEMIA, BLOOD AND BLOOD-FORMING ORGAN DISORDERS",,,93.02,97.67,14
EAPG,0787,"AFTERCARE, BURNS, CORROSIONS, OTHER INJURIES RELATED TO THE SKIN AND SUB TIS",,,64.11,67.32,14
EAPG,0800,ACUTE LEUKEMIA,,,139.6,146.58,14
EAPG,0801,"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",,,100.44,105.46,14
EAPG,0802,RADIOTHERAPY,,,74.28,77.99,14
EAPG,0803,CHEMOTHERAPY,,,111.8,117.39,14
EAPG,0804,LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,,,89.92,94.42,14
EAPG,0805,SEPTICEMIA AND DISSEMINATED INFECTIONS,,,358.63,376.56,14
EAPG,0806,"INTRAOPERATIVE, POST-OPERATIVE OR POST-TRAUMATIC INFECTIONS AND COMPLICATIONS",,,112.87,118.51,14
EAPG,0807,FEVER AND OTHER INFLAMMATORY CONDITIONS,,,180.7,189.74,14
EAPG,0808,VIRAL ILLNESS,,,159.46,167.43,14
EAPG,0809,OTHER INFECTIOUS AND PARASITIC DISEASES,,,82.01,86.11,14
EAPG,0810,H. PYLORI INFECTION,,,64.69,67.92,14
EAPG,0812,VIRAL MENINGITIS,,,130.11,136.62,14
EAPG,0820,SCHIZOPHRENIA,,,113.95,119.65,14
EAPG,0821,MAJOR DEPRESSIVE DIAGNOSES AND  OTHER OR UNSPECIFIED PSYCHOSES,,,76.8,80.64,14
EAPG,0822,PERSONALITY AND IMPULSE CONTROL DIAGNOSES,,,120.03,126.03,14
EAPG,0823,BIPOLAR DISORDERS,,,87.35,91.72,14
EAPG,0824,DEPRESSION EXCEPT MAJOR DEPRESSIVE DIAGNOSES,,,99.12,104.08,14
EAPG,0825,ADJUSTMENT DISORDERS AND NEUROSES EXCEPT DEPRESSIVE DIAGNOSES,,,83.31,87.48,14
EAPG,0826,ACUTE ANXIETY AND DELIRIUM STATES,,,109.71,115.2,14
EAPG,0827,ORGANIC BEHAVIORAL HEALTH DISTURBANCES,,,75.62,79.4,14
EAPG,0828,INTELLECTUAL DISABILITY,,,72.02,75.62,14
EAPG,0829,CHILDHOOD BEHAVIORAL DIAGNOSES,,,77.41,81.28,14
EAPG,0830,EATING DISORDERS,,,87.23,91.59,14
EAPG,0831,OTHER BEHAVIORAL HEALTH DIAGNOSES,,,107.38,112.75,14
EAPG,0832,INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,,,268.14,281.55,14
EAPG,0840,OPIOID ABUSE AND DEPENDENCE,,,78.6,82.53,14
EAPG,0841,COCAINE ABUSE AND DEPENDENCE,,,151.43,159.0,14
EAPG,0842,ALCOHOL ABUSE AND DEPENDENCE,,,145.64,152.92,14
EAPG,0843,OTHER DRUG ABUSE AND DEPENDENCE,,,138.96,145.91,14
EAPG,0850,ALLERGIC REACTIONS,,,137.62,144.5,14
EAPG,0851,POISONING OR TOXIC EFFECTS OF MEDICINAL AGENTS,,,147.48,154.85,14
EAPG,0852,OTHER COMPLICATIONS OF TREATMENT,,,94.75,99.49,14
EAPG,0853,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",,,88.55,92.98,14
EAPG,0854,TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,,,108.05,113.45,14
EAPG,0860,EXTENSIVE 3RD DEGREE OR FULL THICKNESS BURNS,,,90.21,94.72,14
EAPG,0861,PARTIAL THICKNESS BURNS,,,90.51,95.04,14
EAPG,0867,ENCOUNTERS FOR CONTACT WITH HEALTH SERVICES,,,67.04,70.39,14
EAPG,0869,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE INJURIES",,,67.82,71.21,14
EAPG,0870,REHABILITATION,,,80.35,84.37,14
EAPG,0871,"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",,,90.23,94.74,14
EAPG,0872,OTHER AFTERCARE AND CONVALESCENCE,,,84.42,88.64,14
EAPG,0873,NEONATAL AFTERCARE,,,51.01,53.56,14
EAPG,0874,AFTERCARE FOR JOINT REPLACEMENT,,,65.03,68.28,14
EAPG,0875,CONTRACEPTIVE MANAGEMENT,,,80.72,84.76,14
EAPG,0876,ADULT PREVENTIVE MEDICINE,,,81.94,86.04,14
EAPG,0877,CHILD PREVENTIVE MEDICINE,,,69.32,72.79,14
EAPG,0878,GYNECOLOGIC PREVENTIVE MEDICINE,,,57.49,60.36,14
EAPG,0879,PREVENTIVE OR SCREENING ENCOUNTER,,,76.43,80.25,14
EAPG,0880,HIV INFECTION,,,118.87,124.81,14
EAPG,0881,AIDS,,,120.4,126.42,14
EAPG,0882,GENETIC COUNSELING,,,91.04,95.59,14
EAPG,0883,ALTERATION IN CONSCIOUSNESS,,,209.1,219.56,14
EAPG,0900,AUTOPSY AND POST-MORTEM EXAMINATION SERVICES,,,79.88,83.87,14
EAPG,2016,LEVEL II ALLERGY TESTS,,,19.76,20.75,14
EAPG,2020,NONINVASIVE VENTILATION SUPPORT,,,73.62,77.3,14
EAPG,2030,MINOR MUSCULOSKELETAL PROCEDURES,,,90.45,94.97,14
EAPG,2040,LEVEL I DRUG SCREENING AND DEFINITIVE TESTS,,,5.92,6.22,14
EAPG,2041,LEVEL II DRUG SCREENING AND DEFINITIVE TESTS,,,29.68,31.16,14
EAPG,2042,LEVEL III DRUG SCREENING AND DEFINITIVE TESTS,,,68.68,72.11,14
EAPG,2043,LEVEL III BLOOD AND TISSUE TYPING TESTS,,,70.04,73.54,14
EAPG,2044,"LEVEL IV COMPLEX LABORATORY, MOLECULAR PATHOLOGY AND GENETIC TESTS",,,278.93,292.88,14
EAPG,2045,ADVANCED MOLECULAR PATHOLOGY AND GENETIC TESTS,,,1002.07,1052.17,14
EAPG,2061,CLASS I BLOOD PRODUCTS,,,70.55,74.08,14
EAPG,2062,CLASS II BLOOD PRODUCTS,,,158.18,166.09,14
EAPG,2070,MONTHLY CARE AND CASE MANAGEMENT SERVICES,,,30.12,31.63,14
EAPG,2071,MONTHLY BEHAVIORAL HEALTH CARE AND CASE MANAGEMENT SERVICES,,,42.29,44.4,14
EAPG,2072,MONTHLY TREATMENT MANAGEMENT SERVICES,,,21.04,22.09,14
EAPG,3011,BONE CONDUCTION HEARING DEVICE IMPLANTATION,,,4549.78,4777.27,14
EAPG,3030,SPINAL IMPLANTATION OF DRUG INFUSION DEVICE,,,6358.7,6676.64,14
EAPG,3033,"INGUINAL, FEMORAL AND UMBILICAL HERNIA REPAIR",,,1895.82,1990.61,14
EAPG,3035,ABDOMINAL HERNIA REPAIR,,,2298.68,2413.61,14
EAPG,3050,OTHER TRANSPLANT PROCEDURES,,,2657.84,2790.73,14
EAPG,3051,HEART AND/OR LUNG TRANSPLANT,,,6680.42,7014.44,14
EAPG,3052,KIDNEY TRANSPLANT,,,3970.69,4169.22,14
EAPG,3060,VENTRICULAR ASSIST DEVICE PROCEDURES,,,16332.27,17148.88,14
EAPG,3070,EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) PROCEDURES,,,4119.95,4325.95,14
EAPG,4010,LEVEL I OPIOID TREATMENT PROGRAM SERVICES,,,107.26,112.62,14
EAPG,4011,LEVEL II OPIOID TREATMENT PROGRAM SERVICES,,,197.99,207.89,14
HCPCS,A0396,TUBE SALIVARY BYPASS RADI 10MM,1026.0,564.3,307.8,887.49,38
HCPCS,A2001,"Innovamatrix ac, per sq cm",,,945.66,1167.48,6
HCPCS,A2002,Mirragen adv wnd mat per sq,,,149.41,184.46,6
HCPCS,A2004,"Xcellistem, 1 mg",,,13.4,16.54,6
HCPCS,A2005,"Microlyte matrix, per sq cm",,,218.57,269.84,6
HCPCS,A2006,MATRIX NOVASORB MTX 20X40CM,33000.0,18150.0,9900.0,29040.0,35
HCPCS,A2007,"Restrata, per sq cm",,,69.15,85.37,6
HCPCS,A2008,"Theragenesis, per sq cm",,,77.21,95.32,6
HCPCS,A2009,"Symphony, per sq cm",,,107.47,132.68,6
HCPCS,A2013,"Innovamatrix fs, per sq cm",,,1054.81,1302.23,6
HCPCS,A2014,Omeza collag per 100 mg,,,61.18,75.53,6
HCPCS,A2015,"Phoenix wnd mtrx, per sq cm",,,1235.23,1524.98,6
HCPCS,A2019,Kerecis marigen shld sq cm,,,586.67,724.28,6
HCPCS,A2021,Neomatrix per sq cm,,,1151.46,1421.56,6
HCPCS,A2022,Innovabrn/innovamatx xl sqcm,,,1110.91,1371.49,6
HCPCS,A2023,"Innovamatrix pd, 1 mg",,,12.77,15.77,6
HCPCS,A2024,Resolve or xenopatch sq cm,,,1666.37,2057.24,6
HCPCS,A2025,Miro3d per cubic cm,,,213.56,263.66,6
HCPCS,A4215,KIT NDL BIOP PASSIVE 2.2MM,3816.0,2098.8,1144.8,3300.84,38
HCPCS,A4215,NDL ENDO US ULTRA 25G 5.2F,1062.0,584.1,318.6,918.63,38
HCPCS,A4215,NDL PNEUMO 120MM,292.27,160.75,87.68,252.81,38
HCPCS,A4215,NDL SHARKCORE SS STL 22GA,1107.0,608.85,332.1,957.56,38
HCPCS,A4215,TY LUMBAR PUNCT 22GX3.5IN NDL,239.43,131.69,71.83,207.11,38
HCPCS,A4216,"Sterile water/saline, 10 ml",,,0.62,0.64,15
HCPCS,A4217,"Sterile water/saline, 500 ml",,,4.38,4.51,15
HCPCS,A4221,Supp non-insulin inf cath/wk,,,25.19,25.95,15
HCPCS,A4222,Infusion supplies with pump,,,47.78,49.21,15
HCPCS,A4224,Supply insulin inf cath/wk,,,25.19,25.95,15
HCPCS,A4225,Sup/ext insulin inf pump syr,,,3.38,3.48,15
HCPCS,A4239,Non-adju cgm supply allow,,,267.92,275.96,15
HCPCS,A4255,Glucose monitor platforms,,,5.74,5.91,15
HCPCS,A4256,Calibrator solution/chips,,,3.38,3.48,15
HCPCS,A4257,Replace Lensshield Cartridge,,,17.83,18.36,15
HCPCS,A4258,Lancet device each,,,2.12,2.18,15
HCPCS,A4259,Lancets per box,,,1.42,1.46,15
HCPCS,A4264,HC PERM IMPLANT CONTRACEPTIVE INTRATUBAL OCCL DEV,4711.5,2591.33,1413.45,4146.12,35
HCPCS,A4265,Paraffin,,,4.76,4.9,15
HCPCS,A4271,Home lancing/test cartridges,,,33.43,34.43,15
HCPCS,A4280,Brst prsths adhsv attchmnt,,,7.44,7.66,15
HCPCS,A4310,Insert tray w/o bag/cath,,,10.79,11.11,15
HCPCS,A4311,Catheter w/o bag 2-way latex,,,20.7,21.32,15
HCPCS,A4312,Cath w/o bag 2-way silicone,,,25.2,25.96,15
HCPCS,A4313,Catheter w/bag 3-way,,,25.88,26.66,15
HCPCS,A4314,Cath w/drainage 2-way latex,,,35.32,36.38,15
HCPCS,A4315,Cath w/drainage 2-way silcne,,,36.85,37.96,15
HCPCS,A4316,Cath w/drainage 3-way,,,39.68,40.87,15
HCPCS,A4320,Irrigation tray,,,7.46,7.68,15
HCPCS,A4322,Irrigation syringe,,,4.26,4.39,15
HCPCS,A4326,Male external catheter,,,13.08,13.47,15
HCPCS,A4327,Fem urinary collect dev cup,,,62.01,63.87,15
HCPCS,A4328,Fem urinary collect pouch,,,14.58,15.02,15
HCPCS,A4330,Stool collection pouch,,,9.89,10.19,15
HCPCS,A4331,Extension drainage tubing,,,4.44,4.57,15
HCPCS,A4332,Lube sterile packet,,,0.15,0.15,15
HCPCS,A4333,Urinary cath anchor device,,,3.1,3.19,15
HCPCS,A4334,Urinary cath leg strap,,,6.87,7.08,15
HCPCS,A4336,Urethral insert,,,2.01,2.07,15
HCPCS,A4338,Indwelling catheter latex,,,17.14,17.65,15
HCPCS,A4340,Indwelling catheter special,,,44.36,45.69,15
HCPCS,A4341,Iduc valve pat inst repl,,,340.93,351.16,15
HCPCS,A4342,Iduc valve sply repl,,,860.84,886.67,15
HCPCS,A4344,Cath indw foley 2 way silicn,,,22.36,23.03,15
HCPCS,A4346,Cath indw foley 3 way,,,27.17,27.99,15
HCPCS,A4349,Disposable male external cat,,,2.81,2.89,15
HCPCS,A4351,Straight tip urine catheter,,,2.53,2.61,15
HCPCS,A4352,Coude tip urinary catheter,,,7.62,7.85,15
HCPCS,A4353,Intermittent urinary cath,,,9.79,10.08,15
HCPCS,A4354,Cath insertion tray w/bag,,,16.26,16.75,15
HCPCS,A4355,Bladder irrigation tubing,,,12.46,12.83,15
HCPCS,A4356,Ext ureth clmp or compr dvc,,,63.75,65.66,15
HCPCS,A4357,Bedside drainage bag,,,13.57,13.98,15
HCPCS,A4358,Urinary leg or abdomen bag,,,9.27,9.55,15
HCPCS,A4360,Disposable ext urethral dev,,,0.69,0.71,15
HCPCS,A4361,Ostomy face plate,,,25.65,26.42,15
HCPCS,A4362,Solid skin barrier,,,4.12,4.24,15
HCPCS,A4363,"Ostomy clamp, replacement",,,3.16,3.25,15
HCPCS,A4364,SYS SKIN CLOSURE DERMABOND 22,455.97,250.79,3.49,394.41,53
HCPCS,A4366,Ostomy vent,,,1.8,1.85,15
HCPCS,A4367,Ostomy belt,,,10.28,10.59,15
HCPCS,A4368,Ostomy filter,,,0.35,0.36,15
HCPCS,A4369,Skin barrier liquid per oz,,,3.39,3.49,15
HCPCS,A4371,Skin barrier powder per oz,,,5.1,5.25,15
HCPCS,A4372,Skin barrier solid 4x4 equiv,,,5.87,6.05,15
HCPCS,A4373,Skin barrier with flange,,,8.76,9.02,15
HCPCS,A4375,Drainable plastic pch w fcpl,,,23.99,24.71,15
HCPCS,A4376,Drainable rubber pch w fcplt,,,66.48,68.47,15
HCPCS,A4377,Drainable plstic pch w/o fp,,,5.99,6.17,15
HCPCS,A4378,Drainable rubber pch w/o fp,,,42.96,44.25,15
HCPCS,A4379,Urinary plastic pouch w fcpl,,,20.98,21.61,15
HCPCS,A4380,Urinary rubber pouch w fcplt,,,52.16,53.72,15
HCPCS,A4381,Urinary plastic pouch w/o fp,,,6.46,6.65,15
HCPCS,A4382,Urinary hvy plstc pch w/o fp,,,34.4,35.43,15
HCPCS,A4383,Urinary rubber pouch w/o fp,,,39.38,40.56,15
HCPCS,A4384,Ostomy faceplt/silicone ring,,,13.42,13.82,15
HCPCS,A4385,Ost skn barrier sld ext wear,,,7.12,7.33,15
HCPCS,A4387,Ost clsd pouch w att st barr,,,3.14,3.23,15
HCPCS,A4388,Drainable pch w ex wear barr,,,6.09,6.27,15
HCPCS,A4389,Drainable pch w st wear barr,,,8.67,8.93,15
HCPCS,A4390,Drainable pch ex wear convex,,,13.41,13.81,15
HCPCS,A4391,Urinary pouch w ex wear barr,,,9.87,10.17,15
HCPCS,A4392,Urinary pouch w st wear barr,,,11.42,11.76,15
HCPCS,A4393,Urine pch w ex wear bar conv,,,12.63,13.01,15
HCPCS,A4394,Ostomy pouch liq deodorant,,,3.62,3.73,15
HCPCS,A4395,Ostomy pouch solid deodorant,,,0.05,0.05,15
HCPCS,A4396,Peristomal hernia supprt blt,,,56.56,58.26,15
HCPCS,A4398,Ostomy irrigation bag,,,19.31,19.89,15
HCPCS,A4399,Ostomy irrig cone/cath w brs,,,17.14,17.65,15
HCPCS,A4400,Ostomy irrigation set,,,68.28,70.33,15
HCPCS,A4402,Lubricant per ounce,,,2.23,2.3,15
HCPCS,A4404,Ostomy ring each,,,2.34,2.41,15
HCPCS,A4405,Nonpectin based ostomy paste,,,4.77,4.91,15
HCPCS,A4406,Pectin based ostomy paste,,,8.0,8.24,15
HCPCS,A4407,"Ext wear ost skn barr <=4sq""",,,12.24,12.61,15
HCPCS,A4408,"Ext wear ost skn barr >4sq""",,,13.79,14.2,15
HCPCS,A4409,Ost skn barr convex <=4 sq i,,,8.67,8.93,15
HCPCS,A4410,Ost skn barr extnd >4 sq,,,12.63,13.01,15
HCPCS,A4411,Ost skn barr extnd =4sq,,,7.12,7.33,15
HCPCS,A4412,Ost pouch drain high output,,,3.78,3.89,15
HCPCS,A4413,2 pc drainable ost pouch,,,7.7,7.93,15
HCPCS,A4414,Ost sknbar w/o conv<=4 sq in,,,6.87,7.08,15
HCPCS,A4415,Ost skn barr w/o conv >4 sqi,,,8.38,8.63,15
HCPCS,A4416,Ost pch clsd w barrier/filtr,,,3.85,3.97,15
HCPCS,A4417,Ost pch w bar/bltinconv/fltr,,,5.21,5.37,15
HCPCS,A4418,Ost pch clsd w/o bar w filtr,,,2.53,2.61,15
HCPCS,A4419,Ost pch for bar w flange/flt,,,2.41,2.48,15
HCPCS,A4422,Ost pouch absorbent material,,,0.15,0.15,15
HCPCS,A4423,Ost pch for bar w lk fl/fltr,,,2.59,2.67,15
HCPCS,A4424,Ost pch drain w bar & filter,,,6.65,6.85,15
HCPCS,A4425,Ost pch drain for barrier fl,,,5.0,5.15,15
HCPCS,A4426,Ost pch drain 2 piece system,,,3.81,3.92,15
HCPCS,A4427,Ost pch drain/barr lk flng/f,,,3.9,4.02,15
HCPCS,A4428,Urine ost pouch w faucet/tap,,,9.11,9.38,15
HCPCS,A4429,Urine ost pouch w bltinconv,,,11.53,11.88,15
HCPCS,A4430,Ost urine pch w b/bltin conv,,,11.9,12.26,15
HCPCS,A4431,Ost pch urine w barrier/tapv,,,8.67,8.93,15
HCPCS,A4432,Os pch urine w bar/fange/tap,,,5.01,5.16,15
HCPCS,A4433,Urine ost pch bar w lock fln,,,4.69,4.83,15
HCPCS,A4434,Ost pch urine w lock flng/ft,,,5.25,5.41,15
HCPCS,A4435,1pc ost pch drain hgh output,,,8.05,8.29,15
HCPCS,A4436,Irr supply sleev reus per mo,,,26.79,27.59,15
HCPCS,A4437,Irr supply sleev disp per mo,,,26.79,27.59,15
HCPCS,A4438,Adhesive clip ext ens contr,,,1.93,1.99,15
HCPCS,A4453,"Rec cath any transanal, each",,,13.76,14.17,15
HCPCS,A4455,Adhesive remover per ounce,,,1.69,1.74,15
HCPCS,A4456,"Adhesive remover, wipes",,,0.34,0.35,15
HCPCS,A4459,"Transanal irrigation, any",,,157.27,161.99,15
HCPCS,A4461,Surgicl dress hold non-reuse,,,4.61,4.75,15
HCPCS,A4463,Surgical dress holder reuse,,,18.6,19.16,15
HCPCS,A4481,Tracheostoma filter,,,0.51,0.53,15
HCPCS,A4541,Monthly supp use with e0733,,,40.26,41.47,15
HCPCS,A4542,Supp ext up limb tremor stim,,,516.52,532.02,15
HCPCS,A4544,Electro nerve stimulator rls,,,6.22,6.41,15
HCPCS,A4545,Suppl accessor tibial stim,,,37.78,38.91,15
HCPCS,A4550,KIT PERFLOURON,2005.02,1102.77,601.51,1734.34,38
HCPCS,A4550,PACK CUSTOM ANGIO DRAPE,486.45,267.55,145.94,420.78,38
HCPCS,A4550,PACK CUSTOM ANT EYE,338.45,186.15,101.54,292.76,38
HCPCS,A4550,PACK CUSTOM C SECTION FMLH,391.86,215.53,117.56,338.96,38
HCPCS,A4550,PACK CUSTOM CATH LAB FMLH,570.8,313.94,171.24,493.74,38
HCPCS,A4550,PACK CUSTOM FREEFLAP RECIPIENT,1246.41,685.53,373.92,1078.14,38
HCPCS,A4550,PACK CUSTOM MICROVASCULAR,1242.72,683.5,372.82,1074.95,38
HCPCS,A4550,PACK CUSTOM ORGAN DONATION SUP,575.0,316.25,172.5,497.38,38
HCPCS,A4550,PACK CUSTOM POSTERIOR EYE,513.65,282.51,154.1,444.31,38
HCPCS,A4550,PACK VITRECTOMY ANT 23GA,910.04,500.53,273.01,787.18,38
HCPCS,A4550,TRAY THORACENTESIS,399.63,219.8,119.89,345.68,38
HCPCS,A4556,KIT ENSITE X ELECTRODE PATCH,5590.05,3074.53,16.97,4835.39,53
HCPCS,A4557,"Lead wires, pair",,,12.86,13.25,15
HCPCS,A4558,Conductive gel or paste,,,7.62,7.85,15
HCPCS,A4559,Coupling gel or paste,,,0.13,0.13,15
HCPCS,A4561,Pessary reusable rub anytype,,,28.64,29.5,15
HCPCS,A4562,GLIDEWIRE ANGL 3CM .035X180CM,310.5,170.78,71.15,268.58,53
HCPCS,A4563,Vag inser rectal control sys,,,1647.63,1697.06,15
HCPCS,A4565,Slings,,,10.76,11.08,15
HCPCS,A4595,TENS suppl 2 lead per month,,,12.39,12.76,15
HCPCS,A4596,Ces system monthly supp,,,40.26,41.47,15
HCPCS,A4608,Transtracheal oxygen cath,,,70.04,72.14,15
HCPCS,A4614,Hand-held PEFR meter,,,33.23,34.23,15
HCPCS,A4615,Cannula nasal,,,1.02,1.05,15
HCPCS,A4616,Tubing (oxygen) per foot,,,0.08,0.08,15
HCPCS,A4617,Mouth piece,,,4.33,4.46,15
HCPCS,A4620,Variable concentration mask,,,0.89,0.92,15
HCPCS,A4623,Tracheostomy inner cannula,,,9.16,9.43,15
HCPCS,A4625,Trach care kit for new trach,,,9.68,9.97,15
HCPCS,A4626,Tracheostomy cleaning brush,,,3.78,3.89,15
HCPCS,A4629,Tracheostomy care kit,,,6.5,6.7,15
HCPCS,A4648,"HC TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",2969.0,1632.95,890.7,2612.72,70
HCPCS,A4648,HC US BX MARKER,575.0,316.25,172.5,506.0,70
HCPCS,A4649,2.0 VOLT(TM) DB AO QC 115MM/30MM CALIB,629.28,346.11,188.78,544.33,38
HCPCS,A4649,2.0 VOLT(TM) DB AO QC 145MM/60MM CALIB,629.28,346.11,188.78,544.33,38
HCPCS,A4649,APPL CLIP ENDO ETHIC LG,386.0,212.3,115.8,333.89,38
HCPCS,A4649,APPL CLIP ENDO ROTAT MED/LG,386.0,212.3,115.8,333.89,38
HCPCS,A4649,APPL LIGACLIP MULT SM 20,240.81,132.45,72.24,208.3,38
HCPCS,A4649,APPL LIGACLIP STR MED 20,240.81,132.45,72.24,208.3,38
HCPCS,A4649,BALLOON COLPOTOMIZER KOH OCCLU,482.14,265.18,144.64,417.05,38
HCPCS,A4649,BAND LIGATOR UNIV 6 8.6-11.3MM,900.0,495.0,270.0,778.5,38
HCPCS,A4649,BIT DRILL 1.4X87X27MM 90,350.75,192.92,105.23,303.4,38
HCPCS,A4649,BIT DRILL AO SM 4.2X180MM,575.0,316.25,172.5,497.38,38
HCPCS,A4649,BIT DRILL AO STL 3.5X130MM,575.0,316.25,172.5,497.38,38
HCPCS,A4649,BIT DRILL AO STL 4.2X340MM,575.0,316.25,172.5,497.38,38
HCPCS,A4649,BIT DRILL AO STL 4X180MM,575.0,316.25,172.5,497.38,38
HCPCS,A4649,BIT DRILL AO STL SM 4.2X300MM,575.0,316.25,172.5,497.38,38
HCPCS,A4649,BLADE BONE MILL MED 5MM,1173.47,645.41,352.04,1015.05,38
HCPCS,A4649,BLADE DERMAT ZIMMER,230.92,127.01,69.28,199.75,38
HCPCS,A4649,BLADE PATELLA W/PILOT SZ 41MM,575.0,316.25,172.5,497.38,38
HCPCS,A4649,BLADE RECIP SHT TAPER 27MM,390.83,214.96,117.25,338.07,38
HCPCS,A4649,BLADE TREPHINE LACRIMAL SISLER,441.26,242.7,132.38,381.69,38
HCPCS,A4649,BRUSH BIOP URET 3.5X115CM,492.09,270.65,147.63,425.66,38
HCPCS,A4649,BUR FLUT TPS RND ELITE 3MM,534.46,293.96,160.34,462.31,38
HCPCS,A4649,BUR LEGEND 14CM 3MM,540.5,297.28,162.15,467.53,38
HCPCS,A4649,BUR LEGEND 9CM 3MM MH,540.5,297.28,162.15,467.53,38
HCPCS,A4649,BUR TPS DIAMOND ELITE 3MM,570.86,313.98,171.26,493.79,38
HCPCS,A4649,BUR TPS DIAMOND ELITE 4MM,534.46,293.96,160.34,462.31,38
HCPCS,A4649,BUR TPS MATCHSTICK 3MM,575.0,316.25,172.5,497.38,38
HCPCS,A4649,CANN ART BLUNT 18FR 12IN,301.59,165.88,90.48,260.88,38
HCPCS,A4649,CANN ART BLUNT 24FR 12IN,301.59,165.88,90.48,260.88,38
HCPCS,A4649,CANN CORN ART PERF STR 6MM,569.25,313.09,170.78,492.4,38
HCPCS,A4649,CANN DLP SILIC RCSP 13FR,533.89,293.64,160.17,461.81,38
HCPCS,A4649,CANN DLP SILIC RCSP 15FR,533.89,293.64,160.17,461.81,38
HCPCS,A4649,CANN HYDRATOME RX44 20MM 260CM,1808.37,994.61,542.51,1564.24,38
HCPCS,A4649,CANN HYDRATOME RX49 20MM 260CM,1808.37,994.61,542.51,1564.24,38
HCPCS,A4649,CANN SILIC W/CUFF 15FR,501.52,275.84,150.46,433.81,38
HCPCS,A4649,CANN VEN 31FR,231.78,127.48,69.53,200.49,38
HCPCS,A4649,CANN VEN DUAL 32/40FR,316.25,173.94,94.88,273.56,38
HCPCS,A4649,CANN VEN SGL STAGE 22FR,231.78,127.48,69.53,200.49,38
HCPCS,A4649,CANN VEN SGL STAGE 24FR,231.78,127.48,69.53,200.49,38
HCPCS,A4649,CANN VEN SGL STAGE RT ANG 28FR,231.78,127.48,69.53,200.49,38
HCPCS,A4649,CAPSULE PILLCAM SB3-EX 12HR,2214.9,1218.2,664.47,1915.89,38
HCPCS,A4649,CATH CHOLANGIOGRAM 5.5FR,460.35,253.2,138.11,398.2,38
HCPCS,A4649,CATH IAB 7.5FR 40ML 6IN,4500.0,2475.0,1350.0,3892.5,38
HCPCS,A4649,CATH IAB 7FR 34ML 6IN,4322.3,2377.27,1296.69,3738.79,38
HCPCS,A4649,CATH IAB 8FR 50ML 6IN,4500.0,2475.0,1350.0,3892.5,38
HCPCS,A4649,CATH PASSER DUAL END,506.0,278.3,151.8,437.69,38
HCPCS,A4649,CLIP ANEU L 90DEG ANGL 7.5MM,2165.31,1190.93,649.59,1872.99,38
HCPCS,A4649,CLIP ANEU L FEN 90DEG 5/5MM,2165.31,1190.93,649.59,1872.99,38
HCPCS,A4649,CLIP ANEU L MINI PERM 60DEG 3,2165.31,1190.93,649.59,1872.99,38
HCPCS,A4649,CLIP ANEU L MINI PERM 60DEG 4,2165.31,1190.93,649.59,1872.99,38
HCPCS,A4649,CLIP ANEU L MINI PERM CRVD 3MM,2165.31,1190.93,649.59,1872.99,38
HCPCS,A4649,CLIP ANEU L MINI PERM CRVD 4MM,2165.31,1190.93,649.59,1872.99,38
HCPCS,A4649,CLIP ANEU L MINI PERM NARW 3MM,2165.31,1190.93,649.59,1872.99,38
HCPCS,A4649,CLIP ANEU L MINI PERM NARW 5MM,2165.31,1190.93,649.59,1872.99,38
HCPCS,A4649,CLIP ANEU L MINI PERM S/CRVD 4,2165.31,1190.93,649.59,1872.99,38
HCPCS,A4649,CLIP ANEU L MINI TEMP CRVD 4MM,2165.31,1190.93,649.59,1872.99,38
HCPCS,A4649,CLIP ANEU L PERM 50DEG CRVD 9,2165.31,1190.93,649.59,1872.99,38
HCPCS,A4649,CLIP ANEU L PERM 90DEG 5/3MM,2165.31,1190.93,649.59,1872.99,38
HCPCS,A4649,CLIP ANEU L PERM 90DEG ANGL 10,2165.31,1190.93,649.59,1872.99,38
HCPCS,A4649,CLIP ANEU L PERM ANGL SIDE 8MM,2165.31,1190.93,649.59,1872.99,38
HCPCS,A4649,CLIP ANEU L PERM J-CURVE 7MM,2165.31,1190.93,649.59,1872.99,38
HCPCS,A4649,CLIP ANEU L PERM STRONG CRVD 9,2165.31,1190.93,649.59,1872.99,38
HCPCS,A4649,CLIP ANEU L TEMP FEN STR 5MM,2165.31,1190.93,649.59,1872.99,38
HCPCS,A4649,CLIP ENDO SET 12/6 GC,3145.5,1730.03,943.65,2720.86,38
HCPCS,A4649,CLIP HEMOLOK XL,479.26,263.6,143.78,414.56,38
HCPCS,A4649,CLIP TI LG,274.1,150.76,82.23,237.1,38
HCPCS,A4649,CUTTER LINEAR 100MM,789.75,434.37,236.93,683.13,38
HCPCS,A4649,DEVICE DUETTE MULTI BAND 5FR,1318.5,725.18,395.55,1140.5,38
HCPCS,A4649,DEVICE DUETTE MULTI BAND 7FR,1318.5,725.18,395.55,1140.5,38
HCPCS,A4649,DEVICE PURSTRING DISP,955.53,525.55,286.66,826.53,38
HCPCS,A4649,DEVICE SUT CINCH OVERSTITCH,783.0,430.65,234.9,677.3,38
HCPCS,A4649,DILAT INTRO 18FR,364.44,200.45,109.33,315.24,38
HCPCS,A4649,DILAT INTRO 20FR,364.44,200.45,109.33,315.24,38
HCPCS,A4649,DILAT INTRO 22FR,364.44,200.45,109.33,315.24,38
HCPCS,A4649,DRILL ACUTRAK2 MINI,1687.5,928.13,506.25,1459.69,38
HCPCS,A4649,DRILL SCALED 2.5MM,783.0,430.65,234.9,677.3,38
HCPCS,A4649,DRN LUMBAR W/GRAD,1076.53,592.1,322.96,931.2,38
HCPCS,A4649,FCP BIOP SUPERTRAX,575.0,316.25,172.5,497.38,38
HCPCS,A4649,FCP REVOLUTION ILM TIP 23GA,575.0,316.25,172.5,497.38,38
HCPCS,A4649,FCP REVOLUTION SERR 23GA,575.0,316.25,172.5,497.38,38
HCPCS,A4649,GRAFT SKIN CARRIER 16X14 STL,277.09,152.4,83.13,239.68,38
HCPCS,A4649,GUIDE PIN DRILL TIP 2.4MM,590.63,324.85,177.19,510.89,38
HCPCS,A4649,HLDR ENDO STITCH NDL,1817.77,999.78,545.33,1572.37,38
HCPCS,A4649,HNDPC LIGASURE CRVD SM JAW,2172.65,1194.96,651.8,1879.34,38
HCPCS,A4649,HNDPC VERSAJET 15DEG,4117.5,2264.63,1235.25,3561.64,38
HCPCS,A4649,HNDPC VERSAJET 45DEG,4117.5,2264.63,1235.25,3561.64,38
HCPCS,A4649,INFLATOR PNEU,835.65,459.61,250.7,722.84,38
HCPCS,A4649,INSERT SUT HLDR OCTOBASE RETR,279.28,153.61,83.78,241.58,38
HCPCS,A4649,INST ENDO CLOSE TROCAR SITE,429.29,236.11,128.79,371.34,38
HCPCS,A4649,INST LIGATOR POLYLOOP 2.8,546.25,300.44,163.88,472.51,38
HCPCS,A4649,INST MANIPUL UTER ZUMI 4.5MM,355.18,195.35,106.55,307.23,38
HCPCS,A4649,INST PERF DISP 7MM,1035.0,569.25,310.5,895.28,38
HCPCS,A4649,KIT ELECTRODE L165MM STANDARD BASIC FOR MENISCECTOMY ESA,272.26,149.75,81.68,235.5,38
HCPCS,A4649,KIT LASER SHEATH 16FR,12450.0,6847.5,3735.0,10769.25,38
HCPCS,A4649,KIT SCULP CEMENT,327.69,180.23,98.31,283.45,38
HCPCS,A4649,KIT VASOVIEW HEMOPRO VESSEL,5530.12,3041.57,1659.04,4783.55,38
HCPCS,A4649,KNIFE HYBRID I JET 2.3MMX1.9M,2553.3,1404.32,765.99,2208.6,38
HCPCS,A4649,KNIFE HYBRID T JET 2.3MMX1.9M,2553.3,1404.32,765.99,2208.6,38
HCPCS,A4649,KNIFE NDLKNIFE RX,773.78,425.58,232.13,669.32,38
HCPCS,A4649,MICRO MAT DISP 5FR,320.56,176.31,96.17,277.28,38
HCPCS,A4649,MICROVAC 13FR,363.97,200.19,109.19,314.83,38
HCPCS,A4649,NDL BRONCH BRUSH,440.45,242.25,132.14,380.99,38
HCPCS,A4649,NDL CAUTERY COLORADO 2CM,575.0,316.25,172.5,497.38,38
HCPCS,A4649,NDL CAUTERY COLORADO 3CM,472.94,260.12,141.88,409.09,38
HCPCS,A4649,NDL CAUTERY COLORADO 4CM,472.94,260.12,141.88,409.09,38
HCPCS,A4649,NDL KNIFE SGL LUM 5FRX200CM,841.5,462.83,252.45,727.9,38
HCPCS,A4649,PAPILLITOME,819.0,450.45,245.7,708.44,38
HCPCS,A4649,PIN DRILL TRIM-IT 1.5MMX100MM,1653.75,909.57,496.13,1430.49,38
HCPCS,A4649,PIN STEALTH STL 100MM,1436.85,790.27,431.06,1242.88,38
HCPCS,A4649,PIN STEALTH STL 150MM,1436.85,790.27,431.06,1242.88,38
HCPCS,A4649,PLEDGET FELT TEFLON SZ3,301.7,165.94,90.51,260.97,38
HCPCS,A4649,PROBE APC STR FIRE 7.2FT,1107.0,608.85,332.1,957.56,38
HCPCS,A4649,PROBE VITRECTOMY 4MM 23GA,387.9,213.35,116.37,335.53,38
HCPCS,A4649,PROCISE EZ VIEW W/ INTG CABLE,1593.5,876.43,478.05,1378.38,38
HCPCS,A4649,PUNCH AOR SCANLAN 2.7MM 7.5IN,278.3,153.07,83.49,240.73,38
HCPCS,A4649,PUNCH AOR SCANLAN 3.5MM 7.5IN,278.3,153.07,83.49,240.73,38
HCPCS,A4649,PUNCH AOR SCANLAN 4MM 7.5IN,278.3,153.07,83.49,240.73,38
HCPCS,A4649,PUNCH AOR SCANLAN 6MM 7.5IN,278.3,153.07,83.49,240.73,38
HCPCS,A4649,RELOAD ECHELON 60MM,773.32,425.33,232.0,668.92,38
HCPCS,A4649,RELOAD ENDOCUTTER 75MM,352.36,193.8,105.71,304.79,38
HCPCS,A4649,RELOAD GIA 55,237.3,130.52,71.19,205.26,38
HCPCS,A4649,RELOAD GIA ENDO 45 3.5MM,575.0,316.25,172.5,497.38,38
HCPCS,A4649,RESERVOIR OMMAYA CSF,2315.25,1273.39,694.58,2002.69,38
HCPCS,A4649,RETR 4 PRONG,405.89,223.24,121.77,351.09,38
HCPCS,A4649,RETR ENDOPADDLE BALLOON,1977.98,1087.89,593.39,1710.95,38
HCPCS,A4649,RETR II ENDO 10MM,1723.86,948.13,517.16,1491.14,38
HCPCS,A4649,RETR IRIS FLEX DISP,464.31,255.38,139.29,401.63,38
HCPCS,A4649,SCISS REVOLUTION CRV 25GA DISP,893.7,491.54,268.11,773.05,38
HCPCS,A4649,SCISS REVOLUTION CRVD 23GA,835.88,459.74,250.76,723.04,38
HCPCS,A4649,SCISS RND 5MM DAVINCI,1200.02,660.02,360.01,1038.02,38
HCPCS,A4649,SCREW FEMALE PSN 2.5X25MM,350.52,192.79,105.16,303.2,38
HCPCS,A4649,SET BLOCK ENDOBROCH ARNDT 7F,1089.0,598.95,326.7,941.99,38
HCPCS,A4649,SET COOL POINT IRRIG TUBE 260,402.5,221.38,120.75,348.16,38
HCPCS,A4649,SET DILAT URETHRDAL,1122.98,617.64,336.89,971.38,38
HCPCS,A4649,SET IRRIG FLOW 2 SXN STRYKER,311.31,171.23,93.39,269.28,38
HCPCS,A4649,SHUNT CAROTID FLEXCEL 13CM,1165.5,641.03,349.65,1008.16,38
HCPCS,A4649,SHUNT INTRACORON 1.5MM,460.81,253.45,138.24,398.6,38
HCPCS,A4649,SNARE STD 9-15MM 6FR,1305.0,717.75,391.5,1128.83,38
HCPCS,A4649,SOL EMBOLIC LIQUID ONYX 18,8798.0,4838.9,2639.4,7610.27,38
HCPCS,A4649,SPHINCTEROTOME CANN 4.9FR 20MM,924.12,508.27,277.24,799.36,38
HCPCS,A4649,STABILIZER TISSUE OCTOPUS AS,6129.63,3371.3,1838.89,5302.13,38
HCPCS,A4649,STAPLE GUN 55,442.75,243.52,132.83,382.98,38
HCPCS,A4649,STAPLE GUN 75 TCT 75,575.0,316.25,172.5,497.38,38
HCPCS,A4649,STAPLE TCT 100 3.8MM,536.19,294.91,160.86,463.8,38
HCPCS,A4649,STAPLER ENDO LINEAR 45 2.5MM,575.0,316.25,172.5,497.38,38
HCPCS,A4649,STAPLER ETS 45MM,926.06,509.34,277.82,801.04,38
HCPCS,A4649,STAPLER LINEAR 30MM 4.8,427.05,234.88,128.12,369.4,38
HCPCS,A4649,STAPLER POWR COMPACT 60,1503.41,826.88,451.02,1300.45,38
HCPCS,A4649,STAPLER SKIN INSORB SUBCUTICLR,382.84,210.57,114.85,331.16,38
HCPCS,A4649,STAPLER TA 30 3.5MM,1579.46,868.71,473.84,1366.23,38
HCPCS,A4649,STIM NEURO PULSE NERVE,281.12,154.62,84.34,243.17,38
HCPCS,A4649,SUCT MICRO VAC 5FR,303.31,166.83,90.99,262.36,38
HCPCS,A4649,SUT ENDO STITCH 2-0 SURGIDAC,384.45,211.45,115.34,332.55,38
HCPCS,A4649,SUT ENDO STITCH SURGIDAC 0 GRN,802.35,441.3,240.71,694.03,38
HCPCS,A4649,SUT ENDO STITCH SURGIDAC 2-0,802.35,441.3,240.71,694.03,38
HCPCS,A4649,SUT ETHIBOND 3-0 V-5 18IN WH,461.61,253.89,138.48,399.29,38
HCPCS,A4649,SUT ETHIBOND 4-0 RB-1 18IN GRN,384.16,211.29,115.25,332.3,38
HCPCS,A4649,SUT ETHILON 2 LR 60IN BLK,232.59,127.93,69.78,201.19,38
HCPCS,A4649,SUT FIBERWIRE LOOP 2 26IN GRN,362.42,199.34,108.73,313.49,38
HCPCS,A4649,SUT GORE-TEX CV8 TTC-9 18IN WH,241.96,133.08,72.59,209.3,38
HCPCS,A4649,SUT MAXON 0 GS-21 18IN GRN,233.28,128.31,69.98,201.79,38
HCPCS,A4649,SUT NYL ACS 10-0 CU-8 8IN BLK,279.16,153.54,83.75,241.47,38
HCPCS,A4649,SUT PDS II 3-0 SH 36IN VIOL DA,287.67,158.22,86.3,248.83,38
HCPCS,A4649,SUT PDS II 4-0 TF 27IN VIOL,304.0,167.2,91.2,262.96,38
HCPCS,A4649,SUT POLYSORB 0 ES-9 48IN,384.45,211.45,115.34,332.55,38
HCPCS,A4649,SUT POLYSORB 2-0 ES-9 48IN,384.45,211.45,115.34,332.55,38
HCPCS,A4649,SUT PROLENE 3-0 SH-1 48IN BLU,395.66,217.62,118.7,342.25,38
HCPCS,A4649,SUT SURGIDAC 0 ES-9 48IN GRN,384.45,211.45,115.34,332.55,38
HCPCS,A4649,SUT TAPE LABRAL 1.5MM 36IN WH,422.86,232.58,126.86,365.77,38
HCPCS,A4649,SUT VICRYL 9-0 5IN VIOL BRD,847.13,465.93,254.14,732.77,38
HCPCS,A4649,SUT VLOC 3-0 CV23 BLK 12IN,286.7,157.69,86.01,248.0,38
HCPCS,A4649,SUT VLOCL 3-0 CV-23,235.64,129.61,70.69,203.83,38
HCPCS,A4649,SUT VLOCL 3-0 CV-23 6IN GRN,235.64,129.61,70.69,203.83,38
HCPCS,A4649,SUT VLOCM 2-0 GS-21 6IN,235.64,129.61,70.69,203.83,38
HCPCS,A4649,SUT VLOCM 2-0 GS-21 9IN,235.64,129.61,70.69,203.83,38
HCPCS,A4649,SUT VLOCM 3-0 V-20 12IN VIOL,235.64,129.61,70.69,203.83,38
HCPCS,A4649,SYS CLOSURE XL CARTER THOMASON,862.65,474.46,258.8,746.19,38
HCPCS,A4649,SYS ENDOSUT OVERSTITCH,5554.07,3054.74,1666.22,4804.27,38
HCPCS,A4649,SYS FEMOSTOP COMP,575.0,316.25,172.5,497.38,38
HCPCS,A4649,SYS PORT CLOSURE THOMASON II,864.27,475.35,259.28,747.59,38
HCPCS,A4649,SYS RETRIEVAL INZII 12/15MM,557.75,306.77,167.33,482.45,38
HCPCS,A4649,SYS RUMI II KOH EFFIC 3.5CM,766.75,421.72,230.03,663.24,38
HCPCS,A4649,SYS RUMI II KOH EFFIC 4CM,766.75,421.72,230.03,663.24,38
HCPCS,A4649,TEMPLATE CRANIECTOMY RNS STIMU,1890.0,1039.5,567.0,1634.85,38
HCPCS,A4649,TIP EXT DURASEAL APPL 8CM,621.99,342.1,186.6,538.02,38
HCPCS,A4649,TIP EXT FOR PROGEL 16CM,735.75,404.67,220.73,636.42,38
HCPCS,A4649,TIP EXT FOR PROGEL 29CM,735.75,404.67,220.73,636.42,38
HCPCS,A4649,TIP OZII 30DEG,407.68,224.23,122.3,352.64,38
HCPCS,A4649,TIP UTERINE MANIPUL 10CM GRN,307.05,168.88,92.12,265.6,38
HCPCS,A4649,TIP UTERINE MANIPUL 12CM ORG,307.05,168.88,92.12,265.6,38
HCPCS,A4649,TIP UTERINE MANIPUL 6CM WH,307.05,168.88,92.12,265.6,38
HCPCS,A4649,TIP UTERINE MANIPUL 8CM BLU,307.05,168.88,92.12,265.6,38
HCPCS,A4649,TOOL REDUCTION 2.4MM X 78MM THREADED SELF DRILLING HEX COUPL,628.43,345.64,188.53,543.59,38
HCPCS,A4649,TROCAR ENDO BLADELESS 12MM,811.26,446.2,243.38,701.74,38
HCPCS,A4649,TROCAR OPTICAL Z-THRD 15X100MM,258.75,142.32,77.63,223.82,38
HCPCS,A4649,TUBE CANALICULAR CONCEPT,968.94,532.92,290.68,838.13,38
HCPCS,A4649,TUBE CARBOJET CO2,945.0,519.75,283.5,817.43,38
HCPCS,A4649,TUBE CUSA XL MANIFOLD,765.09,420.8,229.53,661.8,38
HCPCS,A4649,TUNNEL VNS,2601.0,1430.55,780.3,2249.87,38
HCPCS,A4649,VALVE CONTOUR REG LOW,2925.0,1608.75,877.5,2530.13,38
HCPCS,A4649,VALVE STRATA PROGRAMABLE SHUNT,10916.58,6004.12,3274.97,9442.84,38
HCPCS,A4649,WAND PROCISE MAX PLASMA,448.5,246.68,134.55,387.95,38
HCPCS,A4649,WAND REFLEX W/INTEGRATED CABLE,517.5,284.63,155.25,447.64,38
HCPCS,A5051,Pouch clsd w barr attached,,,2.88,2.97,15
HCPCS,A5052,Clsd ostomy pouch w/o barr,,,2.08,2.14,15
HCPCS,A5053,Clsd ostomy pouch faceplate,,,2.05,2.11,15
HCPCS,A5054,Clsd ostomy pouch w/flange,,,2.51,2.59,15
HCPCS,A5055,Stoma cap,,,2.01,2.07,15
HCPCS,A5056,1 pc ost pouch w filter,,,6.53,6.73,15
HCPCS,A5057,1 pc ost pou w built-in conv,,,13.41,13.81,15
HCPCS,A5061,Pouch drainable w barrier at,,,4.94,5.09,15
HCPCS,A5062,Drnble ostomy pouch w/o barr,,,3.12,3.21,15
HCPCS,A5063,Drain ostomy pouch w/flange,,,3.78,3.89,15
HCPCS,A5071,Urinary pouch w/barrier,,,8.4,8.65,15
HCPCS,A5072,Urinary pouch w/o barrier,,,4.94,5.09,15
HCPCS,A5073,Urinary pouch on barr w/flng,,,4.44,4.57,15
HCPCS,A5081,"Stoma plug or seal, any type",,,4.63,4.77,15
HCPCS,A5082,Continent stoma catheter,,,16.63,17.13,15
HCPCS,A5083,Stoma absorptive cover,,,0.9,0.93,15
HCPCS,A5093,Ostomy accessory convex inse,,,2.73,2.81,15
HCPCS,A5102,Bedside drain btl w/wo tube,,,31.53,32.48,15
HCPCS,A5105,Urinary suspensory,,,56.97,58.68,15
HCPCS,A5112,Urinary leg bag,,,47.51,48.94,15
HCPCS,A5113,Latex leg strap,,,6.58,6.78,15
HCPCS,A5114,Foam/fabric leg strap,,,10.89,11.22,15
HCPCS,A5121,Solid skin barrier 6x6,,,9.46,9.74,15
HCPCS,A5122,Solid skin barrier 8x8,,,17.66,18.19,15
HCPCS,A5126,Disk/foam pad +or- adhesive,,,1.83,1.88,15
HCPCS,A5131,Appliance cleaner,,,18.83,19.39,15
HCPCS,A5200,Percutaneous catheter anchor,,,15.8,16.27,15
HCPCS,A5500,Diab shoe for density insert,,,88.85,91.52,15
HCPCS,A5501,Diabetic custom molded shoe,,,266.47,274.46,15
HCPCS,A5503,Diabetic shoe w/roller/rockr,,,45.26,46.62,15
HCPCS,A5504,Diabetic shoe with wedge,,,45.26,46.62,15
HCPCS,A5505,Diab shoe w/metatarsal bar,,,45.26,46.62,15
HCPCS,A5506,Diabetic shoe w/off set heel,,,45.26,46.62,15
HCPCS,A5507,Modification diabetic shoe,,,45.26,46.62,15
HCPCS,A5512,Multi den insert direct form,,,36.24,37.33,15
HCPCS,A5513,Multi den insert custom mold,,,54.08,55.7,15
HCPCS,A5514,Mult den insert dir carv/cam,,,54.08,55.7,15
HCPCS,A6010,Collagen based wound filler,,,43.27,44.57,15
HCPCS,A6011,Collagen gel/paste wound fil,,,3.19,3.29,15
HCPCS,A6021,Collagen dressing <=16 sq in,,,29.38,30.26,15
HCPCS,A6022,Collagen drsg>16<=48 sq in,,,29.38,30.26,15
HCPCS,A6023,Collagen dressing >48 sq in,,,265.9,273.88,15
HCPCS,A6024,Collagen dsg wound filler,,,8.64,8.9,15
HCPCS,A6154,Wound pouch each,,,20.09,20.69,15
HCPCS,A6196,Alginate dressing <=16 sq in,,,10.28,10.59,15
HCPCS,A6197,Alginate drsg >16 <=48 sq in,,,22.98,23.67,15
HCPCS,A6199,Alginate drsg wound filler,,,7.37,7.59,15
HCPCS,A6203,Composite drsg <= 16 sq in,,,4.71,4.85,15
HCPCS,A6204,Composite drsg >16<=48 sq in,,,8.69,8.95,15
HCPCS,A6207,Contact layer >16<= 48 sq in,,,10.26,10.57,15
HCPCS,A6208,DRSG ACTICOAT BURN 8X16,236.27,129.95,70.88,204.37,38
HCPCS,A6209,Foam drsg <=16 sq in w/o bdr,,,10.44,10.75,15
HCPCS,A6210,Foam drg >16<=48 sq in w/o b,,,27.84,28.68,15
HCPCS,A6211,Foam drg > 48 sq in w/o brdr,,,41.04,42.27,15
HCPCS,A6212,Foam drg <=16 sq in w/border,,,13.57,13.98,15
HCPCS,A6214,Foam drg > 48 sq in w/border,,,14.39,14.82,15
HCPCS,A6216,Non-sterile gauze<=16 sq in,,,0.05,0.05,15
HCPCS,A6219,Gauze <= 16 sq in w/border,,,1.33,1.37,15
HCPCS,A6220,Gauze >16 <=48 sq in w/bordr,,,3.62,3.73,15
HCPCS,A6222,Gauze <=16 in no w/sal w/o b,,,2.98,3.07,15
HCPCS,A6223,Gauze >16<=48 no w/sal w/o b,,,3.39,3.49,15
HCPCS,A6224,Gauze > 48 in no w/sal w/o b,,,5.03,5.18,15
HCPCS,A6229,Gauze >16<=48 sq in watr/sal,,,5.03,5.18,15
HCPCS,A6231,Hydrogel dsg<=16 sq in,,,6.55,6.75,15
HCPCS,A6232,Hydrogel dsg>16<=48 sq in,,,9.59,9.88,15
HCPCS,A6233,Hydrogel dressing >48 sq in,,,26.79,27.59,15
HCPCS,A6234,Hydrocolld drg <=16 w/o bdr,,,9.15,9.42,15
HCPCS,A6235,Hydrocolld drg >16<=48 w/o b,,,23.5,24.21,15
HCPCS,A6236,Hydrocolld drg > 48 in w/o b,,,38.07,39.21,15
HCPCS,A6237,Hydrocolld drg <=16 in w/bdr,,,11.05,11.38,15
HCPCS,A6238,Hydrocolld drg >16<=48 w/bdr,,,31.86,32.82,15
HCPCS,A6240,Hydrocolld drg filler paste,,,17.11,17.62,15
HCPCS,A6241,Hydrocolloid drg filler dry,,,3.59,3.7,15
HCPCS,A6242,Hydrogel drg <=16 in w/o bdr,,,8.46,8.71,15
HCPCS,A6243,Hydrogel drg >16<=48 w/o bdr,,,17.22,17.74,15
HCPCS,A6244,Hydrogel drg >48 in w/o bdr,,,54.89,56.54,15
HCPCS,A6245,Hydrogel drg <= 16 in w/bdr,,,10.16,10.46,15
HCPCS,A6246,Hydrogel drg >16<=48 in w/b,,,13.88,14.3,15
HCPCS,A6247,Hydrogel drg > 48 sq in w/b,,,33.23,34.23,15
HCPCS,A6248,Hydrogel drsg gel filler,,,22.7,23.38,15
HCPCS,A6251,Absorpt drg <=16 sq in w/o b,,,2.78,2.86,15
HCPCS,A6252,Absorpt drg >16 <=48 w/o bdr,,,4.55,4.69,15
HCPCS,A6253,Absorpt drg > 48 sq in w/o b,,,8.85,9.12,15
HCPCS,A6254,Absorpt drg <=16 sq in w/bdr,,,1.67,1.72,15
HCPCS,A6255,Absorpt drg >16<=48 in w/bdr,,,4.25,4.38,15
HCPCS,A6257,Transparent film <= 16 sq in,,,2.14,2.2,15
HCPCS,A6258,Transparent film >16<=48 in,,,6.02,6.2,15
HCPCS,A6259,Transparent film > 48 sq in,,,15.28,15.74,15
HCPCS,A6266,Impreg gauze no h20/sal/yard,,,2.67,2.75,15
HCPCS,A6402,Sterile gauze <= 16 sq in,,,0.15,0.15,15
HCPCS,A6403,Sterile gauze>16 <= 48 sq in,,,0.57,0.59,15
HCPCS,A6407,"Packing strips, non-impreg",,,2.61,2.69,15
HCPCS,A6410,Sterile eye pad,,,0.52,0.54,15
HCPCS,A6441,"Pad band w>=3"" <5""/yd",,,0.95,0.98,15
HCPCS,A6442,"Conform band n/s w<3""/yd",,,0.23,0.24,15
HCPCS,A6443,"Conform band n/s w>=3""<5""/yd",,,0.39,0.4,15
HCPCS,A6444,"Conform band n/s w>=5""/yd",,,0.78,0.8,15
HCPCS,A6445,"Conform band s w <3""/yd",,,0.44,0.45,15
HCPCS,A6446,"Conform band s w>=3"" <5""/yd",,,0.54,0.56,15
HCPCS,A6447,"Conform band s w >=5""/yd",,,0.95,0.98,15
HCPCS,A6448,"Lt compres band <3""/yd",,,1.61,1.66,15
HCPCS,A6449,"Lt compres band >=3"" <5""/yd",,,2.45,2.52,15
HCPCS,A6450,"Lt compres band >=5""/yd",,,2.45,2.52,15
HCPCS,A6451,"Mod compres band w>=3""<5""/yd",,,2.45,2.52,15
HCPCS,A6452,"High compres band w>=3""<5""yd",,,8.24,8.49,15
HCPCS,A6453,"Self-adher band w <3""/yd",,,0.88,0.91,15
HCPCS,A6454,"Self-adher band w>=3"" <5""/yd",,,1.1,1.13,15
HCPCS,A6455,"Self-adher band >=5""/yd",,,1.95,2.01,15
HCPCS,A6456,"Zinc paste band w >=3""<5""/yd",,,1.75,1.8,15
HCPCS,A6457,Tubular dressing,,,1.59,1.64,15
HCPCS,A6520,G com garmnt glove nghttime,,,123.13,126.82,15
HCPCS,A6521,G com garmnt glove nght cust,,,488.56,503.22,15
HCPCS,A6522,G com garment arm nighttime,,,299.18,308.16,15
HCPCS,A6523,G com garment arm nght custm,,,709.85,731.15,15
HCPCS,A6524,G com garmnt lwr leg/ft nght,,,373.26,384.46,15
HCPCS,A6525,G com garm lwrleg/ft ngt cus,,,753.55,776.16,15
HCPCS,A6526,G com garmt full leg/ft nght,,,674.84,695.09,15
HCPCS,A6527,G garmt full leg/ft nght cus,,,1240.94,1278.17,15
HCPCS,A6528,G com garment bra nighttime,,,648.9,668.37,15
HCPCS,A6529,G com garmt bra night custm,,,1025.36,1056.12,15
HCPCS,A6530,Compression stocking BK18-30,,,38.04,39.18,15
HCPCS,A6533,Gc stocking thighlngth 18-30,,,53.42,55.02,15
HCPCS,A6534,Gc stocking thighlngth 30-40,,,61.0,62.83,15
HCPCS,A6535,Gc stocking thighlngth 40+,,,70.23,72.34,15
HCPCS,A6536,Gc stocking full lngth 18-30,,,72.01,74.17,15
HCPCS,A6537,Gc stocking full lngth 30-40,,,85.37,87.93,15
HCPCS,A6538,Gc stocking full lngth 40+,,,99.95,102.95,15
HCPCS,A6539,Gc stocking waistlngth 18-30,,,95.29,98.15,15
HCPCS,A6540,Gc stocking waistlngth 30-40,,,113.61,117.02,15
HCPCS,A6541,Gc stocking waistlngth 40+,,,134.58,138.62,15
HCPCS,A6550,Neg pres wound ther drsg set,,,31.08,32.01,15
HCPCS,A6552,Grad com stocking bk 30-40,,,56.45,58.14,15
HCPCS,A6553,G com stcking bk 30-40 custm,,,220.43,227.04,15
HCPCS,A6554,Grad com stocking bk 40+,,,77.62,79.95,15
HCPCS,A6555,G com stcking bk 40+ custm,,,220.43,227.04,15
HCPCS,A6556,G com stcking thgh18-30 cust,,,302.09,311.15,15
HCPCS,A6557,G com stcking thgh30-40 cust,,,302.09,311.15,15
HCPCS,A6558,G com stcking thgh 40+ cust,,,311.75,321.1,15
HCPCS,A6562,G com stckng waist18-30 cust,,,988.68,1018.34,15
HCPCS,A6563,G com stckng waist30-40 cust,,,988.68,1018.34,15
HCPCS,A6564,G com stckng waist 40+ cust,,,1065.02,1096.97,15
HCPCS,A6565,Grad comp gauntlet custom,,,170.84,175.97,15
HCPCS,A6566,Grad com garment neck/head,,,248.05,255.49,15
HCPCS,A6567,G com garment neck/head cust,,,779.38,802.76,15
HCPCS,A6568,G com garment torso/shldr,,,161.89,166.75,15
HCPCS,A6569,G com garmnt torso/shdr cust,,,921.85,949.51,15
HCPCS,A6570,Grad com garment genital,,,110.3,113.61,15
HCPCS,A6571,G com garment genital custm,,,662.94,682.83,15
HCPCS,A6572,Grad com garment toe caps,,,102.35,105.42,15
HCPCS,A6573,Grad com garmnt toe cap cust,,,242.87,250.16,15
HCPCS,A6574,Custom gradient sleev/glov,,,309.63,318.92,15
HCPCS,A6575,Gradient comp sleev/glov,,,100.34,103.35,15
HCPCS,A6576,Custom grad com sleeve med,,,190.03,195.73,15
HCPCS,A6577,Custom grad cm sleeve heavy,,,157.28,162.0,15
HCPCS,A6578,Gradient comp sleeve,,,77.46,79.78,15
HCPCS,A6579,Custom grad com glove med,,,305.02,314.17,15
HCPCS,A6580,Custom grad com glove heavy,,,302.78,311.86,15
HCPCS,A6581,Gradient comp glove,,,71.07,73.2,15
HCPCS,A6582,Gradient comp gauntlet,,,47.4,48.82,15
HCPCS,A6583,Grad com wrap w straps bk,,,155.92,160.6,15
HCPCS,A6585,Grad com wrap w straps ak,,,184.62,190.16,15
HCPCS,A6586,Grad com wrap w strap fu leg,,,543.9,560.22,15
HCPCS,A6587,Grad com wrap w straps foot,,,71.25,73.39,15
HCPCS,A6588,Grad com wrap w strap arm,,,237.46,244.58,15
HCPCS,A6589,Grad com wrap w straps bra,,,93.74,96.55,15
HCPCS,A6590,Urinary cath disp suc pump,,,437.4,450.52,15
HCPCS,A6591,Urinary cath suc pump,,,88.86,91.53,15
HCPCS,A6594,G comp bandge liner lwr extr,,,34.13,35.15,15
HCPCS,A6595,G comp bandge liner upr extr,,,33.57,34.58,15
HCPCS,A6596,G comp bandge conform gauze,,,0.18,0.19,15
HCPCS,A6597,G comp bandage long stretch,,,1.51,1.56,15
HCPCS,A6598,G comp bandage med stretch,,,0.73,0.75,15
HCPCS,A6599,G comp bandage short stretch,,,1.66,1.71,15
HCPCS,A6600,G com bandge hgh dn foam sht,,,2.99,3.08,15
HCPCS,A6601,G com bandge hgh dn foam pad,,,3.36,3.46,15
HCPCS,A6602,G com bandge hgh dn foamroll,,,4.9,5.05,15
HCPCS,A6603,G com bandge low dn foamchnl,,,2.3,2.37,15
HCPCS,A6604,G com bandge low dn foam flt,,,1.34,1.38,15
HCPCS,A6605,G com bandage padded foam,,,1.53,1.58,15
HCPCS,A6606,G com bandage padded textile,,,4.55,4.69,15
HCPCS,A6607,G com bandage tub protct lyr,,,1.22,1.26,15
HCPCS,A6608,G com bandage tub protct pad,,,5.07,5.22,15
HCPCS,A6610,G com stcking bk 18-30 custm,,,220.43,227.04,15
HCPCS,A7018,Water distilled w/nebulizer,,,0.43,0.44,15
HCPCS,A7040,One way chest drain valve,,,56.5,58.2,15
HCPCS,A7041,DRN PNEUMONECTOMY,772.52,424.89,106.21,668.23,53
HCPCS,A7048,Vacuum drain bottle/tube kit,,,59.15,60.92,15
HCPCS,A7501,Tracheostoma valve w diaphra,,,146.73,151.13,15
HCPCS,A7502,Replacement diaphragm/fplate,,,69.75,71.84,15
HCPCS,A7503,HMES filter holder or cap,,,15.85,16.33,15
HCPCS,A7504,Tracheostoma HMES filter,,,0.95,0.98,15
HCPCS,A7505,HMES or trach valve housing,,,6.55,6.75,15
HCPCS,A7506,HMES/trachvalve adhesivedisk,,,0.45,0.46,15
HCPCS,A7507,Integrated filter & holder,,,3.49,3.59,15
HCPCS,A7508,Housing & Integrated Adhesiv,,,4.01,4.13,15
HCPCS,A7509,Heat & moisture exchange sys,,,1.97,2.03,15
HCPCS,A7520,"HC TRACHEOSTOMY/LARYNGECTOMY TUBE, NONCUFFFED, EACH",738.5,406.18,66.33,649.88,50
HCPCS,A7521,Trach/laryn tube cuffed,,,65.73,67.7,15
HCPCS,A7522,Trach/laryn tube stainless,,,63.1,64.99,15
HCPCS,A7524,Tracheostoma stent/stud/bttn,,,108.17,111.42,15
HCPCS,A7525,Tracheostomy mask,,,2.88,2.97,15
HCPCS,A7526,Tracheostomy tube collar,,,4.74,4.88,15
HCPCS,A7527,Trach/laryn tube plug/stop,,,5.0,5.15,15
HCPCS,A9279,KIT CAMINO INTRACRANIAL PRESS,3593.97,1976.69,1078.19,3108.78,38
HCPCS,A9500,technetium Tc-99m sestamibi Kit 30 millicurie,528.34,290.59,158.5,464.94,48
HCPCS,A9502,technetium Tc-99m tetrofosmin Kit 33 millicurie,483.81,266.1,145.14,425.75,48
HCPCS,A9503,technetium Tc-99m medronate Kit 30 millicurie,140.51,77.29,42.15,123.65,48
HCPCS,A9505,thallous chloride Tl-201 2 MCI/ML Solution 1 millicurie,264.21,145.32,79.26,232.5,48
HCPCS,A9506,Tc-99m graphite crucible,,,328.6,338.46,15
HCPCS,A9509,sodium iodide I-123 Cap 1 millicurie,236.0,129.8,70.8,207.68,48
HCPCS,A9510,technetium Tc-99m disofenin Kit 15 millicurie,139.73,76.86,41.92,122.96,48
HCPCS,A9512,technetium Tc-99m pertechnetate Kit 1 millicurie,20.35,11.2,6.11,17.91,48
HCPCS,A9513,lutetium Lu-177 dotatate 370 MBQ/ML Solution 1 millicurie,832.0,457.6,249.6,732.16,63
HCPCS,A9515,Choline c-11,,,2062.94,2124.83,15
HCPCS,A9516,sodium iodide I-123 Cap 0.99 millicurie,236.0,129.8,70.8,207.68,48
HCPCS,A9517,sodium iodide I-131 Cap 1 millicurie,144.95,79.73,23.13,127.56,63
HCPCS,A9520,technetium Tc-99m tilmanocept Kit 0.5 millicurie,1508.5,829.68,452.55,1327.48,48
HCPCS,A9521,technetium Tc-99m exametazime Kit 25 millicurie,4810.6,2645.83,802.34,4233.33,63
HCPCS,A9524,Iodinated I 131 Albumin 25 MCCI/ML Solution Prefilled Syringe 1 Each Syringe,1080.0,594.0,324.0,950.4,48
HCPCS,A9526,ammonia N-13 Kit 40 millicurie,1286.8,707.74,386.04,1132.38,48
HCPCS,A9527,Iodine I-125 sodium iodide,,,208.58,214.84,15
HCPCS,A9528,sodium iodide I-131 Cap 1 millicurie,63.75,35.07,19.13,56.1,48
HCPCS,A9530,"I131 iodide sol, rx",,,20.88,21.51,15
HCPCS,A9532,iodinated I-125 albumin Kit 5 microcurie(s),2031.1,1117.11,609.33,1787.37,48
HCPCS,A9537,technetium Tc-99m mebrofenin Kit 15 millicurie,97.35,53.55,29.21,85.67,48
HCPCS,A9538,technetium Tc-99m pyrophosphate Kit 25 millicurie,216.83,119.26,65.05,190.81,48
HCPCS,A9540,technetium Tc-99m macro aggregated albumin Kit 10 millicurie,979.0,538.45,293.7,861.52,48
HCPCS,A9541,technetium Tc-99m sulfur colloid Kit 20 millicurie,401.75,220.97,120.53,353.54,48
HCPCS,A9542,"In111 ibritumomab, dx",,,798.02,821.96,15
HCPCS,A9543,"Y90 ibritumomab, rx",,,56824.55,58529.29,15
HCPCS,A9547,In111 oxyquinoline,,,772.64,795.82,15
HCPCS,A9548,indium In-111 pentetate disodium Solution 0.5 millicurie,2845.9,1565.25,715.29,2504.39,63
HCPCS,A9551,technetium Tc-99m dimercaptosuccinic acid Kit 10 millicurie,2578.75,1418.32,773.63,2269.3,48
HCPCS,A9552,fludeoxyglucose F-18 20-300 MCI/ML Solution 45 millicurie,1724.05,948.23,517.22,1517.16,48
HCPCS,A9553,sodium chromate Cr-51 Kit 250 millicurie,1436.95,790.33,431.09,1264.52,48
HCPCS,A9555,Cardiogen-82 Recon Soln 1 Each Package,300.0,165.0,90.0,264.0,48
HCPCS,A9556,gallium citrate Ga-67 2 MCI/ML Solution 1 millicurie,98.37,54.11,29.51,86.57,48
HCPCS,A9557,technetium Tc-99m bicisate Kit 25 millicurie,4301.11,2365.62,683.8,3784.98,63
HCPCS,A9558,xenon Xe-133 gas 10 MCI Gas 10 millicurie,219.75,120.87,65.93,193.38,48
HCPCS,A9560,technetium Tc-99m tagged red blood cells Kit 20 millicurie,344.32,189.38,103.3,303.0,48
HCPCS,A9560,technetium Tc-99m tagged red blood cells Kit 30 millicurie,509.0,279.95,152.7,447.92,48
HCPCS,A9562,technetium Tc-99m mertiatide Kit 15 millicurie,1146.25,630.44,343.88,1008.7,48
HCPCS,A9563,P32 Na phosphate,,,179.12,184.49,15
HCPCS,A9567,technetium Tc-99m pentetate Kit 25 millicurie,296.29,162.96,88.89,260.74,48
HCPCS,A9568,Technetium tc99m arcitumomab,,,809.51,833.8,15
HCPCS,A9569,Technetium TC-99m auto WBC,,,1040.32,1071.53,15
HCPCS,A9570,indium In-111 oxyquinoline associated WBCs Kit 1 millicurie,5950.78,3272.93,1031.39,5236.69,63
HCPCS,A9572,indium In-111 pentetreotide Kit 6 millicurie,11116.9,6114.3,1914.61,9782.87,63
HCPCS,A9573,"Inj, gadopiclenol, 1 ml",,,17.05,23.02,2
HCPCS,A9575,Inj gadoterate meglumi 0.1ml,,,0.6,0.81,2
HCPCS,A9576,Inj prohance multipack,,,7.1,9.59,2
HCPCS,A9577,Inj multihance,,,8.7,11.75,2
HCPCS,A9578,Inj multihance multipack,,,8.55,11.54,2
HCPCS,A9579,"Gad-base MR contrast NOS,1ml",,,7.35,9.92,2
HCPCS,A9580,sodium fluorine F-18 Kit 30 millicurie,632.62,347.95,189.79,556.71,48
HCPCS,A9581,HC INJ GADOXETATE DISODIUM EOVIST 10 ML VIAL PER ML,48.0,26.4,12.62,99.23,96
HCPCS,A9582,iobenguane I-123 10 MCI/5ML Solution 15 millicurie,10867.0,5976.85,1781.43,9562.96,63
HCPCS,A9584,ioflupane I-123 185 MBQ/2.5ML Solution 5 millicurie,4166.14,2291.38,1249.84,3666.2,63
HCPCS,A9585,"HC INJECTION, GADOBUTROL, 0.1 ML",3.0,1.65,0.9,2.6,96
HCPCS,A9586,florbetapir F-18 500-1900 MBQ/ML Solution 10 millicurie,5897.86,3243.83,1769.36,5190.12,63
HCPCS,A9587,gallium Ga-68 dotatate Kit 0.1 millicurie,94.27,51.85,28.28,82.96,63
HCPCS,A9588,fluciclovine F-18 9-221 MCI/ML Solution 1 millicurie,1252.0,688.6,268.42,1101.76,63
HCPCS,A9589,hexaminolevulinate 100 mg Recon Soln 1 Each Vial,5494.4,3021.92,1648.32,9614.23,48
HCPCS,A9591,fluoroestradiol F-18 4-100 MCI/ML Solution 1 Each Vial,13855.0,7620.25,498.67,12192.4,63
HCPCS,A9592,Copper cu 64 dotatate diag,,,595.1,612.95,15
HCPCS,A9593,Gallium GA-68 PSMA-11 UCSF,,,534.91,550.96,15
HCPCS,A9594,"Gallium GA-68 PSMA-11, UCLA",,,372.17,383.34,15
HCPCS,A9595,F-18 piflufolastat 9 MCI Solution Prefilled Syringe 1 Each Syringe,16616.56,9139.11,332.44,14622.57,63
HCPCS,A9596,Gallium illuccix 1 millicure,,,511.55,526.9,15
HCPCS,A9600,Sr89 strontium,,,4146.34,4270.73,15
HCPCS,A9601,Flortaucipir inj 1 millicuri,,,3710.0,3821.3,15
HCPCS,A9602,Fluorodopa f-18 diag per mci,,,873.84,900.06,15
HCPCS,A9604,Sm 153 lexidronam,,,4314.91,4444.36,15
HCPCS,A9606,HC XOFIGO-RADIUM 223 DICHLORIDE INJ PER MICROCURIE,539.0,296.45,161.7,474.32,63
HCPCS,A9607,lutetium Lu-177 vipivotide tetraxetan 1000 MBQ/ML Solution 1 millicurie,660.25,363.14,198.08,581.02,63
HCPCS,A9608,Flotufolastat f18 diag 1 mci,,,671.22,691.36,15
HCPCS,A9611,"Flurpiridaz f18, diag, 1 mci",,,530.0,545.9,15
HCPCS,A9615,"Inj, pegulicianine, 1 mg",,,37.51,38.63,15
HCPCS,A9616,Gallium gozellix 1 millicuri,,,1171.3,1206.44,15
HCPCS,A9697,"Inj, magtrace per study dose",,,1254.0,1291.62,15
HCPCS,A9800,gallium Ga-68 gozetotide 25 MCG Kit 7 millicurie,17314.0,9522.7,381.01,15236.32,63
HCPCS,B4034,Enter feed supkit syr by day,,,3.74,3.85,15
HCPCS,B4035,Enteral feed supp pump per d,,,6.61,6.81,15
HCPCS,B4036,Enteral feed sup kit grav by,,,5.12,5.27,15
HCPCS,B4081,Enteral ng tubing w/ stylet,,,18.79,19.35,15
HCPCS,B4082,Enteral ng tubing w/o stylet,,,13.25,13.65,15
HCPCS,B4083,Enteral stomach tube levine,,,1.96,2.02,15
HCPCS,B4087,"Gastro/jejuno tube, std",,,32.74,33.72,15
HCPCS,B4088,"Gastro/jejuno tube, low-pro",,,37.79,38.92,15
HCPCS,B4148,Enteral feed elastomer daily,,,7.03,7.24,15
HCPCS,B4149,EF blenderized foods,,,1.23,1.27,15
HCPCS,B4150,EF complet w/intact nutrient,,,0.46,0.47,15
HCPCS,B4152,EF calorie dense>/=1.5Kcal,,,0.39,0.4,15
HCPCS,B4153,EF hydrolyzed/amino acids,,,1.47,1.51,15
HCPCS,B4154,EF spec metabolic noninherit,,,0.8,0.82,15
HCPCS,B4155,EF incomplete/modular,,,0.86,0.89,15
HCPCS,B4164,Parenteral 50% dextrose solu,,,24.66,25.4,15
HCPCS,B4168,Parenteral sol amino acid 3.,,,35.96,37.04,15
HCPCS,B4176,Parenteral sol amino acid 7-,,,69.57,71.66,15
HCPCS,B4178,Parenteral sol amino acid >,,,83.49,85.99,15
HCPCS,B4180,Parenteral sol carb > 50%,,,35.4,36.46,15
HCPCS,B4185,Pn soln nos 10 grams lipids,,,16.29,16.78,15
HCPCS,B4187,"Omegaven, 10 grams lipids",,,16.29,16.78,15
HCPCS,B4189,Parenteral sol amino acid &,,,257.9,265.64,15
HCPCS,B4193,Parenteral sol 52-73 gm prot,,,333.24,343.24,15
HCPCS,B4197,Parenteral sol 74-100 gm pro,,,405.72,417.89,15
HCPCS,B4199,Parenteral sol > 100gm prote,,,463.6,477.51,15
HCPCS,B4216,Parenteral nutrition additiv,,,11.2,11.54,15
HCPCS,B4220,Parenteral supply kit premix,,,11.61,11.96,15
HCPCS,B4222,Parenteral supply kit homemi,,,14.33,14.76,15
HCPCS,B4224,Parenteral administration ki,,,36.27,37.36,15
HCPCS,B5000,Parenteral sol renal-amirosy,,,17.25,17.77,15
HCPCS,B5100,Parenteral solution hepatic,,,6.74,6.94,15
HCPCS,C1062,HC IR KIT SPINE JACK,12783.0,7030.65,3834.9,18485.0,35
HCPCS,C1601,SCOPE ASCOPE 5 BRONCH 5.6X2.8,1930.5,1061.78,579.15,1669.88,38
HCPCS,C1603,"HC IR KIT LASER CAVA CLEAR, RETRIEVAL DEVICE",23572.0,12964.6,7071.6,20389.78,38
HCPCS,C1713,11MM ROD CONNECTOR,2025.0,1113.75,607.5,1782.0,35
HCPCS,C1713,500 MM HEX ROD SPINAL ELEMENTS,900.0,495.0,270.0,792.0,35
HCPCS,C1713,ADAPTER DIAPHYSEAL STCKNG OSS,859.23,472.58,257.77,756.12,35
HCPCS,C1713,ANCHOR GII QUICK+ CP-2,3996.0,2197.8,1198.8,3516.48,35
HCPCS,C1713,ANCHOR MITEK MINI W 2-0 SUT,3735.0,2054.25,1120.5,3286.8,35
HCPCS,C1713,ANCHOR SUPER 2 W/ETHIBOND,3532.5,1942.88,1059.75,3108.6,35
HCPCS,C1713,ANCHOR SUT 2.8MM Q-FIX W/2 MT,2160.0,1188.0,648.0,1900.8,35
HCPCS,C1713,CABLE ZIM TI 1.8X914MM,2244.6,1234.53,673.38,1975.25,35
HCPCS,C1713,CERES SELF TAPPING VARIABLE SCREW 4.0X16MM,575.0,316.25,172.5,506.0,35
HCPCS,C1713,CLIP ANEU L PERM STR 12MM,2165.31,1190.93,649.59,1905.47,35
HCPCS,C1713,CLIP ANEU L TEMP STRONG CRVD 5,2165.31,1190.93,649.59,1905.47,35
HCPCS,C1713,COMP LCK X STRT/CRVE ROD,3600.0,1980.0,1080.0,3168.0,35
HCPCS,C1713,"EXPEDIUM SPINE SYSTEM PRE-CONTOURED ROD, MEDIUM DIAMETER 5.5",3147.75,1731.27,944.33,2770.02,35
HCPCS,C1713,"EXPEDIUM SPINE SYSTEM PRE-CONTOURED ROD, SHORT DIAMETER 5.5M",3147.75,1731.27,944.33,2770.02,35
HCPCS,C1713,EXTENDED SET SCREW,287.5,158.13,86.25,253.0,35
HCPCS,C1713,HC IR IMPLANT FLOW SCREW,2672.0,1469.6,801.6,2351.36,35
HCPCS,C1713,HC IR MISC IMPLANT SCREW,1095.0,602.25,328.5,963.6,35
HCPCS,C1713,HC IR MISC WASHER,146.0,80.3,43.8,128.48,35
HCPCS,C1713,HC IR PRO-DENSE INJECTABLE REGENERATIVE GRAFT 10CC,12276.0,6751.8,3682.8,10802.88,35
HCPCS,C1713,"HC IR SCREW FENESTRATED , MISC",4778.0,2627.9,1433.4,4204.64,35
HCPCS,C1713,HEX SET SCREW,287.5,158.13,86.25,253.0,35
HCPCS,C1713,HOOK LAMINAR LUMBAR LARGE,2025.0,1113.75,607.5,1782.0,35
HCPCS,C1713,IMPL ENDOTINE FOREHEAD 3MM,1473.75,810.57,442.13,1296.9,35
HCPCS,C1713,IMPL FLEXHD THIN 2X4CM,618.75,340.32,185.63,544.5,35
HCPCS,C1713,IMPL FLEXHD ULTRA THIN 2X4CM,618.75,340.32,185.63,544.5,35
HCPCS,C1713,IMPL OMNIPORE CUSTOM CRANIAL,27225.0,14973.75,8167.5,23958.0,35
HCPCS,C1713,IMPL YOKE REINF OSS,4701.95,2586.08,1410.59,4137.72,35
HCPCS,C1713,KIT LNG NAIL TI LT 13X420X125,5984.3,3291.37,1795.29,5266.18,35
HCPCS,C1713,KIT LNG NAIL TI RT 10X400X125,5984.3,3291.37,1795.29,5266.18,35
HCPCS,C1713,KIT LNG NAIL TI RT 11X400X125,5984.3,3291.37,1795.29,5266.18,35
HCPCS,C1713,KIT SENSIGHT BUR HOLE DEVICEC,2014.88,1108.19,604.46,1773.09,35
HCPCS,C1713,KIT SUTURELOC MENISCAL REPAIR,8719.36,4795.65,2615.81,7673.04,35
HCPCS,C1713,MATRIX BONE PEARLMATRIX 5.0CC,15444.0,8494.2,4633.2,13590.72,35
HCPCS,C1713,MULTIAXIAL CROSS CONNECTOR PREBENT L55 TO 80,2250.0,1237.5,675.0,1980.0,35
HCPCS,C1713,NAIL FEM RECON SYS LT 10X460MM,7235.44,3979.5,2170.63,6367.19,35
HCPCS,C1713,NAIL FEMORAL RETROGRADE LONG T2 10x380MM,7930.65,4361.86,2379.2,6978.97,35
HCPCS,C1713,NAIL FEMORAL RETROGRADE LONG T2 11x220MM,7930.65,4361.86,2379.2,6978.97,35
HCPCS,C1713,NAIL FEMORAL RETROGRADE LONG T2 11x260MM,7930.65,4361.86,2379.2,6978.97,35
HCPCS,C1713,NAIL FEMORAL RETROGRADE LONG T2 11x380MM,7930.65,4361.86,2379.2,6978.97,35
HCPCS,C1713,NAIL FEMORAL RETROGRADE LONG T2 11x400MM,7930.65,4361.86,2379.2,6978.97,35
HCPCS,C1713,NAIL FEMORAL RETROGRADE LONG T2 11x420MM,7930.65,4361.86,2379.2,6978.97,35
HCPCS,C1713,NAIL FEMORAL RETROGRADE LONG T2 12x360MM,7930.65,4361.86,2379.2,6978.97,35
HCPCS,C1713,NAIL FEMORAL RETROGRADE LONG T2 12x380MM,7930.65,4361.86,2379.2,6978.97,35
HCPCS,C1713,NAIL FEMORAL RETROGRADE LONG T2 12x400MM,7930.65,4361.86,2379.2,6978.97,35
HCPCS,C1713,NAIL FEMORAL RETROGRADE LONG T2 12x420MM,7930.65,4361.86,2379.2,6978.97,35
HCPCS,C1713,NAIL FEMORAL RETROGRADE LONG T2 13x300MM,7930.65,4361.86,2379.2,6978.97,35
HCPCS,C1713,NAIL FEMORAL RETROGRADE LONG T2 13x340MM,7930.65,4361.86,2379.2,6978.97,35
HCPCS,C1713,NAIL FEMORAL RETROGRADE LONG T2 13x360MM,7930.65,4361.86,2379.2,6978.97,35
HCPCS,C1713,NAIL FEMORAL RETROGRADE LONG T2 13x440MM,7930.65,4361.86,2379.2,6978.97,35
HCPCS,C1713,NAIL FEMORAL RETROGRADE LONG T2 9x380MM,7930.65,4361.86,2379.2,6978.97,35
HCPCS,C1713,NAIL FLEX CRVD 3X450MM,846.0,465.3,253.8,744.48,35
HCPCS,C1713,NAIL FLEX CRVD TI 2.5X450MM,828.0,455.4,248.4,728.64,35
HCPCS,C1713,NAIL FLEX CRVD TI 2X300MM,751.5,413.33,225.45,661.32,35
HCPCS,C1713,NAIL IM TIBIAL 10.0X375MM,5772.65,3174.96,1731.8,5079.93,35
HCPCS,C1713,NAIL IM TIBIAL 10.0X390MM,5772.65,3174.96,1731.8,5079.93,35
HCPCS,C1713,NAIL IM TIBIAL 11.0X315MM,5772.65,3174.96,1731.8,5079.93,35
HCPCS,C1713,NAIL IM TIBIAL 11.0X375MM,5772.65,3174.96,1731.8,5079.93,35
HCPCS,C1713,NAIL IM TIBIAL 9.0X360MM,5772.65,3174.96,1731.8,5079.93,35
HCPCS,C1713,NAIL TROCHANTERIC 125 11X180MM,3825.0,2103.75,1147.5,3366.0,35
HCPCS,C1713,OVERWATCH STANDARD DUALFIX SCR,2475.0,1361.25,742.5,2178.0,35
HCPCS,C1713,PIN HALF APEX THRD 5X60X200MM,431.25,237.19,129.38,379.5,35
HCPCS,C1713,PLATE BONE 22 HOLE 263MM RECONSTRUCTION STAINLESS STEEL FOR,2812.63,1546.95,843.79,2475.11,35
HCPCS,C1713,PLATE BONE 24 HOLE CURVED BROAD STAINLESS STEEL LCP FOR 3.5M,3342.02,1838.12,1002.61,2940.98,35
HCPCS,C1713,PLATE BONE CONDYLAR RIGHT 20 HOLE STERILE CURVED 405MM STAIN,8968.36,4932.6,2690.51,7892.16,35
HCPCS,C1713,PLATE BONE FEMUR DISTAL LATERAL RIGHT 14 HOLE 310MM LOCKING,10395.75,5717.67,3118.73,9148.26,35
HCPCS,C1713,PLATE BONE HUMERUS PROXIMAL LATERAL LEFT 4 HOLE 99MM LOCKING,7988.75,4393.82,2396.63,7030.1,35
HCPCS,C1713,PLATE BONE HUMERUS PROXIMAL LATERAL LEFT 6 HOLE 125MM LOCKIN,9221.3,5071.72,2766.39,8114.74,35
HCPCS,C1713,PLATE BONE METAPHYSEAL 18 HOLE 242MM TITANIUM LCP FOR 3.5MM,4592.68,2525.98,1377.8,4041.56,35
HCPCS,C1713,PLATE BONE PELVIC 9 HOLE FLEX STRAIGHT 106.5MM STAINLESS STE,2110.5,1160.78,633.15,1857.24,35
HCPCS,C1713,PLATE BONE PERIARTICULAR HUMERUS PROXIMAL RIGHT 8 HOLE 199MM,6129.14,3371.03,1838.74,5393.64,35
HCPCS,C1713,PLATE BONE TIBIA POSTEROMEDIAL PROXIMAL 6 HOLE 131MM STAINLE,3573.63,1965.5,1072.09,3144.79,35
HCPCS,C1713,PLATE BONE TIBIA PROXIMAL LATERAL LEFT 14 HOLE 251MM LOCKING,8665.2,4765.86,2599.56,7625.38,35
HCPCS,C1713,PLATE BONE TIBIA PROXIMAL MEDIAL LEFT 12 HOLE 175MM LOCKING,7880.85,4334.47,2364.26,6935.15,35
HCPCS,C1713,PLATE BONE TIBIA PROXIMAL MEDIAL LEFT 8 HOLE 123MM LOCKING T,7440.95,4092.53,2232.29,6548.04,35
HCPCS,C1713,PLATE HUM RT 5HOLE 4MMX112MM,7988.75,4393.82,2396.63,7030.1,35
HCPCS,C1713,PLATE SPINAL ANTERIOR CERVICAL 28MM 1 LEVEL LOCKING TITANIUM,3237.03,1780.37,971.11,2848.59,35
HCPCS,C1713,PLATE SPINAL ANTERIOR CERVICAL 57MM 3 LEVEL LOCKING TITANIUM,3617.87,1989.83,1085.36,3183.73,35
HCPCS,C1713,PLT BN RADIUS RT 2XL 8 HOLE 100MM NARROW FOR 2/2.7MM SCR,5407.45,2974.1,1622.24,4758.56,35
HCPCS,C1713,PLT DIST MED HUMERUS 4H 92MM,3987.0,2192.85,1196.1,3508.56,35
HCPCS,C1713,PLT DISTL HUM L 3.5X266MM 12H,11736.2,6454.91,3520.86,10327.86,35
HCPCS,C1713,PLT DISTL LAT FIB L 3.5X109MM,4980.0,2739.0,1494.0,4382.4,35
HCPCS,C1713,PLT DISTL LAT FIB L 3.5X137MM,5291.25,2910.19,1587.38,4656.3,35
HCPCS,C1713,PLT DISTL MED TIB L 3.5X111MM,9590.65,5274.86,2877.2,8439.77,35
HCPCS,C1713,PLT DISTL TIB L 2.7/3.5X161MM,10126.0,5569.3,3037.8,8910.88,35
HCPCS,C1713,PLT DISTL TIB R 2.7/3.5X105MM,9590.65,5274.86,2877.2,8439.77,35
HCPCS,C1713,PLT DISTL TIB R 2.7/3.5X189MM,10657.2,5861.46,3197.16,9378.34,35
HCPCS,C1713,PLT HOOK 2.7X72MM 7H NS,7590.35,4174.7,2277.11,6679.51,35
HCPCS,C1713,PLT HOOK 3.5X79MM 5H NS,7590.35,4174.7,2277.11,6679.51,35
HCPCS,C1713,PLT LAT FEM L 5.0X337MM 14H,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1713,PLT LAT FEM R 5.0X371MM 16H,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1713,PLT LAT FEM R 5.0X406MM 18H,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1713,PLT LAT TIB L 3.5X123MM 4H,9507.65,5229.21,2852.3,8366.73,35
HCPCS,C1713,PLT LAT TIB L 3.5X151MM 6H,9773.25,5375.29,2931.98,8600.46,35
HCPCS,C1713,PLT LAT TIB R 3.5X123MM 4H,9507.65,5229.21,2852.3,8366.73,35
HCPCS,C1713,PLT LAT TIB R 3.5X291MM 16H,12147.05,6680.88,3644.12,10689.4,35
HCPCS,C1713,PLT LAT TIB R 3.5X95MM 2H,9507.65,5229.21,2852.3,8366.73,35
HCPCS,C1713,PLT LCK TIBIA RT 6H 4X123MM,7582.05,4170.13,2274.62,6672.2,35
HCPCS,C1713,PLT MED FEM L 3.5X110MM 3H,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1713,PLT MED FEM L 3.5X124MM 4H,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1713,PLT MED FEM L 3.5X152MM 6H,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1713,PLT MED FEM R 3.5X152MM 6H,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1713,PLT MED FEM R 3.5X96MM 2H,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1713,PLT MED FEM R 5.0X189MM 6H,15929.1,8761.01,4778.73,14017.61,35
HCPCS,C1713,PLT MED TIB R 3.5X128MM 8H,10657.2,5861.46,3197.16,9378.34,35
HCPCS,C1713,PLT MED TIB R 3.5X240MM 16H,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1713,PLT NON-COMP CMF MED 0.6MM MED,4838.07,2660.94,1451.42,4257.5,35
HCPCS,C1713,PLT PARTIAL TIB L 3.5X113MM 5H,11092.95,6101.13,3327.89,9761.8,35
HCPCS,C1713,PLT PARTIAL TIB R 3.5X113MM 5H,11092.95,6101.13,3327.89,9761.8,35
HCPCS,C1713,PLT PARTIAL TIB R 3.5X127MM 6H,11092.95,6101.13,3327.89,9761.8,35
HCPCS,C1713,PLT PARTIAL TIB R 3.5X85MM 3H,10561.75,5808.97,3168.53,9294.34,35
HCPCS,C1713,PLT POSTERIOR FIB R 2.7X109MM,9984.9,5491.7,2995.47,8786.71,35
HCPCS,C1713,PLT POSTERIOR TIB L 3.5X159MM,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1713,PLT POSTERIOR TIB L 3.5X75MM,10881.3,5984.72,3264.39,9575.54,35
HCPCS,C1713,PLT POSTERIOR TIB R 3.5X75MM,10881.3,5984.72,3264.39,9575.54,35
HCPCS,C1713,PLT POSTMED TIB L 3.5X82MM 5H,10018.1,5509.96,3005.43,8815.93,35
HCPCS,C1713,PLT POSTMED TIB L 3.5X96MM 6H,10018.1,5509.96,3005.43,8815.93,35
HCPCS,C1713,PLT POSTMED TIB R 3.5X68MM 4H,8901.75,4895.97,2670.53,7833.54,35
HCPCS,C1713,PLT PROX HUM L 3.5X119MM 5H,10561.75,5808.97,3168.53,9294.34,35
HCPCS,C1713,PLT PROX HUM R 3.5X301MM 18H,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1713,PLT PROX TIB R 5.0X178MM 8H,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1713,PLT STR BROAD 3.5X113MM 7H,4500.0,2475.0,1350.0,3960.0,35
HCPCS,C1713,PLT STR BROAD 5.0X188MM 9H,9242.05,5083.13,2772.62,8133.0,35
HCPCS,C1713,PLT STR BROAD 5.0X205MM 10H,10034.7,5519.09,3010.41,8830.54,35
HCPCS,C1713,PLT STR NARW 3.5X115MM 8H,5419.9,2980.95,1625.97,4769.51,35
HCPCS,C1713,PLT STR NARW 5.0X188MM 9H,11827.5,6505.13,3548.25,10408.2,35
HCPCS,C1713,PLT STR NARW 5.0X205MM 10H,11827.5,6505.13,3548.25,10408.2,35
HCPCS,C1713,PLT T-SHAPE 2.7MM 3TX10,5540.25,3047.14,1662.08,4875.42,35
HCPCS,C1713,PLT T-SHAPE 2.7MM 5TX10,6129.55,3371.26,1838.87,5394.0,35
HCPCS,C1713,PLT TUBULAR 3.5X110MM 9H NS,3537.0,1945.35,1061.1,3112.56,35
HCPCS,C1713,PLT TUBULAR 3.5X122MM 10H NS,3537.0,1945.35,1061.1,3112.56,35
HCPCS,C1713,PLT TUBULAR 3.5X98MM 8H NS,2632.5,1447.88,789.75,2316.6,35
HCPCS,C1713,PLT VARIAX 2 LONG BASE RT 67MM,3234.47,1778.96,970.34,2846.33,35
HCPCS,C1713,PLT VARIAX COMP BROAD CVD 14H,2907.0,1598.85,872.1,2558.16,35
HCPCS,C1713,PLT VARIAX COMP BROAD CVD 9H,2443.5,1343.93,733.05,2150.28,35
HCPCS,C1713,POLYAXIAL SCREW 3.5 X 14MM,2475.0,1361.25,742.5,2178.0,35
HCPCS,C1713,POLYAXIAL SCREW 3.5 X 28MM,2475.0,1361.25,742.5,2178.0,35
HCPCS,C1713,PUTTY BONE GRAFT IFACTOR 2.5CC,5810.0,3195.5,1743.0,5112.8,35
HCPCS,C1713,PUTTY MAGNETOS EASYPACK 1.5CC,3510.0,1930.5,1053.0,3088.8,35
HCPCS,C1713,ROD POST PRELORDOSED 5.5X75MM,787.5,433.13,236.25,693.0,35
HCPCS,C1713,ROD STR EXTRA TI STL 6X300MM,5602.5,3081.38,1680.75,4930.2,35
HCPCS,C1713,SCREW ABUTMENT OPRA 87,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1713,SCREW AXSOS CANC S/T NS 4X14MM,823.5,452.93,247.05,724.68,35
HCPCS,C1713,SCREW AXSOS CANC S/T NS 4X20MM,823.5,452.93,247.05,724.68,35
HCPCS,C1713,SCREW AXSOS CANC S/T NS 4X22MM,823.5,452.93,247.05,724.68,35
HCPCS,C1713,SCREW AXSOS CANC S/T NS 4X24MM,823.5,452.93,247.05,724.68,35
HCPCS,C1713,SCREW AXSOS CANC S/T NS 4X26MM,823.5,452.93,247.05,724.68,35
HCPCS,C1713,SCREW AXSOS CANC S/T NS 4X28MM,823.5,452.93,247.05,724.68,35
HCPCS,C1713,SCREW AXSOS CANC S/T NS 4X34MM,823.5,452.93,247.05,724.68,35
HCPCS,C1713,SCREW AXSOS CANC S/T NS 4X36MM,823.5,452.93,247.05,724.68,35
HCPCS,C1713,SCREW AXSOS CANC S/T NS 4X38MM,823.5,452.93,247.05,724.68,35
HCPCS,C1713,SCREW AXSOS CANC S/T NS 4X40MM,823.5,452.93,247.05,724.68,35
HCPCS,C1713,SCREW AXSOS CANC S/T NS 4X42MM,823.5,452.93,247.05,724.68,35
HCPCS,C1713,SCREW AXSOS CANC S/T NS 4X44MM,823.5,452.93,247.05,724.68,35
HCPCS,C1713,SCREW AXSOS CANC S/T NS 4X46MM,823.5,452.93,247.05,724.68,35
HCPCS,C1713,SCREW AXSOS CANC S/T NS 4X48MM,823.5,452.93,247.05,724.68,35
HCPCS,C1713,SCREW AXSOS CANC S/T NS 4X50MM,823.5,452.93,247.05,724.68,35
HCPCS,C1713,SCREW AXSOS CORT S/T 4.5X30MM,247.25,135.99,74.18,217.58,35
HCPCS,C1713,SCREW AXSOS CORT S/T 4.5X32MM,247.25,135.99,74.18,217.58,35
HCPCS,C1713,SCREW AXSOS CORT S/T 4.5X36MM,247.25,135.99,74.18,217.58,35
HCPCS,C1713,SCREW AXSOS CORT S/T 4.5X38MM,247.25,135.99,74.18,217.58,35
HCPCS,C1713,SCREW AXSOS CORT S/T 4.5X42MM,247.25,135.99,74.18,217.58,35
HCPCS,C1713,SCREW AXSOS CORT S/T 4.5X44MM,247.25,135.99,74.18,217.58,35
HCPCS,C1713,SCREW AXSOS CORT S/T 4.5X46MM,247.25,135.99,74.18,217.58,35
HCPCS,C1713,SCREW AXSOS CORT S/T 4.5X55MM,247.25,135.99,74.18,217.58,35
HCPCS,C1713,SCREW AXSOS CORT S/T 4.5X85MM,247.25,135.99,74.18,217.58,35
HCPCS,C1713,SCREW BONE 5X34MM CORTICAL T20 DRIVE LOCKING SELF TAPPING TI,868.5,477.68,260.55,764.28,35
HCPCS,C1713,SCREW BONE 5X50MM STERILE T25 STARDRIVE RECESS LOCKING SELF,757.8,416.79,227.34,666.86,35
HCPCS,C1713,SCREW BONE 5X65MM VARIABLE ANGLE T25 STARDRIVE RECESS LOCKIN,769.46,423.21,230.84,677.12,35
HCPCS,C1713,SCREW BONE 5X75MM VARIABLE ANGLE T25 STARDRIVE RECESS LOCKIN,769.46,423.21,230.84,677.12,35
HCPCS,C1713,SCREW BONE 5X80MM VARIABLE ANGLE T25 STARDRIVE RECESS LOCKIN,769.46,423.21,230.84,677.12,35
HCPCS,C1713,SCREW BONE 6.4X105MM STERILE ANTIROTATION TITANIUM FEMORAL N,948.78,521.83,284.63,834.93,35
HCPCS,C1713,SCREW BONE 7X80MM CANCELLOUS CANNULATED FULLY THREADED SELF,982.71,540.5,294.81,864.78,35
HCPCS,C1713,SCREW BONE L13MM DIA6MM CORTICAL HUMERAL TITANIUM ADVANCED C,575.0,316.25,172.5,506.0,35
HCPCS,C1713,SCREW BONE T10 FTHRD 2.7X34,488.75,268.82,146.63,430.1,35
HCPCS,C1713,SCREW BONE T10 FTHRD 3.5X65,488.75,268.82,146.63,430.1,35
HCPCS,C1713,SCREW BONE T8 FTHRD 2.4X22,465.75,256.17,139.73,409.86,35
HCPCS,C1713,SCREW CANC FTHRD 7.3DIA 140MM,960.25,528.14,288.08,845.02,35
HCPCS,C1713,SCREW CANC FTHRD 7.3DIA 150MM,960.25,528.14,288.08,845.02,35
HCPCS,C1713,SCREW CANC FTHRD TI 4.0X65MM,241.5,132.83,72.45,212.52,35
HCPCS,C1713,SCREW CANC FTHRD TI 4X48MM,630.0,346.5,189.0,554.4,35
HCPCS,C1713,SCREW CANC FTHRD TI 4X60MM,241.5,132.83,72.45,212.52,35
HCPCS,C1713,SCREW CANC S/D FTHRD 4.5X72MM,882.0,485.1,264.6,776.16,35
HCPCS,C1713,SCREW CANN FTHRD TI 5.0X70MM,828.0,455.4,248.4,728.64,35
HCPCS,C1713,SCREW CENTRAL OPRA E/F,2598.75,1429.32,779.63,2286.9,35
HCPCS,C1713,SCREW CORT LCK TI 3.5X11MM,437.0,240.35,131.1,384.56,35
HCPCS,C1713,SCREW CORT LCK TI 3.5X14MM,460.0,253.0,138.0,404.8,35
HCPCS,C1713,SCREW CORT T8 DRIVE 2.7X12MM,327.75,180.27,98.33,288.42,35
HCPCS,C1713,SCREW CORT T8 DRIVE 2.7X18MM,327.75,180.27,98.33,288.42,35
HCPCS,C1713,SCREW CORT T8 DRIVE 2.7X20MM,327.75,180.27,98.33,288.42,35
HCPCS,C1713,SCREW CORT T8 DRIVE 2.7X24MM,419.75,230.87,125.93,369.38,35
HCPCS,C1713,SCREW CORT T8 DRIVE 2.7X30MM,419.75,230.87,125.93,369.38,35
HCPCS,C1713,SCREW CORT T8 DRIVE 2.7X32MM,419.75,230.87,125.93,369.38,35
HCPCS,C1713,SCREW CORT T8 DRIVE 2.7X34MM,419.75,230.87,125.93,369.38,35
HCPCS,C1713,SCREW CORT T8 DRIVE 2.7X38MM,419.75,230.87,125.93,369.38,35
HCPCS,C1713,SCREW CORT T8 DRIVE 2.7X40MM,419.75,230.87,125.93,369.38,35
HCPCS,C1713,SCREW CORT T8 DRIVE 2.7X42MM,419.75,230.87,125.93,369.38,35
HCPCS,C1713,SCREW CORT T8 DRIVE 2.7X44MM,419.75,230.87,125.93,369.38,35
HCPCS,C1713,SCREW CORT T8 DRIVE 2.7X60MM,465.75,256.17,139.73,409.86,35
HCPCS,C1713,SCREW CORT T8 DRIVE 2.7X70MM,465.75,256.17,139.73,409.86,35
HCPCS,C1713,SCREW FEN SPINAL POSTERIOR THORACOLUMBOSACRAL PEDICLE 6MM X,4455.0,2450.25,1336.5,3920.4,70
HCPCS,C1713,SCREW FEN SPNL SYS 8.5X85MM,15510.0,8530.5,4653.0,13648.8,35
HCPCS,C1713,SCREW FTHRD SS NS 6.5X130MM,1403.6,771.98,421.08,1235.17,35
HCPCS,C1713,SCREW FTHRD SS NS 6.5X145MM,1403.6,771.98,421.08,1235.17,35
HCPCS,C1713,SCREW FTHRD SS NS 6.5X150MM,1403.6,771.98,421.08,1235.17,35
HCPCS,C1713,SCREW FTHRD SS NS 6.5X155MM,1403.6,771.98,421.08,1235.17,35
HCPCS,C1713,SCREW FTHRD SS NS 6.5X160MM,1403.6,771.98,421.08,1235.17,35
HCPCS,C1713,SCREW FTHRD SS NS 6.5X45MM,1079.46,593.71,323.84,949.92,35
HCPCS,C1713,SCREW FTHRD SS NS 6.5X50MM,1079.46,593.71,323.84,949.92,35
HCPCS,C1713,SCREW FTHRD SS NS 6.5X65MM,1079.46,593.71,323.84,949.92,35
HCPCS,C1713,SCREW FTHRD SS NS 6.5X70MM,1079.46,593.71,323.84,949.92,35
HCPCS,C1713,SCREW FTHRD SS NS 6.5X75MM,1079.46,593.71,323.84,949.92,35
HCPCS,C1713,SCREW FTHRD SS NS 6.5X80MM,1079.46,593.71,323.84,949.92,35
HCPCS,C1713,SCREW FTHRD SS NS 6.5X85MM,1079.46,593.71,323.84,949.92,35
HCPCS,C1713,SCREW FTHRD SS NS 6.5X90MM,1079.46,593.71,323.84,949.92,35
HCPCS,C1713,SCREW FTHRD SS NS 6.5X95MM,1079.46,593.71,323.84,949.92,35
HCPCS,C1713,SCREW FTHRD SS NS 8.0X155MM,1456.25,800.94,436.88,1281.5,35
HCPCS,C1713,SCREW FTHRD SS NS 8.0X160MM,1456.25,800.94,436.88,1281.5,35
HCPCS,C1713,SCREW FTHRD SS NS 8.0X165MM,1456.25,800.94,436.88,1281.5,35
HCPCS,C1713,SCREW FTHRD SS NS 8.0X75MM,1120.19,616.11,336.06,985.77,35
HCPCS,C1713,SCREW FTHRD TI NS 6.5X130MM,1403.6,771.98,421.08,1235.17,35
HCPCS,C1713,SCREW GRAFT OPRA F/G,5141.85,2828.02,1542.56,4524.83,35
HCPCS,C1713,SCREW LAG T2 RECON 6.5X100MM,706.5,388.58,211.95,621.72,35
HCPCS,C1713,SCREW LAG T2 RECON 6.5X75MM,706.5,388.58,211.95,621.72,35
HCPCS,C1713,SCREW LAG T2 RECON 6.5X80MM,706.5,388.58,211.95,621.72,35
HCPCS,C1713,SCREW LAG T2 RECON 6.5X85MM,706.5,388.58,211.95,621.72,35
HCPCS,C1713,SCREW LAG T2 RECON 6.5X90MM,706.5,388.58,211.95,621.72,35
HCPCS,C1713,SCREW LAG TI 10.5X110MM,1606.5,883.58,481.95,1413.72,35
HCPCS,C1713,SCREW LCK T10 FTHRD 3.5X44,702.0,386.1,210.6,617.76,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X12MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X14MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X16MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X18MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X20MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X22MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X24MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X26MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X28MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X30MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X32MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X34MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X36MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X38MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X40MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X42MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X44MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X46MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X48MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X50MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X55MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X60MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X65MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X70MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X75MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X80MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T15 DRIVE 3.5X85MM,1044.0,574.2,313.2,918.72,35
HCPCS,C1713,SCREW LCK T20 DRIVE 5.0X14MM,1089.0,598.95,326.7,958.32,35
HCPCS,C1713,SCREW LCK T20 DRIVE 5.0X16MM,1116.0,613.8,334.8,982.08,35
HCPCS,C1713,SCREW LCK T20 DRIVE 5.0X18MM,1116.0,613.8,334.8,982.08,35
HCPCS,C1713,SCREW LCK T8 DRIVE 2.7X10MM,945.0,519.75,283.5,831.6,35
HCPCS,C1713,SCREW LCK T8 DRIVE 2.7X12MM,945.0,519.75,283.5,831.6,35
HCPCS,C1713,SCREW LCK T8 DRIVE 2.7X14MM,945.0,519.75,283.5,831.6,35
HCPCS,C1713,SCREW LCK T8 DRIVE 2.7X26MM,945.0,519.75,283.5,831.6,35
HCPCS,C1713,SCREW LCK T8 DRIVE 2.7X28MM,945.0,519.75,283.5,831.6,35
HCPCS,C1713,SCREW LCK T8 DRIVE 2.7X36MM,945.0,519.75,283.5,831.6,35
HCPCS,C1713,SCREW LCK T8 DRIVE 2.7X38MM,945.0,519.75,283.5,831.6,35
HCPCS,C1713,SCREW LCK T8 DRIVE 2.7X40MM,945.0,519.75,283.5,831.6,35
HCPCS,C1713,SCREW LCK T8 DRIVE 2.7X46MM,958.5,527.18,287.55,843.48,35
HCPCS,C1713,SCREW LCK T8 DRIVE 2.7X48MM,958.5,527.18,287.55,843.48,35
HCPCS,C1713,SCREW LCK T8 DRIVE 2.7X8MM,945.0,519.75,283.5,831.6,35
HCPCS,C1713,SCREW LCK T8 FTHRD 2.7X38,630.0,346.5,189.0,554.4,35
HCPCS,C1713,SCREW LOW PROF 5.0MMX32.5MM,720.0,396.0,216.0,633.6,35
HCPCS,C1713,SCREW LOW PROF 5.0MMX42.5MM,720.0,396.0,216.0,633.6,35
HCPCS,C1713,SCREW LOW PROF 5.0MMX50MM,720.0,396.0,216.0,633.6,35
HCPCS,C1713,SCREW LOW PROF 5.0MMX52.5MM,720.0,396.0,216.0,633.6,35
HCPCS,C1713,SCREW LOW PROF 5.0MMX60MM,1220.85,671.47,366.26,1074.35,35
HCPCS,C1713,SCREW LOW PROF 5.0MMX62.5MM,1220.85,671.47,366.26,1074.35,35
HCPCS,C1713,SCREW LOW PROF 5.0MMX67.5MM,720.0,396.0,216.0,633.6,35
HCPCS,C1713,SCREW MAS TULIP SS 5.5X6 QUAD,2893.5,1591.43,868.05,2546.28,35
HCPCS,C1713,SCREW MAS TULIP SS 5.5X6MM DBL,2893.5,1591.43,868.05,2546.28,35
HCPCS,C1713,SCREW MATRIX S/D TI 1.85X8MM,329.36,181.15,98.81,289.84,35
HCPCS,C1713,SCREW RDC MAS 5.5X6MM DBL STL,2979.0,1638.45,893.7,2621.52,35
HCPCS,C1713,SCREW SCHANZ 2.5/4X10MM,3964.5,2180.48,1189.35,3488.76,35
HCPCS,C1713,SCREW SCHANZ 2.5/4X20MM,3964.5,2180.48,1189.35,3488.76,35
HCPCS,C1713,SCREW SCHANZ 2.5/4X8MM,220250.0,121137.5,66075.0,193820.0,35
HCPCS,C1713,SCREW SET CARBOCLEAR HYBRID,2700.0,1485.0,810.0,2376.0,35
HCPCS,C1713,SCREW SMARTLCK HMMF S/D 2X8MM,782.73,430.51,234.82,688.8,35
HCPCS,C1713,SCREW SOLID SPINAL POSTERIOR THORACOLUMBOSACRAL PEDICLE 6MM,3217.5,1769.63,965.25,2831.4,70
HCPCS,C1713,SCREW SPINAL 3.5X12MM FOR 4MM ROD POSTERIOR OCCIPITOCERVICOT,4624.22,2543.33,1387.27,4069.31,35
HCPCS,C1713,SCREW SPINAL 3.5X14MM FOR 4MM ROD POSTERIOR OCCIPITOCERVICOT,4624.22,2543.33,1387.27,4069.31,35
HCPCS,C1713,SCREW SPINAL 4X12MM VARIABLE ANGLE SELF DRILLING TITANIUM SK,575.0,316.25,172.5,506.0,35
HCPCS,C1713,SCREW SPINAL LUMBAR 5.5X30MM,1125.0,618.75,337.5,990.0,35
HCPCS,C1713,SCREW SPINAL LUMBAR 5.5X40MM,1125.0,618.75,337.5,990.0,35
HCPCS,C1713,SCREW SPINAL LUMBAR 5X25MM,1125.0,618.75,337.5,990.0,35
HCPCS,C1713,SCREW SPINAL LUMBAR 5X30MM,1125.0,618.75,337.5,990.0,35
HCPCS,C1713,SCREW SPINAL LUMBAR 5X35MM,1125.0,618.75,337.5,990.0,35
HCPCS,C1713,SCREW SPINAL LUMBAR 5X40MM,1125.0,618.75,337.5,990.0,35
HCPCS,C1713,SCREW SPINAL POSTERIOR THORACOLUMBOSACRAL PEDICLE 4.5MM X 30,3217.5,1769.63,965.25,2831.4,35
HCPCS,C1713,SCREW SPINAL POSTERIOR THORACOLUMBOSACRAL PEDICLE 6MM X 30MM,3217.5,1769.63,965.25,2831.4,35
HCPCS,C1713,SCREW SPINAL POSTERIOR THORACOLUMBOSACRAL PEDICLE 6MM X 35MM,3217.5,1769.63,965.25,2831.4,35
HCPCS,C1713,SCREW SPNL BREAK-OFF DBL,419.75,230.87,125.93,369.38,35
HCPCS,C1713,SCREW SPNL BREAK-OFF QUAD,419.75,230.87,125.93,369.38,35
HCPCS,C1713,SCREW SPNL SACROILIAC 12X40MMC,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1713,SCREW SPNL SACROILIAC 12X50MMC,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1713,SCREW SPNL X NONCANN  7.5X40MM,12870.0,7078.5,3861.0,11325.6,35
HCPCS,C1713,SCREW SPNL X NONCANN  8.5X40MM,12870.0,7078.5,3861.0,11325.6,35
HCPCS,C1713,SCREW VARIAX LCK T6 2X14MM,882.0,485.1,264.6,776.16,35
HCPCS,C1713,SCREW VARIAX T6 2X12MM,575.0,316.25,172.5,506.0,35
HCPCS,C1713,SCRW 5X38MM HEX DRV SLF TAP/DRILL TITAN LOW PROF ASNIS III,693.0,381.15,207.9,609.84,35
HCPCS,C1713,SCRW SPNL POST OCT 4X12MM FOR 4MM ROD POLY STRL TI SYM,3700.98,2035.54,1110.29,3256.86,35
HCPCS,C1713,SCRW SPNL POST TCS PED 4.5X35MM FOR 5.5/6MM ROD POLY SOLID,3217.5,1769.63,965.25,2831.4,35
HCPCS,C1713,SCRW SPNL POST TCS PED 5MMX30MM POLY SOLID,3217.5,1769.63,965.25,2831.4,35
HCPCS,C1713,SCRW SPNL POST TCS PED 5MMX35MM POLY SOLID,3217.5,1769.63,965.25,2831.4,35
HCPCS,C1713,SCRW SPNL POST TCS PED 5MMX50MM POLY SOLID,3217.5,1769.63,965.25,2831.4,35
HCPCS,C1713,SCRW SPNL POST TCS PED 6MMX50MM FOR 5.5/6MM ROD POLY FEN,4455.0,2450.25,1336.5,3920.4,35
HCPCS,C1713,SCRW SPNL POST TCS PED 6MMX50MM FOR 5.5/6MM ROD POLY SOLID,3217.5,1769.63,965.25,2831.4,35
HCPCS,C1713,SCRW SPNL POST TCS PED 7MMX40MM FOR 5.5/6MM ROD POLYL SOLID,3217.5,1769.63,965.25,2831.4,35
HCPCS,C1713,SCRW SPNL POST TCS PED 7X35MM FOR 5.5/6MM ROD POLY SOLID,3217.5,1769.63,965.25,2831.4,35
HCPCS,C1713,SCRW SPNL POST TCS PED 7X45MM FOR 5.5/6MM ROD POLY SOLID,3217.5,1769.63,965.25,2831.4,35
HCPCS,C1713,SCRW SPNL POST TCS PED 7X50MM FOR 5.5/6MM ROD POLY SOLID,3836.25,2109.94,965.25,3920.4,70
HCPCS,C1713,SCRW SPNL POST TCS PED 8X60MM FOR 5.5/6MM ROD POLY FAV SOLID,4500.0,2475.0,1350.0,3960.0,35
HCPCS,C1713,SCRW SPNL POST TCS PEDICLE 4.5MM X 25MM POLY SOLID,3217.5,1769.63,965.25,2831.4,35
HCPCS,C1713,SCRW SPNL POSTR TCS PED 5MMX40MM FOR 5.5/6MM  POLY SOLID,3217.5,1769.63,965.25,2831.4,35
HCPCS,C1713,SET C2 A0SCREW,287.5,158.13,86.25,253.0,35
HCPCS,C1713,SET MODULEX MAS 4 HEAD 5.5MMC,2398.5,1319.18,719.55,2110.68,35
HCPCS,C1713,SET SCREW,287.5,158.13,86.25,253.0,35
HCPCS,C1713,SET SCREW SPINAL POLYAXIAL PEDICLE PERLA,287.5,158.13,86.25,253.0,35
HCPCS,C1713,SET SCREW SPINAL POSTERIOR THORACOLUMBOSACRAL T27 FOR 5.5MM/,379.5,208.73,113.85,333.96,35
HCPCS,C1713,SET SCREW SPINAL T27 2 PER PACK,702.0,386.1,210.6,617.76,35
HCPCS,C1713,SET SCREW SPINAL T27 4 PER PACK,1404.0,772.2,421.2,1235.52,35
HCPCS,C1713,SETSCREW (PACKED BY 2),575.0,316.25,172.5,506.0,35
HCPCS,C1713,SIZE D CROSS CONNECTOR,1575.0,866.25,472.5,1386.0,35
HCPCS,C1713,STEM HUMERAL PLUS LNG SZ 3,14569.5,8013.23,4370.85,12821.16,35
HCPCS,C1713,STERILE CURE LP 25MM VARIABLE Φ5.5 SELF TAPPING DL SCREW,1125.0,618.75,337.5,990.0,35
HCPCS,C1713,"STERILE CURE LP 37MM, ANTERIOR PLATE ASSEMBLY",12035.0,6619.25,3610.5,10590.8,35
HCPCS,C1713,SYS IB LIG AUG+ W/JUMPSTART,6514.46,3582.96,1954.34,5732.72,35
HCPCS,C1713,TIGHTROPE ABS 3 HOLE BUTTON 11MM CONCAVE,1300.05,715.03,390.02,1144.04,35
HCPCS,C1713,WIRE K 3.2X450MM,431.25,237.19,129.38,379.5,35
HCPCS,C1713,WIRE K 3X285MM,408.25,224.54,122.48,359.26,35
HCPCS,C1713,WIRE K DBL TROCAR STL .054X4IN,287.5,158.13,86.25,253.0,35
HCPCS,C1713,WIRE K FIXAT W/STOP 1.6X150MM,575.0,316.25,172.5,506.0,35
HCPCS,C1713,WIRE K TEMP FIX 2X315MM,230.0,126.5,69.0,202.4,35
HCPCS,C1714,HC CORONARY LASER ATHRECTOMY CATH,7273.0,4000.15,2181.9,6291.15,38
HCPCS,C1714,HC IR DEVICE ATHRECTOMY,12761.0,7018.55,3828.3,11038.27,38
HCPCS,C1714,"HC IR DEVICE ATHRECTOMY, ROTATIONAL, ROTAPRO",7242.0,3983.1,2172.6,6264.33,38
HCPCS,C1714,HC IR DEVICE SILVERHAWK,12825.0,7053.75,3847.5,11093.63,38
HCPCS,C1715,HC BRACHYTHERAPY NDL,230.0,126.5,69.0,202.4,35
HCPCS,C1716,"Brachytx, non-str, Gold-198",,,868.33,894.38,15
HCPCS,C1717,HC BRACHYTX NON-STR HDR IR-192,894.0,491.7,268.2,786.72,50
HCPCS,C1719,"Brachytx, NS, Non-HDRIr-192",,,564.5,581.44,15
HCPCS,C1721,DEFIB COBALT XT DR MRI DUAL DF4C,33000.0,18150.0,9900.0,29040.0,35
HCPCS,C1722,DEFIB COBALT XT VR MRI DF4C,33000.0,18150.0,9900.0,29040.0,35
HCPCS,C1724,"HC IR DEVICE ATHRECTOMY, ROTATIONAL",12783.0,7030.65,3834.9,11057.3,38
HCPCS,C1724,HC ROTOBLATOR BURR TRANSLUMINAL ATHERECT CATH,5074.0,2790.7,1522.2,4389.01,38
HCPCS,C1725,BALLOON RELIANT 12FR 46X100CM,1912.5,1051.88,573.75,1654.31,38
HCPCS,C1725,BALLOON TRI-LOBE 26MM-42MM,3163.5,1739.93,949.05,2736.43,38
HCPCS,C1725,BALLOON Z-MED II 20MMX40MM,3411.0,1876.05,1023.3,2950.52,38
HCPCS,C1725,CATH BALLOON 2.8MM CH 195CM L,616.81,339.25,185.04,533.54,38
HCPCS,C1725,CATH BALLOON PTS SIZING 25MM,1355.4,745.47,406.62,1172.42,38
HCPCS,C1725,CATH DILAT ARMADA 35 4X40X80,396.75,218.22,119.03,343.19,38
HCPCS,C1725,CATH DILAT ARMADA 35 6X40X80,373.75,205.57,112.13,323.29,38
HCPCS,C1725,CATH DILAT ARMADA 35 8X40X80,396.75,218.22,119.03,343.19,38
HCPCS,C1725,CATH SPRINT OTW 2.5X20MM,431.25,237.19,129.38,373.03,38
HCPCS,C1725,DILAT BALLOON 4-5-6MM 100CM,1822.5,1002.38,546.75,1576.46,38
HCPCS,C1725,DILAT CRE 18-20MM 8CM,628.43,345.64,188.53,543.59,38
HCPCS,C1725,HC ARMADA PTA BALLOON,379.0,208.45,113.7,327.84,38
HCPCS,C1725,HC CATH BERENSTEIN .038X100CM 5FR,230.0,126.5,69.0,198.95,38
HCPCS,C1725,HC CONQUEST PTA BALLOON,816.0,448.8,244.8,705.84,38
HCPCS,C1725,HC CORONARY SINUS BALLOON CATH,682.5,375.38,204.75,590.36,38
HCPCS,C1725,HC CUTTING BALLOON CATH,2450.0,1347.5,735.0,2119.25,38
HCPCS,C1725,HC DORADO PTA BALLOON,746.5,410.58,223.95,645.72,38
HCPCS,C1725,"HC GUIDELINER CATHETER, TRANSLUMINAL ANGIOPLASTY, NON-LASER",2042.5,1123.38,612.75,1766.76,38
HCPCS,C1725,HC IR BALLOON ADMIRAL,575.0,316.25,172.5,497.38,38
HCPCS,C1725,HC IR BALLOON AGILTRAC,606.0,333.3,181.8,524.19,38
HCPCS,C1725,HC IR BALLOON AMPHIRION,622.0,342.1,186.6,538.03,38
HCPCS,C1725,HC IR BALLOON ARMADA,374.0,205.7,112.2,323.51,38
HCPCS,C1725,HC IR BALLOON ARMADA LOW PROFILE,575.0,316.25,172.5,497.38,38
HCPCS,C1725,HC IR BALLOON ATLAS,885.0,486.75,265.5,765.53,38
HCPCS,C1725,HC IR BALLOON BLUEMAX,1006.0,553.3,301.8,870.19,38
HCPCS,C1725,HC IR BALLOON CONQUEST,652.0,358.6,195.6,563.98,38
HCPCS,C1725,HC IR BALLOON COYOTE LOW PROFILE,818.5,450.18,245.55,708.0,38
HCPCS,C1725,HC IR BALLOON CROSSTELLA,1335.0,734.25,400.5,1154.78,38
HCPCS,C1725,HC IR BALLOON CUTTING,2705.0,1487.75,811.5,2339.83,38
HCPCS,C1725,HC IR BALLOON CUTTING HIGH,5038.5,2771.18,1511.55,4358.3,38
HCPCS,C1725,HC IR BALLOON DORADO,591.0,325.05,177.3,511.22,38
HCPCS,C1725,HC IR BALLOON ENFORCER,667.5,367.13,200.25,577.39,38
HCPCS,C1725,HC IR BALLOON FOX CROSS,575.0,316.25,172.5,497.38,38
HCPCS,C1725,HC IR BALLOON FOX PLUS,402.5,221.38,120.75,348.16,38
HCPCS,C1725,HC IR BALLOON GATEWAY,4974.5,2735.98,1492.35,4302.94,38
HCPCS,C1725,HC IR BALLOON LOW PROFILE,422.5,232.38,126.75,365.46,38
HCPCS,C1725,HC IR BALLOON MAVERICK,683.0,375.65,204.9,590.8,38
HCPCS,C1725,HC IR BALLOON MUSTANG,575.0,316.25,172.5,497.38,38
HCPCS,C1725,HC IR BALLOON PROFILER,907.5,499.13,272.25,784.99,38
HCPCS,C1725,HC IR BALLOON STERLING,1307.5,719.13,392.25,1130.99,38
HCPCS,C1725,HC IR BALLOON SYMMETRY,1400.0,770.0,420.0,1211.0,38
HCPCS,C1725,HC IR BALLOON SYNERGY,734.0,403.7,220.2,634.91,38
HCPCS,C1725,HC IR BALLOON ULTRATHIN,966.0,531.3,289.8,835.59,38
HCPCS,C1725,HC IR BALLOON VIATRAC,823.5,452.93,247.05,712.33,38
HCPCS,C1725,HC IR BALLOON XXL,1107.5,609.13,332.25,957.99,38
HCPCS,C1725,HC PTCA BALLOON CATH,583.0,320.65,174.9,504.3,38
HCPCS,C1725,HC SHOCKWAVE LITHOTRIPSY CATHETER (C2 CATHETER),10951.0,6023.05,3285.3,9472.62,38
HCPCS,C1725,HC SHOCKWAVE LITHOTRIPSY CATHETER (M5 CATHETER),8030.0,4416.5,2409.0,6945.95,38
HCPCS,C1725,HC STINGRAY CORONARY CTO CATHETER,4911.5,2701.33,1473.45,4248.45,38
HCPCS,C1726,BALLOON DILAT TITAN 4X4X190CM,1057.5,581.63,317.25,914.74,38
HCPCS,C1726,BALLOON DILAT TITAN 6X4X190CM,1057.5,581.63,317.25,914.74,38
HCPCS,C1726,BALLOON DILAT TITAN 8X4X190CM,1057.5,581.63,317.25,914.74,38
HCPCS,C1726,BALLOON EXTRAC PRO RX 15-18MM,641.12,352.62,192.34,554.57,76
HCPCS,C1726,BALLOON EXTRAC PRO RX 9-12MM,641.12,352.62,192.34,554.57,76
HCPCS,C1726,BALLOON EXTRAC PRO XL 15-18MM,559.36,307.65,167.81,483.85,38
HCPCS,C1726,BALLOON EXTRAC PRO XL 9-12MM,559.36,307.65,167.81,483.85,38
HCPCS,C1726,BALLOON UROMAX ULTRA 24FRX4CM,1169.15,643.04,350.75,1011.31,38
HCPCS,C1726,CATH BALLOON,670.5,368.78,201.15,579.98,38
HCPCS,C1726,CATH ENDOFLIP BULLET NOSE TIP,2078.1,1142.96,623.43,1797.56,38
HCPCS,C1726,CATH ENDOFLIP MEASURE ESOPH,2320.2,1276.11,696.06,2006.97,38
HCPCS,C1726,CATH ERCP 5.4FR 2.8MMX195CM,310.5,170.78,93.15,268.58,38
HCPCS,C1726,CATH TITAN DILAT 10MMX4C190M,1057.5,581.63,317.25,914.74,38
HCPCS,C1726,DEVICE SINUS BALLOON,450.11,247.57,135.03,389.35,38
HCPCS,C1726,DILAT BALLOON 15-16.5-18 5.5MM,1282.5,705.38,384.75,1109.36,38
HCPCS,C1726,DILAT BALLOON ELAT 12-13.5-15,1282.5,705.38,384.75,1109.36,38
HCPCS,C1726,DILAT BALLOON ELATION 8-9-10,1282.5,705.38,384.75,1109.36,38
HCPCS,C1726,DILAT BALLOON OD10-11-12MM 2CM,1282.5,705.38,384.75,1109.36,38
HCPCS,C1726,DILAT BALLOON OD6-7-8MM L2CM,1282.5,705.38,384.75,1109.36,38
HCPCS,C1726,DILAT BALLOON OD8-9-10MM L2CM,1282.5,705.38,384.75,1109.36,38
HCPCS,C1726,DILAT CRE 15-18MM 75CM,1324.04,728.23,397.21,1145.29,38
HCPCS,C1726,DILAT CRE 18-20MM 180CM,843.89,464.14,253.17,729.96,38
HCPCS,C1726,DILAT CRE 18-20MM 240CM,843.89,464.14,253.17,729.96,38
HCPCS,C1726,DILAT CRE 18-20MM 75CM,1324.04,728.23,397.21,1145.29,38
HCPCS,C1726,DILAT CRE 6-8MM 240CM,843.89,464.14,253.17,729.96,38
HCPCS,C1726,DILAT CRE 8-10MM 180CM,843.89,464.14,253.17,729.96,38
HCPCS,C1726,DILAT CRE 8-10MM 240CM,843.89,464.14,253.17,729.96,38
HCPCS,C1726,DILAT ESO/PYL/COLON 10-12MM,843.89,464.14,253.17,729.96,38
HCPCS,C1726,DILAT ESO/PYL/COLON 12-15MM,843.89,464.14,253.17,729.96,38
HCPCS,C1726,DILAT ESO/PYL/COLON 15-18MM,843.89,464.14,253.17,729.96,38
HCPCS,C1726,DILAT HERCULES ESOPH 10-12MM,886.5,487.58,265.95,766.82,38
HCPCS,C1726,DILAT HERCULES GUIDED 15-18MM,1039.5,571.73,311.85,899.17,38
HCPCS,C1726,DILAT HERCULES GUIDED 8-10MM,1039.5,571.73,311.85,899.17,38
HCPCS,C1726,"HC IR BALLOON, NON-VASCULAR GI",927.0,509.85,278.1,801.86,38
HCPCS,C1726,"HC IR BRONCH BALLOON, PULMONARY",890.0,489.5,267.0,769.85,38
HCPCS,C1726,"HC OPTILUME CATHETER, BALLOON DILATATION, NONVASCULAR",8694.5,4781.98,2608.35,7520.74,38
HCPCS,C1728,HC CATH BRACHYTX SEED ADMIN,4660.0,2563.0,172.5,7564.43,76
HCPCS,C1729,BAG DRN EXTNL ACCUDRAIN 700ML,241.96,133.08,72.59,209.3,38
HCPCS,C1729,CATH BILIARY DILAT 7-5FR,576.0,316.8,172.8,498.24,38
HCPCS,C1729,CATH DUODENAL ASPIRATION,280.26,154.15,84.08,242.42,38
HCPCS,C1729,CATH LUMBAR CLSD W/GUIDE,1265.04,695.78,379.51,1094.26,38
HCPCS,C1729,CATH PASSER UNISHUNT SM,575.0,316.25,172.5,497.38,38
HCPCS,C1729,CATH PERITONEAL STR 2.2MM 120,1713.74,942.56,514.12,1482.39,38
HCPCS,C1729,CLIP ANEU L PERM MINI STR 7MM,2165.31,1190.93,649.59,1872.99,38
HCPCS,C1729,DEVICE DECOMP COLON 10FR,688.5,378.68,206.55,595.55,38
HCPCS,C1729,DRN BACTISEAL VENTRICUL EXTNL,1901.25,1045.69,570.38,1644.58,38
HCPCS,C1729,DRN CATH VENTRI EXTNL 35CM,726.25,399.44,217.88,628.21,38
HCPCS,C1729,HC CATH DRAIN MP 10.2 FR X 35CM,428.5,235.68,128.55,370.65,38
HCPCS,C1729,HC CATH DRAIN MP 10.2 FR X 45CM,575.0,316.25,172.5,497.38,38
HCPCS,C1729,HC CATH DRAIN MP 18-20 FR X 25 CM,289.5,159.23,86.85,250.42,38
HCPCS,C1729,HC CATH DRAIN MP 20-22 FR X 40 CM,230.0,126.5,69.0,198.95,38
HCPCS,C1729,HC CATH DRAIN MP UT,230.0,126.5,69.0,198.95,76
HCPCS,C1729,HC CATH DRAIN SKAT 6-14 FR,322.0,177.1,96.6,278.53,76
HCPCS,C1729,HC CATH FLEX BIL LOCK-PIG,351.0,193.05,105.3,303.62,76
HCPCS,C1729,HC DRAIN COOK MULTI PURP 25 CM,364.5,200.48,109.35,315.29,38
HCPCS,C1729,HC HYS-SAL CATH MD TECH 5 FR,230.0,126.5,69.0,198.95,114
HCPCS,C1729,HC IR BRONCH PNEUMO KIT,896.0,492.8,268.8,775.04,38
HCPCS,C1729,HC IR BX CASTENADA BRUSH,3049.0,1676.95,914.7,2637.39,38
HCPCS,C1729,HC IR DRAIN ASPIRA CATH KIT,4454.5,2449.98,1336.35,3853.14,38
HCPCS,C1729,HC IR DRAIN BENTEC SILICONE CATH,335.0,184.25,100.5,289.78,38
HCPCS,C1729,HC IR DRAIN BIL X-T HOLES,352.5,193.88,105.75,304.91,38
HCPCS,C1729,HC IR DRAIN COOK BILIARY,388.5,213.68,116.55,336.05,38
HCPCS,C1729,HC IR DRAIN COOK MULTI PURP 45 CM,440.0,242.0,132.0,380.6,38
HCPCS,C1729,HC IR DRAIN COOK MULTI PURP 60 CM,575.0,316.25,172.5,497.38,38
HCPCS,C1729,HC IR DRAIN DAWSON-MUELLER,256.0,140.8,76.8,221.44,38
HCPCS,C1729,HC IR DRAIN FLEXIMA BILIARY,409.0,224.95,122.7,353.79,38
HCPCS,C1729,HC IR DRAIN FLEXIMA NEPH,230.0,126.5,69.0,198.95,38
HCPCS,C1729,HC IR DRAIN LRG BORE MP GORDON,364.5,200.48,109.35,315.29,38
HCPCS,C1729,HC IR DRAIN PLEUREX CATHETER,2965.0,1630.75,889.5,2564.73,38
HCPCS,C1729,HC IR DRAIN SKATER CATH,316.0,173.8,94.8,273.34,38
HCPCS,C1729,HC IR PLEURX KIT,3515.5,1933.53,1054.65,3040.91,38
HCPCS,C1729,KIT BALLOON NEPHRO XFORCE 7FR,1350.0,742.5,405.0,1167.75,38
HCPCS,C1729,KIT CATH PLEURX PLEURAL 15.5F,2549.25,1402.09,764.78,2205.1,38
HCPCS,C1729,RESERVOIR OMAYA 2.5,1925.87,1059.23,577.76,1665.88,38
HCPCS,C1729,SYS DRN EXTERNAL CSF ACCUDRAIN,1112.58,611.92,333.77,962.38,38
HCPCS,C1729,TRAY FUHRMAN PLEURAL DRNAGE,834.75,459.12,250.43,722.06,38
HCPCS,C1729,TUBE DECOMP,657.0,361.35,197.1,568.31,38
HCPCS,C1730,CATH ADVISOR HD GRID MAP DF,9673.65,5320.51,2902.1,8367.71,38
HCPCS,C1730,CATH DECA CRD 6FR,1125.0,618.75,337.5,973.13,38
HCPCS,C1730,CATH EP DECA 7F 2-8MM 120CM,1702.89,936.59,510.87,1473.0,38
HCPCS,C1730,HC CHRISTA EP CATH,3509.0,1929.95,1052.7,3035.29,38
HCPCS,C1730,HC DECA EP CATH,1143.0,628.65,342.9,988.7,38
HCPCS,C1730,HC QUAD EP CATH,1286.0,707.3,385.8,1112.39,38
HCPCS,C1730,KIT BIPOLAR PACING 5FR,576.86,317.28,173.06,498.98,38
HCPCS,C1731,HC DUO DECA EP CATH (1),2593.5,1426.43,778.05,2243.38,38
HCPCS,C1731,HC LASSO EP CATH,4361.0,2398.55,1308.3,3772.27,38
HCPCS,C1732,CATH EP NAVISTAR CRV D TYPE,9698.55,5334.21,2909.57,8389.25,38
HCPCS,C1732,CATH EP NAVISTAR CRV F TYPE,9698.55,5334.21,2909.57,8389.25,38
HCPCS,C1732,HC CARTO THERMOCOOL ABLATION 3D MAPPING EP CATH,6328.5,3480.68,1898.55,5474.15,38
HCPCS,C1732,HC PENTA 3D MAPPING EP CATHETER,5349.5,2942.23,1604.85,4627.32,38
HCPCS,C1733,HC CRYO BALLOON,12120.5,6666.28,3636.15,10484.23,38
HCPCS,C1733,HC DEFLECTABLE-STEERABLE EP CATH,3010.5,1655.78,903.15,2604.08,38
HCPCS,C1733,HC NON CARTO ABLATION EP CATH,3848.0,2116.4,1154.4,3328.52,38
HCPCS,C1747,DEVICE CVAC SYS SGL USE DISP,12450.0,6847.5,3735.0,10769.25,38
HCPCS,C1750,CATH SWAN NECK CRUL 2 CUFF LT,723.78,398.08,217.13,636.93,35
HCPCS,C1750,HC IR CVC BARD HD CATH,822.5,452.38,246.75,711.46,38
HCPCS,C1750,HC IR CVC DECATHLON HD CATH,1355.0,745.25,406.5,1172.08,38
HCPCS,C1750,HC IR CVC HEMOCATH TEMP HD CATH,353.5,194.43,106.05,305.78,38
HCPCS,C1750,HC IR CVC HEMOSPLIT HD CATH,1305.0,717.75,391.5,1128.83,38
HCPCS,C1750,HC IR CVC PALINDROME HD CATH,1100.0,605.0,330.0,951.5,38
HCPCS,C1750,HC IR CVC TUNNELED HD CATH,1111.0,611.05,333.3,961.02,38
HCPCS,C1750,HC IR CVC VAXCEL HD CATH,1342.25,738.24,399.45,1170.35,76
HCPCS,C1750,HC IR CVC VECTORFLOW HD CATH,1562.5,859.38,468.75,1351.56,38
HCPCS,C1751,CATH ARTERIAL SWAN GANZ 4LUMEN,575.0,316.25,172.5,497.38,38
HCPCS,C1751,CATH C-MC 5F 038INX100CM 5CM,563.5,309.93,169.05,487.43,38
HCPCS,C1751,CATH INFSN 100X50CM,683.55,375.96,205.07,591.27,38
HCPCS,C1751,HC IR CVC AQUAPHRS DBL LUMEN CATH,269.5,148.23,80.85,233.12,38
HCPCS,C1751,HC IR CVC CVL ARROW DUAL LUMEN,444.0,244.2,133.2,384.06,38
HCPCS,C1751,HC IR CVC CVL ARROW TRIPLE LUMEN,575.0,316.25,172.5,497.38,38
HCPCS,C1751,HC IR CVC GROSHONG CATH,1492.0,820.6,447.6,1290.58,38
HCPCS,C1751,HC IR CVC HICKMAN CATHETER,796.0,437.8,238.8,688.54,38
HCPCS,C1751,HC IR CVC HICKMAN POWER CATHETER,2278.0,1252.9,683.4,1970.47,38
HCPCS,C1751,HC IR CVC NEOSTAR CATHETER,783.0,430.65,234.9,677.3,38
HCPCS,C1751,HC IR CVC PICC 4 FR,449.0,246.95,134.7,388.39,38
HCPCS,C1751,HC IR CVC PICC LINE,374.0,205.7,112.2,323.51,38
HCPCS,C1751,HC IR CVC PICC LINE POWER,592.0,325.6,177.6,512.08,38
HCPCS,C1751,HC IR CVC PICC LINE W CUFF 5 FR,1232.5,677.88,369.75,1066.11,38
HCPCS,C1751,HC IR CVC PICC TRIPLE LUMEN,803.5,441.93,241.05,695.03,38
HCPCS,C1751,HC IR CVC TRIFUSION CATHETER,1614.5,887.98,484.35,1396.54,38
HCPCS,C1751,HC MIDLINE INF CATH,606.0,333.3,181.8,524.19,38
HCPCS,C1751,HC PICC INF CATH,368.5,202.68,110.55,318.75,114
HCPCS,C1751,HC POWER PICC INF CATH,575.0,316.25,172.5,497.38,76
HCPCS,C1751,HC TRIPLE LUMEN KIT,575.0,316.25,172.5,497.38,38
HCPCS,C1752,HC IR CVC MAHURKAR HD CATH,391.0,215.05,117.3,338.22,38
HCPCS,C1752,HC IR CVC MAHURKAR TRIP LUMEN HD CATH,575.0,316.25,172.5,497.38,38
HCPCS,C1752,HC IR CVC MEDCOMP HD CATH,247.0,135.85,74.1,213.66,38
HCPCS,C1752,HC IR CVC SCHON HD CATH,575.0,316.25,172.5,497.38,38
HCPCS,C1753,CATH OPTICROSS 6 HD,3487.5,1918.13,1046.25,3016.69,38
HCPCS,C1753,CATH OPTICROSS HD 3.1FRX135CM,3487.5,1918.13,1046.25,3016.69,38
HCPCS,C1753,HC INTRAVASC ULTRASOUND CATH,2632.5,1447.88,789.75,2277.11,38
HCPCS,C1753,HC IR CATH IVUS 0.035,4971.5,2734.33,1491.45,4300.35,38
HCPCS,C1753,HC IR CATH IVUS SONIC ULTRASOUND CATH,3335.5,1834.53,1000.65,2885.21,38
HCPCS,C1755,CATH INTRASPINE ASCENDA SHT,4946.8,2720.74,1484.04,4278.98,38
HCPCS,C1757,CATH EMB ART TUBE 4FR 80CM,380.59,209.33,114.18,329.21,38
HCPCS,C1757,CATH EMB GRAFT 5FR 50CM,1826.87,1004.78,548.06,1580.24,38
HCPCS,C1757,CATH EMB LEMAITRE 6FR 40CM,575.0,316.25,172.5,497.38,38
HCPCS,C1757,CATH FOGAR ADHERENT 8MM,1096.07,602.84,328.82,948.1,38
HCPCS,C1757,CATH PRONTO LOW PROF 6FR,2718.0,1494.9,815.4,2351.07,38
HCPCS,C1757,CATH SYNTEL REG TIP 2FR 60CM,760.5,418.28,228.15,657.83,38
HCPCS,C1757,CATH SYNTEL REG TIP 3FR 80CM,575.0,316.25,172.5,497.38,38
HCPCS,C1757,CATH SYNTEL REG TIP 4FR 80CM,575.0,316.25,172.5,497.38,38
HCPCS,C1757,CATH SYNTEL REG TIP 5FR 80CM,575.0,316.25,172.5,497.38,38
HCPCS,C1757,CATH SYNTEL REG TIP 6FR 80CM,575.0,316.25,172.5,497.38,38
HCPCS,C1757,CATH SYNTEL REG TIP 7FR 80CM,575.0,316.25,172.5,497.38,38
HCPCS,C1757,CATH THROMB SOLENT PROX 90CM,15922.5,8757.38,4776.75,13772.96,38
HCPCS,C1757,CLIP ANEU L PERM LIGHT CRVD 7,2165.31,1190.93,649.59,1872.99,38
HCPCS,C1757,CLIP ANEU L PERM STR 7MM,2165.31,1190.93,649.59,1872.99,38
HCPCS,C1757,HC IR THROMB ANGIOJET 6 FR,6712.0,3691.6,2013.6,5805.88,38
HCPCS,C1757,HC IR THROMB ANGIOJET 6 FR/50 CM AVX,5575.5,3066.53,1672.65,4822.81,38
HCPCS,C1757,HC IR THROMB ANGIOJET SOLENT DISTA,8451.5,4648.33,2535.45,7310.55,38
HCPCS,C1757,HC IR THROMB CAPTURE DEVICE,21336.5,11735.08,6400.95,18456.07,38
HCPCS,C1757,HC IR THROMB CATH CLEANER XT 135,3536.0,1944.8,1060.8,3058.64,38
HCPCS,C1757,HC IR THROMB CATH CLEANER XT 65,2965.0,1630.75,889.5,2564.73,38
HCPCS,C1757,HC IR THROMB CATH CLOTTRIEVER,23800.0,13090.0,7140.0,20587.0,38
HCPCS,C1757,HC IR THROMB CATH EMBOLECTOMY,345.5,190.03,103.65,298.86,38
HCPCS,C1757,HC IR THROMB CATH FLOWTRIEVER,33000.0,18150.0,9900.0,28545.0,38
HCPCS,C1757,HC IR THROMB CATH FOGARTY 3 FR,345.5,190.03,103.65,298.86,38
HCPCS,C1757,HC IR THROMB CATH FOGARTY 4 FR,938.5,516.18,281.55,811.8,38
HCPCS,C1757,HC IR THROMB CATH FOGARY ADHERENT,750.0,412.5,225.0,648.75,38
HCPCS,C1757,HC IR THROMB CATH IN THRILL,8360.0,4598.0,2508.0,7231.4,38
HCPCS,C1757,HC IR THROMB CATH INDIGO LIGHTNING,23154.0,12734.7,6946.2,20028.21,38
HCPCS,C1757,HC IR THROMB CATH INDIGO LIGHTNING FLASH,33000.0,18150.0,9900.0,28545.0,38
HCPCS,C1757,HC IR THROMB CATH LIGHTNING BOLT,27267.5,14997.13,8180.25,23586.39,38
HCPCS,C1757,HC IR THROMB EMBOLECTOMY CATH GW,262.5,144.38,78.75,227.06,38
HCPCS,C1757,HC IR THROMB PENUMBRA 3D REVASC,18970.5,10433.78,5691.15,16409.48,38
HCPCS,C1757,HC IR THROMB PENUMBRA INDIGO ASPIRATION CATH  KIT LOW,8151.0,4483.05,2445.3,7050.62,38
HCPCS,C1757,HC IR THROMB PENUMBRA KIT HIGH,17898.0,9843.9,5369.4,15481.77,38
HCPCS,C1757,HC IR THROMB SOLITAIRE DEVICE,20382.5,11210.38,6114.75,17630.86,38
HCPCS,C1757,HC IR THROMB TRELLIS DEVICE,7079.5,3893.73,2123.85,6123.77,38
HCPCS,C1757,HC IR THROMB TREROTOLA CATHETER,3011.5,1656.33,903.45,2604.95,38
HCPCS,C1757,HC IR THROMB TREVO PRO DEVICE,30015.0,16508.25,9004.5,25962.98,38
HCPCS,C1757,HC IR THROMB ZELANTE 8 FR,12697.5,6983.63,3809.25,10983.34,38
HCPCS,C1757,HC IR TROMB PENUMBRA INDIGO ASPIRATION CATH KIT HIGH,12783.0,7030.65,3834.9,11057.3,38
HCPCS,C1757,KIT 5.3X140 TIP/TUBE INDIGO RX,7470.0,4108.5,2241.0,6461.55,38
HCPCS,C1757,SYS POUNCE LP 7FR 150CM,16335.0,8984.25,4900.5,14129.78,38
HCPCS,C1758,CATH URET DL W/AQ 6/10FR 50CM,239.95,131.98,71.99,207.56,38
HCPCS,C1758,HC IR  CATH STENT URET POLLACK,230.0,126.5,69.0,198.95,38
HCPCS,C1759,CATH U/S SOUNDSTAR 3D 8F,12321.35,6776.75,3696.41,10657.97,38
HCPCS,C1759,HC ACUNAV INTRACARDIAC ECHO CATH,3150.0,1732.5,945.0,2724.75,38
HCPCS,C1759,HC IR CATHETER ACUNAV US,11400.0,6270.0,3420.0,9861.0,38
HCPCS,C1759,HC SOUNDSTAR INTRACARDIAC ECHO CATH,7341.0,4037.55,2202.3,6349.97,38
HCPCS,C1760,DEVICE MED CLOSURE PERCLOSE 6F,1017.0,559.35,305.1,879.71,38
HCPCS,C1760,DEVICE PROSTYLE VASC CLOSURE,1017.0,559.35,305.1,879.71,38
HCPCS,C1760,HC CVC-CATALYST LAAO IDE G190285,33000.0,18150.0,9900.0,28545.0,38
HCPCS,C1760,HC IR CLOSER DEVICE 6 FR,1047.5,576.13,314.25,921.8,35
HCPCS,C1760,HC IR CLOSURE DEVICE AXERA,1000.0,550.0,300.0,880.0,35
HCPCS,C1760,HC IR CLOSURE DEVICE PERCLOSE,685.5,377.03,205.65,603.24,35
HCPCS,C1760,HC IR CLOSURE DEVICE STARCLOSE,679.0,373.45,203.7,597.52,35
HCPCS,C1760,"HC IR CLOSURE DEVICE, VASCULAR SEAL",951.0,523.05,285.3,836.88,35
HCPCS,C1760,"HC IR DEVICE, CLOSURE, VASCADE",877.5,482.63,263.25,772.2,35
HCPCS,C1760,HC VASCULAR CLOSURE DEVICE ANGIOSEAL,775.0,426.25,232.5,682.0,35
HCPCS,C1760,HC VASCULAR CLOSURE DEVICE PERCLOSE,945.0,519.75,283.5,831.6,35
HCPCS,C1760,"HC VASCULAR CLOSURE DEVICE, LAA",44751.5,24613.33,13425.45,39381.32,35
HCPCS,C1760,HC VENOUS VASCULAR CLOSURE SYSTEM,1225.0,673.75,367.5,1078.0,35
HCPCS,C1760,SYS VASCADE VASC CLOSURE 6-12FR,1057.5,581.63,317.25,914.74,38
HCPCS,C1761,HC SHOCKWAVE LITHOTRIPSY CATHETER (C2 CATHETER),10951.0,6023.05,3285.3,9472.62,38
HCPCS,C1761,HC SHOCKWAVE LITHOTRIPSY CATHETER (M5 CATHETER),8030.0,4416.5,2409.0,6945.95,38
HCPCS,C1762,ALLOG AXIS DERMIS 4X7CM,6515.5,3583.53,1954.65,5733.64,35
HCPCS,C1762,GRAFT DURA GUARD 4X4CM,1503.59,826.98,451.08,1323.16,35
HCPCS,C1762,GRAFT NERVE AVANCE 1 2X15MM,11234.05,6178.73,3370.22,9885.96,35
HCPCS,C1762,GRAFT NERVE AVANCE 1 2X30MM,14751.0,8113.05,4425.3,12980.88,35
HCPCS,C1762,GRAFT NERVE AVANCE 1 2X50MM,22238.7,12231.29,6671.61,19570.06,35
HCPCS,C1762,GRAFT NERVE AVANCE 1 2X70MM,28228.2,15525.51,8468.46,24840.82,35
HCPCS,C1762,GRAFT NERVE AVANCE 3 4X30MM,14751.0,8113.05,4425.3,12980.88,35
HCPCS,C1762,GRAFT NERVE AVANCE 3 4X70MM,30944.1,17019.26,9283.23,27230.81,35
HCPCS,C1762,GRAFT NERVE AVANCE 4 5X50MM,23852.4,13118.82,7155.72,20990.11,35
HCPCS,C1762,GRAFT SKIN MESH  2:1 154 SQ CM,1836.0,1009.8,550.8,1615.68,35
HCPCS,C1762,GRAFT SKIN MESH 1:1 232 SQ CM,2767.5,1522.13,830.25,2435.4,35
HCPCS,C1762,GRAFT SKIN MESH 2:1 103 SQ CM,1228.5,675.68,368.55,1081.08,35
HCPCS,C1762,GRAFT SKIN MESH 2:1 232 SQ CM,2767.5,1522.13,830.25,2435.4,35
HCPCS,C1762,IMPL TUTOPLAST 4X7CM,10524.4,5788.42,3157.32,9261.47,35
HCPCS,C1762,IMPL TUTOPLAST PERICARDIUM,1026.0,564.3,307.8,902.88,35
HCPCS,C1763,CONN NERVE AXOGUARD 4X10MM,5917.9,3254.85,1775.37,5207.75,35
HCPCS,C1763,CONN NERVE AXOGUARD 5X10MM,5917.9,3254.85,1775.37,5207.75,35
HCPCS,C1763,GRAFT BIODESIGN DURA 4X7CM,3172.5,1744.88,951.75,2791.8,35
HCPCS,C1763,GRAFT BIODESIGN DURA 7X10CM,4441.5,2442.83,1332.45,3908.52,35
HCPCS,C1763,GRAFT DURAGEN MATRIX 2X2,1635.52,899.54,490.66,1439.26,35
HCPCS,C1763,HC IR MISC FISTULA PLUG,11791.5,6485.33,3537.45,10376.52,35
HCPCS,C1763,MATRIX MYRIAD 2 LAYER 10X20CM,4010.63,2205.85,1203.19,3529.35,35
HCPCS,C1763,MATRIX MYRIAD 2 LAYER 20X20XM,6754.13,3714.78,2026.24,5943.63,35
HCPCS,C1763,MATRIX MYRIAD 3 LAYER 10X20CM,7319.6,4025.78,2195.88,6441.25,35
HCPCS,C1763,MATRIX MYRIAD 3 LAYER 5X5CM,992.12,545.67,297.64,873.07,35
HCPCS,C1763,MATRIX MYRIAD 3 LAYER 7X10CM,2976.35,1637.0,892.91,2619.19,35
HCPCS,C1763,MATRIX MYRIAD FINE 2000MG,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1763,MEMBRANE COLLAGEN DURA 3X3,2720.57,1496.32,816.17,2394.1,35
HCPCS,C1763,MEMBRANE COLLAGEN DURA 4X5,4462.56,2454.41,1338.77,3927.05,35
HCPCS,C1763,PATCH PERI-GUARD 10X16CM,4265.78,2346.18,1279.73,3753.89,35
HCPCS,C1766,CATH AGILIS STEERABLE MED CURL,4090.5,2249.78,1227.15,3538.28,38
HCPCS,C1766,HC BIOPSY SHEATH FLEX CATHETER,577.0,317.35,173.1,499.11,38
HCPCS,C1766,HC MICROPUNCTURE SET,351.0,193.05,105.3,303.62,38
HCPCS,C1766,HC MOBI GUIDING SHEATH CATH,2735.5,1504.53,820.65,2366.21,38
HCPCS,C1766,INTRO RB 16FRX35CM,575.0,316.25,172.5,497.38,38
HCPCS,C1766,SHEATH TOURGUIDE CRV 6.5F 9MM,2475.0,1361.25,742.5,2140.88,38
HCPCS,C1766,SHEATH TOURGUIDE CRV 7F 9MM,2475.0,1361.25,742.5,2140.88,38
HCPCS,C1766,SHEATH TOURGUIDE CRV 8.5F 17MM,2475.0,1361.25,742.5,2140.88,38
HCPCS,C1766,SHEATH TOURGUIDE CRVD 90X6.5FRC,2592.0,1425.6,777.6,2242.08,38
HCPCS,C1767,GENERATOR ENTERRA II GASTRIC,33000.0,18150.0,9900.0,29040.0,35
HCPCS,C1767,GENERATOR VNS MODEL 106,89157.5,49036.63,26747.25,78458.6,35
HCPCS,C1767,GENERATOR VNS SENTIVA SGL,100307.5,55169.13,30092.25,88270.6,35
HCPCS,C1767,SYS GEN PULSE INSPIRE II,45562.5,25059.38,13668.75,40095.0,35
HCPCS,C1767,SYS GEN PULSE INSPIRE V,54000.0,29700.0,16200.0,47520.0,35
HCPCS,C1768,GRAFT AAA BIFURC FLEX 12X112,31185.0,17151.75,9355.5,27442.8,35
HCPCS,C1768,GRAFT ENDOPRSTH 16F 26X14X12,33000.0,18150.0,9900.0,29040.0,35
HCPCS,C1768,GRAFT GELSOFT+ BIFURCATE 12X6,4230.0,2326.5,1269.0,3722.4,35
HCPCS,C1768,GRAFT GELSOFT+ BIFURCATE 14X7,4230.0,2326.5,1269.0,3722.4,35
HCPCS,C1768,GRAFT GELSOFT+ BIFURCATE 22X11,4230.0,2326.5,1269.0,3722.4,35
HCPCS,C1768,GRAFT GELSOFT+ BIFURCATE 24X12,4230.0,2326.5,1269.0,3722.4,35
HCPCS,C1768,GRAFT GELSOFT+ STR 18X50,3478.5,1913.18,1043.55,3061.08,35
HCPCS,C1768,GRAFT GELWEAVE ANTEFLO 24X10MM,6913.9,3802.65,2074.17,6084.23,35
HCPCS,C1768,GRAFT GELWEAVE STR 36MMX30CM,3015.0,1658.25,904.5,2653.2,35
HCPCS,C1768,GRAFT GELWEAVE STR L15CM D10MM,3015.0,1658.25,904.5,2653.2,35
HCPCS,C1768,GRAFT GELWEAVE STR L30CM D24MM,3015.0,1658.25,904.5,2653.2,35
HCPCS,C1768,GRAFT GELWEAVE STR L30CM D26MM,3015.0,1658.25,904.5,2653.2,35
HCPCS,C1768,GRAFT GELWEAVE STR L30CM D34MM,3015.0,1658.25,904.5,2653.2,35
HCPCS,C1768,GRAFT GELWEAVE STR L30CM D36MM,3015.0,1658.25,904.5,2653.2,35
HCPCS,C1768,GRAFT HEMASHIELD 10MMX30CM,2263.55,1244.96,679.07,1991.92,35
HCPCS,C1768,GRAFT HEMASHIELD D 8MM L 30CM,2421.99,1332.1,726.6,2131.35,35
HCPCS,C1768,GRAFT PATCH GORE .6MM 5X7.5CM,2205.0,1212.75,661.5,1940.4,35
HCPCS,C1768,GRAFT SIENA PLEXUS 50CM X 26MM,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1768,GRAFT THORACOABDOMINAL 24MM,14817.0,8149.35,4445.1,13038.96,35
HCPCS,C1768,GRAFT THORACOABDOMINAL 26MM,13497.0,7423.35,4049.1,11877.36,35
HCPCS,C1768,GRAFT THORACOABDOMINAL 30MM,14817.0,8149.35,4445.1,13038.96,35
HCPCS,C1768,GRAFT TW STRETCH 6X80CM,5133.55,2823.46,1540.07,4517.52,35
HCPCS,C1768,GRAFT VAS ANTE FLO 30X10MM,6913.9,3802.65,2074.17,6084.23,35
HCPCS,C1768,"HC IR GRAFT, VASCULAR",5259.5,2892.73,1577.85,4628.36,35
HCPCS,C1768,PAD FELT TEFLON 6X6,1381.23,759.68,414.37,1215.48,35
HCPCS,C1768,PATCH PERICARD XENOSURE 1X14CM,1840.5,1012.28,552.15,1619.64,35
HCPCS,C1768,PATCH SUPPLE PERI-GUARD 6X8CM,2963.48,1629.92,889.04,2607.86,35
HCPCS,C1769,CATH COMET PRESSURE WIRE 185CM,2700.0,1485.0,810.0,2335.5,38
HCPCS,C1769,CATH OPTITORQUE JACKY 5FR,258.75,142.32,77.63,223.82,38
HCPCS,C1769,CATH OPTITORQUE SARAH 5FR,258.75,142.32,77.63,223.82,38
HCPCS,C1769,GLIDEWIRE VAS STIFF STR 260CM,330.63,181.85,99.19,285.99,38
HCPCS,C1769,GUIDE PIN 3.2MMX343MM,855.72,470.65,256.72,740.2,38
HCPCS,C1769,GUIDEWIRE BALL TIP 2.5X800MM,575.0,316.25,172.5,497.38,38
HCPCS,C1769,GUIDEWIRE BALL TIP 3X1000MM,575.0,316.25,172.5,497.38,38
HCPCS,C1769,GUIDEWIRE BALL TIP 3X800MM,575.0,316.25,172.5,497.38,38
HCPCS,C1769,GUIDEWIRE BMW .014X190 STR,675.0,371.25,202.5,583.88,38
HCPCS,C1769,GUIDEWIRE COMMAND ES .014X300,850.5,467.78,255.15,735.68,38
HCPCS,C1769,GUIDEWIRE EXT DOC .014-.018,546.25,300.44,163.88,472.51,38
HCPCS,C1769,GUIDEWIRE FIELDER XT-A 190CM,607.5,334.13,182.25,525.49,38
HCPCS,C1769,GUIDEWIRE GLIDEWIRE ADV 260CM,1048.5,576.68,314.55,906.95,38
HCPCS,C1769,GUIDEWIRE JAG HINI .025X260,508.47,279.66,152.54,439.83,38
HCPCS,C1769,GUIDEWIRE JAG STR .035X260,661.0,363.55,198.3,571.77,38
HCPCS,C1769,GUIDEWIRE JAG STR .035X450,661.0,363.55,198.3,571.77,38
HCPCS,C1769,GUIDEWIRE JAGTOME RX 39-20-260,1322.01,727.11,396.6,1143.54,38
HCPCS,C1769,GUIDEWIRE JAGWIRE .035X180CM,575.0,316.25,172.5,497.38,38
HCPCS,C1769,GUIDEWIRE JAGWIRE ANGL .035,508.47,279.66,152.54,439.83,38
HCPCS,C1769,GUIDEWIRE JAGWIRE STR .025,508.47,279.66,152.54,439.83,38
HCPCS,C1769,GUIDEWIRE JAGWIRE STR .035,508.47,279.66,152.54,439.83,38
HCPCS,C1769,GUIDEWIRE LUNDERQUIST 260CM,575.0,316.25,172.5,497.38,38
HCPCS,C1769,GUIDEWIRE LUNDERQUIST 300CM,575.0,316.25,172.5,497.38,38
HCPCS,C1769,GUIDEWIRE LUNDERQUIST EXT CRV,607.5,334.13,182.25,525.49,38
HCPCS,C1769,GUIDEWIRE MAXXWIRE .035X180CM,675.0,371.25,202.5,583.88,38
HCPCS,C1769,GUIDEWIRE PILOT 50 .014INX300,575.0,316.25,172.5,497.38,38
HCPCS,C1769,GUIDEWIRE PILOT200 014X190 STR,575.0,316.25,172.5,497.38,38
HCPCS,C1769,GUIDEWIRE PILOT50 014X190 STR,675.0,371.25,202.5,583.88,38
HCPCS,C1769,GUIDEWIRE SENSOR,242.71,133.5,72.81,209.94,38
HCPCS,C1769,GUIDEWIRE SMOOTH TIP 2.2X800MM,575.0,316.25,172.5,497.38,38
HCPCS,C1769,GUIDEWIRE SMOOTH TIP 3X800MM,575.0,316.25,172.5,497.38,38
HCPCS,C1769,GUIDEWIRE SPARTACORE .014X300,488.75,268.82,146.63,422.77,38
HCPCS,C1769,GUIDEWIRE STORQ .035 180CML,314.99,173.25,94.5,272.47,38
HCPCS,C1769,GUIDEWIRE STORQ .035 300CML,440.22,242.13,132.07,380.79,38
HCPCS,C1769,GUIDEWIRE STR 0.035INX260CM,940.5,517.28,282.15,813.53,38
HCPCS,C1769,GUIDEWIRE ULTRASELCT .018/80/8,330.4,181.72,99.12,285.8,38
HCPCS,C1769,GUIDEWIRE VASC ANGL .035 260CM,940.5,517.28,282.15,813.53,38
HCPCS,C1769,GUIDEWIRE VASCULAR MAGIC TORQUE GLIDEX PLATINUM SHAPEABLE CU,239.6,131.78,71.88,207.25,38
HCPCS,C1769,GUIDEWIRE VERSACORE 175 FLPY,607.5,334.13,182.25,525.49,38
HCPCS,C1769,GUIDEWIRE WHISPER 014X190 STR,675.0,371.25,202.5,583.88,38
HCPCS,C1769,GUIDEWIRE WHISPER 014X300 STR,675.0,371.25,202.5,583.88,38
HCPCS,C1769,GUIDEWIRE WHOLEY J .035INX260,473.34,260.34,142.0,409.44,38
HCPCS,C1769,GUIDEWIRE WHOLEY J 175CMC,452.7,248.99,135.81,391.59,38
HCPCS,C1769,HC AMPLATZ SUPER STIFF GUIDE WIRE 0.035 X 145 CM,230.0,126.5,69.0,198.95,38
HCPCS,C1769,HC AMPLATZ SUPER STIFF GUIDE WIRE 0.035 X 180 CM,230.0,126.5,69.0,198.95,38
HCPCS,C1769,HC AMPLATZ SUPER STIFF GUIDE WIRE 0.035 X 75 CM,230.0,126.5,69.0,198.95,38
HCPCS,C1769,HC GLIDEWIRE STIFF 0.035 180 CM WIRE,292.5,160.88,87.75,253.01,38
HCPCS,C1769,HC GUIDE WIRE PERCUTANEOUS TRANS,406.0,223.3,121.8,351.19,38
HCPCS,C1769,"HC GUIDE WIRE, CARDIOMEMS",1352.5,743.88,405.75,1169.91,38
HCPCS,C1769,HC GUIDEWIRE 0.018,230.0,126.5,69.0,198.95,38
HCPCS,C1769,HC GUIDEWIRE 0.035,230.0,126.5,69.0,198.95,38
HCPCS,C1769,HC GUIDEWIRE 150 CM,230.0,126.5,69.0,198.95,38
HCPCS,C1769,HC GUIDEWIRE 80 CM,230.0,126.5,69.0,198.95,38
HCPCS,C1769,HC GUIDEWIRE AMPLATZ,230.0,126.5,69.0,198.95,76
HCPCS,C1769,HC GUIDEWIRE AMPLATZ 75 CM,278.0,152.9,83.4,240.47,38
HCPCS,C1769,HC GUIDEWIRE FIX CORE J 0.035,278.0,152.9,83.4,240.47,38
HCPCS,C1769,HC GUIDEWIRE ROADRUNNER,230.0,126.5,69.0,198.95,76
HCPCS,C1769,HC GUIDEWIRE SUPSTIFF AMPLATZ,230.0,126.5,69.0,198.95,38
HCPCS,C1769,HC GUIDEWIRE TEFLON,230.0,126.5,69.0,198.95,38
HCPCS,C1769,HC IR GUIDEWIRE ADDL,334.0,183.7,100.2,288.91,38
HCPCS,C1769,HC IR GUIDEWIRE AGILITY 0.010/0.014,743.5,408.93,223.05,643.13,38
HCPCS,C1769,HC IR GUIDEWIRE AMPLATZ,278.0,152.9,83.4,240.47,38
HCPCS,C1769,HC IR GUIDEWIRE ASAHI,2668.5,1467.68,800.55,2308.25,38
HCPCS,C1769,HC IR GUIDEWIRE BALANCE 0.014,266.0,146.3,79.8,230.09,38
HCPCS,C1769,HC IR GUIDEWIRE BAREWIRE X-SUPPORT 190 CM,418.0,229.9,125.4,361.57,38
HCPCS,C1769,HC IR GUIDEWIRE BENTSON 0.035/150,278.0,152.9,83.4,240.47,38
HCPCS,C1769,HC IR GUIDEWIRE BENTSON 0.035/260,230.0,126.5,69.0,198.95,38
HCPCS,C1769,HC IR GUIDEWIRE CONFIANZA 0.014,577.5,317.63,173.25,499.54,38
HCPCS,C1769,HC IR GUIDEWIRE CONFIANZA 0.014 EXCHG,2342.5,1288.38,702.75,2026.26,38
HCPCS,C1769,HC IR GUIDEWIRE EXCHANGE,230.0,126.5,69.0,198.95,38
HCPCS,C1769,HC IR GUIDEWIRE FATHOM,422.5,232.38,126.75,365.46,38
HCPCS,C1769,HC IR GUIDEWIRE GLIDE GOLD TIP,343.5,188.93,103.05,297.13,38
HCPCS,C1769,HC IR GUIDEWIRE GLIDEWIRE 0.018,230.0,126.5,69.0,198.95,38
HCPCS,C1769,HC IR GUIDEWIRE GLIDEWIRE 0.025,230.0,126.5,69.0,198.95,38
HCPCS,C1769,HC IR GUIDEWIRE GLIDEWIRE 0.035,278.0,152.9,83.4,240.47,38
HCPCS,C1769,HC IR GUIDEWIRE GLIDEWIRE EXCHANGE 0.035,230.0,126.5,69.0,198.95,38
HCPCS,C1769,HC IR GUIDEWIRE GLIDEWIRE GT 0.018,575.0,316.25,172.5,497.38,38
HCPCS,C1769,HC IR GUIDEWIRE GLIDEWIRE STIFF 0.035,278.0,152.9,83.4,240.47,38
HCPCS,C1769,HC IR GUIDEWIRE GRAND SLAM 0.014,285.5,157.03,85.65,246.96,38
HCPCS,C1769,HC IR GUIDEWIRE HEAVY DUTY,230.0,126.5,69.0,198.95,38
HCPCS,C1769,HC IR GUIDEWIRE LUNDERQUIST,575.0,316.25,172.5,497.38,38
HCPCS,C1769,HC IR GUIDEWIRE MAGIC TORQUE,300.0,165.0,90.0,259.5,38
HCPCS,C1769,HC IR GUIDEWIRE MIRAGE 0.008,2965.0,1630.75,889.5,2564.73,38
HCPCS,C1769,HC IR GUIDEWIRE NIT VU 110 CM,1165.5,641.03,349.65,1008.16,38
HCPCS,C1769,HC IR GUIDEWIRE NIT VU 180 CM,294.0,161.7,88.2,254.31,38
HCPCS,C1769,HC IR GUIDEWIRE NIT VU 300 CM,353.5,194.43,106.05,305.78,38
HCPCS,C1769,HC IR GUIDEWIRE NIT VU 80 CM,230.0,126.5,69.0,198.95,38
HCPCS,C1769,HC IR GUIDEWIRE NITINOL 0.035,275.0,151.25,82.5,237.88,38
HCPCS,C1769,HC IR GUIDEWIRE NITREX 180 CM,383.0,210.65,114.9,331.3,38
HCPCS,C1769,HC IR GUIDEWIRE NITREX 300 CM,575.0,316.25,172.5,497.38,38
HCPCS,C1769,HC IR GUIDEWIRE NITREX 80 CM,287.5,158.13,86.25,248.69,38
HCPCS,C1769,HC IR GUIDEWIRE PLAT TIP 0.018/7.5 CM,425.0,233.75,127.5,367.63,38
HCPCS,C1769,HC IR GUIDEWIRE PLATINUM PLUS 0.025,230.0,126.5,69.0,198.95,38
HCPCS,C1769,HC IR GUIDEWIRE PLATINUM PLUS 180,386.0,212.3,115.8,333.89,38
HCPCS,C1769,HC IR GUIDEWIRE PLATINUM PLUS 360,575.0,316.25,172.5,497.38,38
HCPCS,C1769,HC IR GUIDEWIRE PROSTREAM,297.0,163.35,89.1,256.91,38
HCPCS,C1769,HC IR GUIDEWIRE QUICKSILVER,575.0,316.25,172.5,497.38,38
HCPCS,C1769,HC IR GUIDEWIRE ROADRUNNER 0.018,575.0,316.25,172.5,497.38,38
HCPCS,C1769,HC IR GUIDEWIRE ROADRUNNER 0.035,230.0,126.5,69.0,198.95,38
HCPCS,C1769,HC IR GUIDEWIRE ROSEN,230.0,126.5,69.0,198.95,38
HCPCS,C1769,HC IR GUIDEWIRE SILVER SPEED,575.0,316.25,172.5,497.38,38
HCPCS,C1769,HC IR GUIDEWIRE SPARTACORE 0.014,431.5,237.33,129.45,373.25,38
HCPCS,C1769,HC IR GUIDEWIRE STEELCORE 0.018,400.0,220.0,120.0,346.0,38
HCPCS,C1769,HC IR GUIDEWIRE STEELCORE 0.035,400.0,220.0,120.0,346.0,38
HCPCS,C1769,HC IR GUIDEWIRE STORQ 0.035,278.0,152.9,83.4,240.47,38
HCPCS,C1769,HC IR GUIDEWIRE SUPRACORE,353.5,194.43,106.05,305.78,38
HCPCS,C1769,HC IR GUIDEWIRE SV 5 0.018,353.5,194.43,106.05,305.78,38
HCPCS,C1769,HC IR GUIDEWIRE SYNCHRO,2969.0,1632.95,890.7,2568.19,38
HCPCS,C1769,HC IR GUIDEWIRE TAD,691.5,380.33,207.45,598.15,38
HCPCS,C1769,HC IR GUIDEWIRE THRUWAY 0.014,402.5,221.38,120.75,348.16,38
HCPCS,C1769,HC IR GUIDEWIRE THRUWAY 0.018,422.5,232.38,126.75,365.46,38
HCPCS,C1769,HC IR GUIDEWIRE TIP DEFLECTING,305.0,167.75,91.5,263.83,38
HCPCS,C1769,HC IR GUIDEWIRE TRANSCEND,2969.0,1632.95,890.7,2568.19,38
HCPCS,C1769,HC IR GUIDEWIRE TRANSEND 300 CM FLOPPY,2969.0,1632.95,890.7,2568.19,38
HCPCS,C1769,HC IR GUIDEWIRE TRAXCESS 0.014,1298.0,713.9,389.4,1122.77,38
HCPCS,C1769,HC IR GUIDEWIRE V18 CONTROL,400.0,220.0,120.0,346.0,38
HCPCS,C1769,HC IR GUIDEWIRE VISIGLIDE GI,778.5,428.18,233.55,673.4,38
HCPCS,C1769,HC IR GUIDEWIRE WATUSI 0.014,959.0,527.45,287.7,829.54,38
HCPCS,C1769,HC IR GUIDEWIRE X-CELERATOR,994.0,546.7,298.2,859.81,38
HCPCS,C1769,HC IR GUIDEWIRE XPEDION,683.0,375.65,204.9,590.8,38
HCPCS,C1769,HC IR GUIDWIRE VICTORY 0.014 12 G,697.0,383.35,209.1,602.91,38
HCPCS,C1769,HC IR GUIDWIRE VICTORY 0.014 25 G,827.5,455.13,248.25,715.79,38
HCPCS,C1769,HC IR GUIDWIRE VICTORY 0.018 12 G,653.5,359.43,196.05,565.28,38
HCPCS,C1769,HC IR GUIDWIRE VICTORY 0.018 25 G,784.0,431.2,235.2,678.16,38
HCPCS,C1769,"HC IR JAGTOME, GI",2969.0,1632.95,890.7,2568.19,38
HCPCS,C1769,HC LUNDERQUIST GUIDE WIRE,583.0,320.65,174.9,504.3,38
HCPCS,C1769,HC RADI WIRE,2341.5,1287.83,702.45,2025.4,38
HCPCS,C1769,HC ROTABLATOR WIRE,649.0,356.95,194.7,561.39,38
HCPCS,C1769,HC SAFARI 2 TAVR GUIDEWIRE,2332.0,1282.6,699.6,2017.18,38
HCPCS,C1769,HC US GUIDEWIRE 80 CM,230.0,126.5,69.0,198.95,76
HCPCS,C1769,KIT PERICARDIOCENTESIS 8.3F 40,576.0,316.8,172.8,498.24,38
HCPCS,C1769,SENSOR DUAL FLEX STR .035X150,252.2,138.71,75.66,218.15,38
HCPCS,C1769,THREADED GUIDE WIRE,244.78,134.63,73.43,211.73,38
HCPCS,C1769,TRAY TRACH PERC BLU RHINO G2,2417.4,1329.57,725.22,2091.05,38
HCPCS,C1769,TRAY TRACH PERCUTAN BLU RHINO,2567.25,1411.99,770.18,2220.67,38
HCPCS,C1769,WIRE ANGL TIP 0.025INX260CM,940.5,517.28,282.15,813.53,38
HCPCS,C1772,PUMP IMPL 30ML,36975.0,20336.25,11092.5,32538.0,35
HCPCS,C1772,PUMP SYNCHROMED III 20MLC,33162.5,18239.38,9948.75,29183.0,35
HCPCS,C1773,DEVICE LEAD LCK 2 .017/.43 65,2714.99,1493.25,814.5,2348.47,38
HCPCS,C1773,DEVICE LEAD LCK E .015/.38 85C,2714.99,1493.25,814.5,2348.47,38
HCPCS,C1773,DEVICE LEAD LCK EZ .015/.38 65,2714.99,1493.25,814.5,2348.47,38
HCPCS,C1773,HC IR DEVICE RETRIEVAL ALIGATOR,9092.5,5000.88,2727.75,7865.01,38
HCPCS,C1773,HC IR FILTER RETRIEVER KIT,2965.0,1630.75,889.5,2564.73,38
HCPCS,C1773,HC IR IVC FILTER RECOVERY RETRIEVAL SYSTEM,1520.0,836.0,456.0,1314.8,38
HCPCS,C1773,HC IR SNARE ENSARE SYSTEM,815.5,448.53,244.65,705.41,38
HCPCS,C1773,HC IR SNARE GOOSENECK,2416.5,1329.08,724.95,2090.27,38
HCPCS,C1773,HC IR SNARE GOOSENECK MICRO,785.5,432.03,235.65,679.46,38
HCPCS,C1773,"HC MERIT MEDICAL ONE SNARE, RETRIEVAL DEVICE, INSERTABLE",2332.0,1282.6,699.6,2017.18,76
HCPCS,C1773,HC RET DEV INSERTABLE,11400.0,6270.0,3420.0,9861.0,38
HCPCS,C1773,HC SET RETRIEVAL - SET NEEDLE EYE SNARE,4555.0,2505.25,1366.5,3940.08,38
HCPCS,C1773,HC SNARE KIT,1539.0,846.45,461.7,1331.24,38
HCPCS,C1773,SNARE FEM EYE 13MM,7806.15,4293.39,2341.85,6752.32,38
HCPCS,C1776,ARTICUL/EZE FEMORAL HEAD CERAMIC 12/14 TAPER 36MM PLUS 1.5,2700.0,1485.0,810.0,2376.0,35
HCPCS,C1776,AUGMENT ACETABULAR SIZE 50 THICK 15MM TRABECULAR METAL,7828.15,4305.49,2348.45,6888.77,35
HCPCS,C1776,AXLE FEM KNEE REDUCE SZ,2202.75,1211.52,660.83,1938.42,35
HCPCS,C1776,BASEPLT TIB KNEE LNG 67MM,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1776,BEARING TIB POLY STL LF 18MM,4519.35,2485.65,1355.81,3977.03,35
HCPCS,C1776,BI-MENTUM ALTRX LINER 43/22,3834.0,2108.7,1150.2,3373.92,35
HCPCS,C1776,BI-MENTUM ALTRX LINER 55/28,3834.0,2108.7,1150.2,3373.92,35
HCPCS,C1776,BUSHING FEM HIP REDUCE SZ,2029.5,1116.23,608.85,1785.96,35
HCPCS,C1776,CAGE TM SHT62/64SHL/54LNR RT,10033.95,5518.68,3010.19,8829.88,35
HCPCS,C1776,CLIP ANEU L TEMP LIGHT CURVED 11MM,2165.31,1190.93,649.59,1905.47,35
HCPCS,C1776,COMP ARTSRF CPS 10 6-9CD LT,4500.0,2475.0,1350.0,3960.0,35
HCPCS,C1776,COMP ARTSRF UC 14 VE 7-12GH LT,4500.0,2475.0,1350.0,3960.0,35
HCPCS,C1776,COMP ARTSRF W/HINGE SZ B,8234.22,4528.83,2470.27,7246.11,35
HCPCS,C1776,COMP CENTRALIZER 10MM,476.73,262.21,143.02,419.52,35
HCPCS,C1776,COMP CENTRALIZER 16MM,476.73,262.21,143.02,419.52,35
HCPCS,C1776,COMP CENTRALIZER 40X28MM RUST,2070.0,1138.5,621.0,1821.6,35
HCPCS,C1776,COMP CENTRALIZER 43X28MM GRY,2070.0,1138.5,621.0,1821.6,35
HCPCS,C1776,COMP CENTRALIZER 44X28MM GRY,2070.0,1138.5,621.0,1821.6,35
HCPCS,C1776,COMP CENTRALIZER 46X28MM BRN,2070.0,1138.5,621.0,1821.6,35
HCPCS,C1776,COMP CENTRALIZER 48X28MM BRN,2070.0,1138.5,621.0,1821.6,35
HCPCS,C1776,COMP CENTRALIZER 50X28MM BRN,2070.0,1138.5,621.0,1821.6,35
HCPCS,C1776,COMP CENTRALIZER 54X28MM BLU,2070.0,1138.5,621.0,1821.6,35
HCPCS,C1776,COMP CENTRALIZER 56X28MM BLU,2070.0,1138.5,621.0,1821.6,35
HCPCS,C1776,COMP CENTRALIZER 9.25MM,476.73,262.21,143.02,419.52,35
HCPCS,C1776,COMP FEM KNEE DIAPHYSEAL 3CM,21671.1,11919.11,6501.33,19070.57,35
HCPCS,C1776,COMP FEM NARW PS PSN 7 LT,6899.38,3794.66,2069.81,6071.45,35
HCPCS,C1776,COMP FEM STD CRPSN 10 LT,6899.38,3794.66,2069.81,6071.45,35
HCPCS,C1776,COMP FEM STD PS PSN 9 RT,6899.38,3794.66,2069.81,6071.45,35
HCPCS,C1776,COMP FEN FINN PROX 7CM RT,22295.46,12262.51,6688.64,19620.0,35
HCPCS,C1776,COMP PATELLA AUG MED 19.5MM,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1776,COMP PATELLA POLY PSN 35MM,1485.0,816.75,445.5,1306.8,35
HCPCS,C1776,COMP PATELLA POLY PSN 38MM,1485.0,816.75,445.5,1306.8,35
HCPCS,C1776,COMP PINN BANTAM GRIPTION 44MM,4117.5,2264.63,1235.25,3623.4,35
HCPCS,C1776,COMP TIB POLY BEARING 16MM,4519.35,2485.65,1355.81,3977.03,35
HCPCS,C1776,COMP TIB PSN 5DEG SZ C LT,2970.0,1633.5,891.0,2613.6,35
HCPCS,C1776,COMP TIB PSN 5DEG SZ G LT,2970.0,1633.5,891.0,2613.6,35
HCPCS,C1776,COMP TIB PSN 5DEG SZ G RT,2970.0,1633.5,891.0,2613.6,35
HCPCS,C1776,COMP VIACIT-E GH 8-11 12MM,4500.0,2475.0,1350.0,3960.0,35
HCPCS,C1776,COMPONENT VIACIT-E GH 8-11 13MM,4500.0,2475.0,1350.0,3960.0,35
HCPCS,C1776,EXT STEM ELEOS SLOT STR 21X140,4500.0,2475.0,1350.0,3960.0,35
HCPCS,C1776,GNS II BICONVEX PAT 26MM,900.0,495.0,270.0,792.0,35
HCPCS,C1776,HEAD CER DELTA 11/13 32 +3,2700.0,1485.0,810.0,2376.0,35
HCPCS,C1776,HEAD CER DLT TS 28 +5.0,3600.0,1980.0,1080.0,3168.0,35
HCPCS,C1776,HEAD CER DLT TS 36 +12,3600.0,1980.0,1080.0,3168.0,35
HCPCS,C1776,HEAD CER DLT TS 36 +8.5,3600.0,1980.0,1080.0,3168.0,35
HCPCS,C1776,HEAD CER FEM 28X+1.5,2700.0,1485.0,810.0,2376.0,35
HCPCS,C1776,HEAD CER FEM BIOX 28X-3.5,3203.37,1761.86,961.01,2818.97,35
HCPCS,C1776,HEAD CER FEM M 5D43 36,3203.37,1761.86,961.01,2818.97,35
HCPCS,C1776,HEAD CER FEM TS 40X+1.5,2700.0,1485.0,810.0,2376.0,35
HCPCS,C1776,HEAD CPLR +3.5 HIGH AEQUALIS,1125.0,618.75,337.5,990.0,35
HCPCS,C1776,HEAD CPLR CENTERED AEQUALIS,1125.0,618.75,337.5,990.0,35
HCPCS,C1776,HEAD FEMORAL 36MM OFFSET +5MM 12/14 TAPER CERAMIC ARTICUL/EZ,2700.0,1485.0,810.0,2376.0,35
HCPCS,C1776,HEAD MTL FEM M-SPEC 40X-2,1761.8,968.99,528.54,1550.38,35
HCPCS,C1776,HEAD MTL FEM/POLY 28X1.5 GRN,1761.8,968.99,528.54,1550.38,35
HCPCS,C1776,HEAD MTL FEM/POLY 28X8.5 BLU,1761.8,968.99,528.54,1550.38,35
HCPCS,C1776,IMPL AXLE OSS,2202.75,1211.52,660.83,1938.42,35
HCPCS,C1776,IMPL BODY 13MM 135DEG AEQUALIS,14975.4,8236.47,4492.62,13178.35,35
HCPCS,C1776,INSERT ARTIC 10MM 8-9CD LT,4500.0,2475.0,1350.0,3960.0,35
HCPCS,C1776,INSERT HUMERAL SIZE 1/2 DIA36MM THK+0MM SYMMETRIC,9573.22,5265.28,2871.97,8424.43,35
HCPCS,C1776,INSERT HUMERAL SIZE 1/2 DIA39MM THK+6MM SYMMETRIC RETENTIVE,9573.22,5265.28,2871.97,8424.43,35
HCPCS,C1776,KIT ENFIT PEG MIC W/PORT 24FR,548.95,301.93,164.69,483.08,35
HCPCS,C1776,KIT HEARTMATE APICAL CUFF MINI,2745.9,1510.25,823.77,2416.39,35
HCPCS,C1776,KIT HOLE COVER UNIV REDAPT,805.19,442.86,241.56,708.57,35
HCPCS,C1776,KNEE ROTATING HINGE KNEE DISET,2695.86,1482.73,808.76,2372.36,35
HCPCS,C1776,LINER POLY ACET NEUT +4X40X60,2484.0,1366.2,745.2,2185.92,35
HCPCS,C1776,LINER POLY ACET NEUT 32X50,2484.0,1366.2,745.2,2185.92,35
HCPCS,C1776,LINER POLY ACET NEUT 36X52,2484.0,1366.2,745.2,2185.92,35
HCPCS,C1776,LINER POLY ACET NEUT 36X54,2484.0,1366.2,745.2,2185.92,35
HCPCS,C1776,LINER POLY ATRX NEUT 28X44OD,2484.0,1366.2,745.2,2185.92,35
HCPCS,C1776,NAIL IM TIBIAL 11.0X360MM,5772.65,3174.96,1731.8,5079.93,35
HCPCS,C1776,PIN FEM RESURFACE AXIAL SZ4,8544.85,4699.67,2563.46,7519.47,35
HCPCS,C1776,PLT LCK BROAD 10H 2.7X90MM,4392.0,2415.6,1317.6,3864.96,35
HCPCS,C1776,PLT LCK BROAD 12H 2.7X108MM,4500.0,2475.0,1350.0,3960.0,35
HCPCS,C1776,PLT LCK BROAD 14H 2.7X125MM,4500.0,2475.0,1350.0,3960.0,35
HCPCS,C1776,PLT LCK BROAD 18H 2.4MM,4500.0,2475.0,1350.0,3960.0,35
HCPCS,C1776,PLT LCK NARW 4H 2.7X42MM,4117.5,2264.63,1235.25,3623.4,35
HCPCS,C1776,PLT LCK NARW 6H 2.4X41MM,3559.5,1957.73,1067.85,3132.36,35
HCPCS,C1776,PLT LCK NARW T 2X5H 2X34MM,3280.5,1804.28,984.15,2886.84,35
HCPCS,C1776,PLT LCK NARW T 3X10H 2.7X87MM,4392.0,2415.6,1317.6,3864.96,35
HCPCS,C1776,PLT LCK NARW T 5X10H 2.7X87MM,4392.0,2415.6,1317.6,3864.96,35
HCPCS,C1776,PLT LCK NARW Y 10H 2.7X92MM,4565.0,2510.75,1369.5,4017.2,35
HCPCS,C1776,POLARSTEM COLLAR LAT. TI/HA 3,4689.5,2579.23,1406.85,4126.76,35
HCPCS,C1776,POLARSTEM COLLAR LAT. TI/HA 4,4689.5,2579.23,1406.85,4126.76,35
HCPCS,C1776,POLARSTEM COLLAR LAT. TI/HA 8,4689.5,2579.23,1406.85,4126.76,35
HCPCS,C1776,POLARSTEM COLLAR STD. TI/HA 4,4689.5,2579.23,1406.85,4126.76,35
HCPCS,C1776,ROD EXFIX CONN 600X11MM NS,861.39,473.77,258.42,758.02,35
HCPCS,C1776,SCREW AXSOS CORT S/T 4.5X60MM,247.25,135.99,74.18,217.58,35
HCPCS,C1776,SCREW AXSOS CORT S/T 4.5X70MM,247.25,135.99,74.18,217.58,35
HCPCS,C1776,SCREW CANN 32MM 7.3X155MM,960.25,528.14,288.08,845.02,35
HCPCS,C1776,SCREW FULL THRD T8 2.4X13MM,575.0,316.25,172.5,506.0,35
HCPCS,C1776,SCREW FULL THRD T8 2.4X40MM,575.0,316.25,172.5,506.0,35
HCPCS,C1776,SCREW FULL THRD T8 2.7X42MM,511.75,281.47,153.53,450.34,35
HCPCS,C1776,SCREW FULL THRD T8 2.7X44MM,511.75,281.47,153.53,450.34,35
HCPCS,C1776,SCREW FULL THRD T8 2.7X46MM,511.75,281.47,153.53,450.34,35
HCPCS,C1776,SCREW FULL THRD T8 2.7X48MM,511.75,281.47,153.53,450.34,35
HCPCS,C1776,SCREW FULL THRD T8 2.7X55MM,575.0,316.25,172.5,506.0,35
HCPCS,C1776,SCREW VARIAX T6 2X24MM,575.0,316.25,172.5,506.0,35
HCPCS,C1776,SCREW VARIAX T6 2X32MM,575.0,316.25,172.5,506.0,35
HCPCS,C1776,SCREW VARIAX T6 2X6MM,575.0,316.25,172.5,506.0,35
HCPCS,C1776,SPACER ELEOS TIBIAL POLY 8MM,6631.7,3647.44,1989.51,5835.9,35
HCPCS,C1776,STEM EXT SHRP FLUT 11X75MM,4500.0,2475.0,1350.0,3960.0,35
HCPCS,C1776,STEM FEM SUMIT CEMT HI SZ3,5602.5,3081.38,1680.75,4930.2,35
HCPCS,C1776,STEM FEM SUMIT CEMT HI SZ5,5602.5,3081.38,1680.75,4930.2,35
HCPCS,C1776,STEM FEM SUMIT CEMT HI SZ7,5602.5,3081.38,1680.75,4930.2,35
HCPCS,C1776,STEM FEM SUMIT CEMT STD SZ2,5602.5,3081.38,1680.75,4930.2,35
HCPCS,C1776,STEM FEM SUMIT CEMT STD SZ4,5602.5,3081.38,1680.75,4930.2,35
HCPCS,C1776,STEM FEM SUMIT CEMT STD SZ5,5602.5,3081.38,1680.75,4930.2,35
HCPCS,C1776,STEM FEM SUMIT CEMT STD SZ6,5602.5,3081.38,1680.75,4930.2,35
HCPCS,C1776,STEM FEM SUMIT CEMT STD SZ7,5602.5,3081.38,1680.75,4930.2,35
HCPCS,C1776,STEM FEMORAL 14MM STANDARD OFFSET REVISION CEMENTLESS GRIT B,24968.79,13732.84,7490.64,21972.54,35
HCPCS,C1776,STEM HUMERAL 14X90MM AEQUALIS,13477.2,7412.46,4043.16,11859.94,35
HCPCS,C1776,STEM HUMERAL 16X90MM AEQUALIS,13477.2,7412.46,4043.16,11859.94,35
HCPCS,C1776,STEM TIB EXT FLUTE 12X130MM,4500.0,2475.0,1350.0,3960.0,35
HCPCS,C1776,STEM TIB PROX CEM 150X9MM,7208.14,3964.48,2162.44,6343.16,35
HCPCS,C1776,TRAY 3/4 8MM REV HRS AEQUALIS,9250.35,5087.7,2775.11,8140.31,35
HCPCS,C1778,HC IR BLUE LEAD KIT,2969.0,1632.95,890.7,2612.72,35
HCPCS,C1778,HC LEAD NEUROSTIMULATOR,995.0,547.25,298.5,875.6,35
HCPCS,C1778,LEAD CUFF STIMULATION,8092.5,4450.88,2427.75,7121.4,35
HCPCS,C1778,LEAD DEPTH 30CM/10MM,14949.0,8221.95,4484.7,13155.12,35
HCPCS,C1778,LEAD DEPTH 30CM/3.5MM,14949.0,8221.95,4484.7,13155.12,35
HCPCS,C1778,LEAD DEPTH 44CM/10MM,14949.0,8221.95,4484.7,13155.12,35
HCPCS,C1778,LEAD DEPTH 44CM/3.5MM,14949.0,8221.95,4484.7,13155.12,35
HCPCS,C1778,LEAD DIFFERENTIAL SENSING 4340,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1778,LEAD PERENNIA FLEX VAGAL NERVE,30419.4,16730.67,9125.82,26769.07,35
HCPCS,C1781,IMPL SEAMGUARD ECHELON 60MM BX,733.14,403.23,219.94,645.16,35
HCPCS,C1781,MESH DURASORB SYN 20X25CM,18150.0,9982.5,5445.0,15972.0,35
HCPCS,C1781,MESH ENFORM 30X30CM,33000.0,18150.0,9900.0,29040.0,35
HCPCS,C1781,MESH ENFORM 8X16CM,9565.75,5261.17,2869.73,8417.86,35
HCPCS,C1781,MESH ENFORM RECTANGULAR 6X16,5154.3,2834.87,1546.29,4535.78,35
HCPCS,C1781,MESH PREPERI ENFORM 20X20CM,17077.5,9392.63,5123.25,15028.2,35
HCPCS,C1781,MESH PREPERI ENFORM 20X25CM,21367.5,11752.13,6410.25,18803.4,35
HCPCS,C1781,MESH PREPERI ENFORM 20X30CM,25624.5,14093.48,7687.35,22549.56,35
HCPCS,C1781,MESH PROLENE 12X12,2061.45,1133.8,618.44,1814.08,35
HCPCS,C1781,MESH PROLENE 6X6,575.0,316.25,172.5,506.0,35
HCPCS,C1781,MESH SYNECOR 30X30CM,21862.5,12024.38,6558.75,19239.0,35
HCPCS,C1781,MESH SYNECOR IP 10X15CM,3240.0,1782.0,972.0,2851.2,35
HCPCS,C1781,MESH SYNECOR IP 12CM,2610.0,1435.5,783.0,2296.8,35
HCPCS,C1781,MESH SYNECOR IP 15X20CM,5967.7,3282.24,1790.31,5251.58,35
HCPCS,C1781,MESH SYNECOR IP 20X25CM,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1781,MESH SYNECOR PRE OVAL 10X15,3217.5,1769.63,965.25,2831.4,35
HCPCS,C1781,MESH SYNECOR PRE OVAL 15X20,5934.5,3263.98,1780.35,5222.36,35
HCPCS,C1781,MESH SYNECOR PRE RECT 12X15,4162.5,2289.38,1248.75,3663.0,35
HCPCS,C1781,MESH SYNECOR PRE RECT 20X25,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1781,MESH SYNECOR PRE RECT 20X30,14305.5,7868.03,4291.65,12588.84,35
HCPCS,C1781,MESH VICRYL KNITTED VKML 12X12,4827.99,2655.4,1448.4,4248.63,35
HCPCS,C1781,MESH VICRYL WOVEN VWML 12X12,4827.99,2655.4,1448.4,4248.63,35
HCPCS,C1783,MICROSTENT HYDRUS,8694.25,4781.84,2608.28,7650.94,35
HCPCS,C1783,SHUNT GLAUCOMA EXPRESS P-50,4101.21,2255.67,1230.36,3609.06,35
HCPCS,C1786,"HC MICRA PACEMAKER, ATRIAL VENTRICAL",33000.0,18150.0,9900.0,29040.0,35
HCPCS,C1786,"HC MICRA PACEMAKER, SINGLE CHAMBER, RATE-RESPONSIVE (IMPLANTABLE)",18900.0,10395.0,5670.0,16632.0,70
HCPCS,C1787,KIT VERCISE DBS LEAD EXT 55CM,7366.25,4051.44,2209.88,6371.81,38
HCPCS,C1788,HC IR CVC PORT BARD DUAL LUMEN POWER,2965.0,1630.75,889.5,2609.2,35
HCPCS,C1788,HC IR CVC PORT BARD SINGLE LUMEN,866.5,476.58,259.95,762.52,35
HCPCS,C1788,HC IR CVC PORT DIGNITY SINGLE LUMEN,866.5,476.58,259.95,762.52,35
HCPCS,C1788,HC IR CVC PORT NAVALYST SINGLE LUMEN,3567.0,1961.85,1070.1,3138.96,35
HCPCS,C1788,HC IR CVC PORT POWER,2237.5,1230.63,671.25,1969.0,35
HCPCS,C1788,HC IR CVC PORT POWERFLOW,2969.0,1632.95,890.7,2612.72,35
HCPCS,C1788,HC IR CVC PORT VORTEX DUAL LUMEN,3665.0,2015.75,1099.5,3225.2,35
HCPCS,C1789,CLIP ANEU L MINI BAYONET 7MM,2165.31,1190.93,649.59,1905.47,35
HCPCS,C1789,CLIP ANEU L MINI STRONG CRVD 4,2165.31,1190.93,649.59,1905.47,35
HCPCS,C1789,EXP MAM ARTOURA+ SMOOTH HP 225,7262.5,3994.38,2178.75,6391.0,35
HCPCS,C1789,EXP MAM ARTOURA+ SMOOTH HP 475,7262.5,3994.38,2178.75,6391.0,35
HCPCS,C1789,EXP MAM ARTOURA+ SMOOTH HP 500,7262.5,3994.38,2178.75,6391.0,35
HCPCS,C1789,EXP MAM CPX4+ SMOOTH MED 450CC,5187.5,2853.13,1556.25,4565.0,35
HCPCS,C1789,EXP MAM CPX4+ SMOOTH MED 650CC,5187.5,2853.13,1556.25,4565.0,35
HCPCS,C1789,EXP MAM CPX4+ SMOOTH MED 800CC,5187.5,2853.13,1556.25,4565.0,35
HCPCS,C1789,EXPANDER BREAST 550CC W7.1XL13.7CM P7.7CM SILICONE SALINE SM,4275.0,2351.25,1282.5,3762.0,35
HCPCS,C1789,IMPL BREA BOOST MODERATE 430CC,4500.0,2475.0,1350.0,3960.0,35
HCPCS,C1789,IMPL BREA BOOST MODERATE 450CC,4500.0,2475.0,1350.0,3960.0,35
HCPCS,C1813,CYL/PUMP 0 ANGL INFRAPUBIC 22,35485.0,19516.75,10645.5,31226.8,35
HCPCS,C1813,CYL/PUMP 0 ANGL SCROTAL 22CM,35485.0,19516.75,10645.5,31226.8,35
HCPCS,C1813,IMPL IPP PUMP CXMS AMS 700,35162.5,19339.38,10548.75,30943.0,35
HCPCS,C1813,RESERVOIR TITAN 125CC,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1817,HC CARDIOSEAL SEPTAL DEFECT IMPL SYS,11863.5,6524.93,3559.05,10439.88,35
HCPCS,C1817,HC GORE HELIX OCCLUDER DEVICE,18792.0,10335.6,5637.6,16536.96,35
HCPCS,C1817,HC VASCULAR AMPLATZER PLUG,2805.0,1542.75,841.5,2468.4,35
HCPCS,C1817,IMPL CARDIOFORM OCCLUDER 32MM,27937.8,15365.79,8381.34,24585.26,35
HCPCS,C1817,IMPL CARDIOFORM OCCLUDER 37MM,27937.8,15365.79,8381.34,24585.26,35
HCPCS,C1817,OCCLU SEPTAL CARDIOFORM 25MM,33000.0,18150.0,9900.0,29040.0,35
HCPCS,C1817,OCCLU SEPTAL CARDIOFORM 30MM,33000.0,18150.0,9900.0,29040.0,35
HCPCS,C1819,HC BI WIRE LOCALIZATION HAWKINS,275.5,151.53,82.65,242.44,35
HCPCS,C1819,HC IR WIRE LOCALIZATION HAWKINS,230.0,126.5,69.0,202.4,35
HCPCS,C1819,HC RADIOA SEED MARKER,575.0,316.25,172.5,506.0,35
HCPCS,C1822,HC IR IPG KIT,36630.0,20146.5,10989.0,32234.4,35
HCPCS,C1830,HC POWERED BONE MARROW BX NEEDLE,881.0,484.55,264.3,762.07,228
HCPCS,C1874,GRAFT AA BIFURC FLEX 28X82MM,31185.0,17151.75,9355.5,27442.8,35
HCPCS,C1874,GRAFT AA ZENITH 32MMX142MM,42867.5,23577.13,12860.25,37723.4,35
HCPCS,C1874,GRAFT AAA ILIAC SPI-Z 13X56,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,GRAFT AAA ILIAC SPI-Z 13X74,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,GRAFT AAA ILIAC SPI-Z 13X90,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,GRAFT AAA ILIAC SPI-Z 16F20X56,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,GRAFT AAA ILIAC SPI-Z 16F20X74,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,GRAFT AAA ILIAC SPI-Z 16X74,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,GRAFT EXCLUD C3 LP 23X14.5X16,33000.0,18150.0,9900.0,29040.0,35
HCPCS,C1874,GRAFT EXCLUD C3 LP 26X14.5X18,33000.0,18150.0,9900.0,29040.0,35
HCPCS,C1874,GRAFT EXCLUDER 12MMX12CM,14708.1,8089.46,4412.43,12943.13,35
HCPCS,C1874,GRAFT EXCLUDER 14.5MMX12CM,14708.1,8089.46,4412.43,12943.13,35
HCPCS,C1874,GRAFT EXCLUDER 14.5MMX14CM,14708.1,8089.46,4412.43,12943.13,35
HCPCS,C1874,GRAFT EXCLUDER 16MMX13.5CM,14708.1,8089.46,4412.43,12943.13,35
HCPCS,C1874,GRAFT EXCLUDER 20MMX11.5CM,14708.1,8089.46,4412.43,12943.13,35
HCPCS,C1874,GRAFT EXCLUDER 23MMX12CM,14708.1,8089.46,4412.43,12943.13,35
HCPCS,C1874,GRAFT EXCLUDER 27MMX10CM,14708.1,8089.46,4412.43,12943.13,35
HCPCS,C1874,"HC BALLOON STENT GRAFT RELIANT, STENT, COATED/COVERED, W/ DELIVERY SYSTEM",2078.0,1142.9,623.4,1828.64,35
HCPCS,C1874,HC DRUG ELUTING STENT,2800.0,1540.0,840.0,2464.0,35
HCPCS,C1874,"HC GORE LIMB ENDOGRAFT (16MM/16MM/9.5CM), STENT, COATED/COVERED, W/ DEL SYS",10587.5,5823.13,3176.25,9317.0,35
HCPCS,C1874,"HC GORE MAIN BODY ENDOGRAFT (26MM/14.5MM/14CM), STNT, CTD/COVRD, W/ DEL SYS",33000.0,18150.0,9900.0,29040.0,35
HCPCS,C1874,"HC IR DRUG ELUTING STENT, ELUVIA 120",12250.0,6737.5,3675.0,10780.0,35
HCPCS,C1874,"HC IR DRUG ELUTING STENT, ELUVIA 40",8196.5,4508.08,2458.95,7212.92,35
HCPCS,C1874,"HC IR DRUG ELUTING STENT, ELUVIA 60",9441.5,5192.83,2832.45,8308.52,35
HCPCS,C1874,"HC IR DRUG ELUTING STENT, ELUVIA 80/100",11400.0,6270.0,3420.0,10032.0,35
HCPCS,C1874,HC IR STENT BALLOON EXPANDABLE COVERED,12761.0,7018.55,3828.3,11229.68,35
HCPCS,C1874,HC IR STENT COVERED,4450.0,2447.5,1335.0,3916.0,35
HCPCS,C1874,HC IR STENT COVERED ATRIUM I CAST,11400.0,6270.0,3420.0,10032.0,35
HCPCS,C1874,HC IR STENT DRUG ELUTING,4971.5,2734.33,1491.45,4374.92,35
HCPCS,C1874,"HC IR STENT DRUG ELUTING ESPRIT BTK, RESORBABLE SCAFFOLD",10375.0,5706.25,3112.5,9130.0,35
HCPCS,C1874,HC IR STENT FLAIR ENDOVASC FLAIRED,9079.5,4993.73,2723.85,7989.96,35
HCPCS,C1874,HC IR STENT FLAIR ENDOVASC STRAIGHT,7621.0,4191.55,2286.3,6706.48,35
HCPCS,C1874,HC IR STENT GRAFT BIFURCATED TREO,28176.0,15496.8,8452.8,24794.88,35
HCPCS,C1874,HC IR STENT GRAFT CONFORM THORACIC,48222.5,26522.38,14466.75,42435.8,35
HCPCS,C1874,HC IR STENT GRAFT COOK THOR PROX MAIN,33000.0,18150.0,9900.0,29040.0,35
HCPCS,C1874,HC IR STENT GRAFT DISSECTION,43155.5,23735.53,12946.65,37976.84,35
HCPCS,C1874,HC IR STENT GRAFT ENDURNT AORTIC EXT,14210.0,7815.5,4263.0,12504.8,35
HCPCS,C1874,HC IR STENT GRAFT ENDURNT BIFUR GRAFT,29123.5,16017.93,8737.05,25628.68,35
HCPCS,C1874,HC IR STENT GRAFT ENDURNT ILIAC LIMB,17017.5,9359.63,5105.25,14975.4,35
HCPCS,C1874,HC IR STENT GRAFT EXCLUDER AORTIC EXTENSION,8558.5,4707.18,2567.55,7531.48,35
HCPCS,C1874,HC IR STENT GRAFT EXCLUDER BI ENDO GRAFT,33000.0,18150.0,9900.0,29040.0,35
HCPCS,C1874,HC IR STENT GRAFT EXCLUDER CONTRALAT LIMB,15154.0,8334.7,4546.2,13335.52,35
HCPCS,C1874,HC IR STENT GRAFT EXCLUDER EXTENSION,12783.0,7030.65,3834.9,11249.04,35
HCPCS,C1874,HC IR STENT GRAFT GORE THORACIC TAG,34816.5,19149.08,10444.95,30638.52,35
HCPCS,C1874,HC IR STENT GRAFT LIMB TREO,17313.0,9522.15,5193.9,15235.44,35
HCPCS,C1874,HC IR STENT GRAFT RELAY THORACIC DISTAL EXT LONG,33000.0,18150.0,9900.0,29040.0,35
HCPCS,C1874,HC IR STENT GRAFT RELAY THORACIC MAIN LOW,33000.0,18150.0,9900.0,29040.0,35
HCPCS,C1874,HC IR STENT GRAFT REPLAY THORACIC DISTAL EXT SHORT,30852.0,16968.6,9255.6,27149.76,35
HCPCS,C1874,HC IR STENT GRAFT REPLAY THORACIC MAIN,36818.0,20249.9,11045.4,32399.84,35
HCPCS,C1874,HC IR STENT GRAFT VISCERAL FENESTRATED,43124.5,23718.48,12937.35,37949.56,35
HCPCS,C1874,HC IR STENT GRAFT ZENITH BI-GRAFT STENT,33000.0,18150.0,9900.0,29040.0,35
HCPCS,C1874,HC IR STENT PERIPHERAL DRUG ELUTING,6221.0,3421.55,1866.3,5474.48,35
HCPCS,C1874,HC IR STENT VIABAHN,12723.0,6997.65,3816.9,11196.24,35
HCPCS,C1874,HC IR STENT VIABAHN HEPARIN COATED,13396.5,7368.08,4018.95,11788.92,35
HCPCS,C1874,HC IR STENT VIATORR,14162.5,7789.38,4248.75,12463.0,35
HCPCS,C1874,HC IR STENT VIATORR CX,18170.5,9993.78,5451.15,15990.04,35
HCPCS,C1874,HC IR STENT WALLFLEX,11400.0,6270.0,3420.0,10032.0,35
HCPCS,C1874,HC IR STENT WALLFLEX FULL-PART COV,11481.0,6314.55,3444.3,10103.28,35
HCPCS,C1874,HC PERIPHERAL COVERED STENT,1985.0,1091.75,595.5,1746.8,35
HCPCS,C1874,STENT ABSOLUT PRO 6F 10X80X80,1773.0,975.15,531.9,1560.24,35
HCPCS,C1874,STENT ABSOLUT PRO 6F 8X100X80,1773.0,975.15,531.9,1560.24,35
HCPCS,C1874,STENT ELUVIA DES 7X120MM 130CM,11620.0,6391.0,3486.0,10225.6,35
HCPCS,C1874,STENT ELUVIA DES 7X60MM 130CM,9130.0,5021.5,2739.0,8034.4,35
HCPCS,C1874,STENT ENDOPRSTH 15F 18X11.5,14708.1,8089.46,4412.43,12943.13,35
HCPCS,C1874,STENT ENDOPRSTH 15F 18X9.5,14708.1,8089.46,4412.43,12943.13,35
HCPCS,C1874,STENT ENDOPRSTH LP 15F 23X14,14708.1,8089.46,4412.43,12943.13,35
HCPCS,C1874,STENT ESOPH ENDOMAXX 19X100MM,11620.0,6391.0,3486.0,10225.6,35
HCPCS,C1874,STENT ESOPH ENDOMAXX 23X100MM,11620.0,6391.0,3486.0,10225.6,35
HCPCS,C1874,STENT ESOPH ENDOMAXX 23X120MM,11620.0,6391.0,3486.0,10225.6,35
HCPCS,C1874,STENT ESOPH ENDOMAXX 23X150MM,11620.0,6391.0,3486.0,10225.6,35
HCPCS,C1874,STENT ESOPH EVOLUTION 18MMX10C,6872.4,3779.82,2061.72,6047.71,35
HCPCS,C1874,STENT ESOPH EVOLUTION 18MMX12C,6872.4,3779.82,2061.72,6047.71,35
HCPCS,C1874,STENT ESOPH EVOLUTION 20MMX10C,6872.4,3779.82,2061.72,6047.71,35
HCPCS,C1874,STENT ESOPH FULL COVR 23X105,9174.45,5045.95,2752.34,8073.52,35
HCPCS,C1874,STENT ESOPH FULL COVR 23X1251,9174.45,5045.95,2752.34,8073.52,35
HCPCS,C1874,STENT ESOPH FULL COVR 23X1551,9174.45,5045.95,2752.34,8073.52,35
HCPCS,C1874,STENT GRAFT AAA ILIAC 20X90MM,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT GRAFT AOR 23X14X102C,29099.4,16004.67,8729.82,25607.47,35
HCPCS,C1874,STENT GRAFT AOR 28X14X102C,29099.4,16004.67,8729.82,25607.47,35
HCPCS,C1874,STENT GRAFT AOR EXT 28X28X49,12470.7,6858.89,3741.21,10974.22,35
HCPCS,C1874,STENT GRAFT BIFUR 23X14X103,29099.4,16004.67,8729.82,25607.47,35
HCPCS,C1874,STENT GRAFT BIFUR 25X14X103,29099.4,16004.67,8729.82,25607.47,35
HCPCS,C1874,STENT GRAFT BIFUR 28X14X103,29099.4,16004.67,8729.82,25607.47,35
HCPCS,C1874,STENT GRAFT BIFUR 36X14X103,29099.4,16004.67,8729.82,25607.47,35
HCPCS,C1874,STENT GRAFT CNTR LMB 16X10X93,14368.2,7902.51,4310.46,12644.02,35
HCPCS,C1874,STENT GRAFT CNTR LMB 16X13X124,14440.8,7942.4400000000005,4310.46,12771.79,70
HCPCS,C1874,STENT GRAFT CNTR LMB 16X13X156,18671.4,10269.27,5601.42,16430.83,35
HCPCS,C1874,STENT GRAFT CNTR LMB 16X13X93,14368.2,7902.51,4310.46,12644.02,35
HCPCS,C1874,STENT GRAFT CNTR LMB 16X16X156,18671.4,10269.27,5601.42,16430.83,35
HCPCS,C1874,STENT GRAFT CNTR LMB 16X16X93,13566.3,7461.47,4069.89,11938.34,35
HCPCS,C1874,STENT GRAFT CNTR LMB 16X20X124,14513.4,7982.37,4354.02,12771.79,35
HCPCS,C1874,STENT GRAFT CNTR LMB 16X28X124,14513.4,7982.37,4354.02,12771.79,35
HCPCS,C1874,STENT GRAFT ENDOPRSTH 34X34X15,48222.5,26522.38,14466.75,42435.8,35
HCPCS,C1874,STENT GRAFT ENDOPRSTH 40X40X15,48222.5,26522.38,14466.75,42435.8,35
HCPCS,C1874,STENT ICAST 7X59MM 80CM,11973.17,6585.25,3591.95,10536.39,35
HCPCS,C1874,STENT ICAST 8X38MM 80CM,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT ILIAC EXTENDER 14.5X7,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT ILIAC OMNILINK 7X29X135,1912.5,1051.88,573.75,1683.0,35
HCPCS,C1874,STENT INTERN ILIAC 10X7,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT INTERN ILIAC 14.5X10,33000.0,18150.0,9900.0,29040.0,35
HCPCS,C1874,STENT INTERN ILIAC 14.5X7,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT PROTEGE GPS 14X80X80,2619.0,1440.45,785.7,2304.72,35
HCPCS,C1874,STENT SYNERGY MEGATRON 3.5X20,3262.5,1794.38,978.75,2871.0,35
HCPCS,C1874,STENT SYNERGY MEGATRON 3.5X32,3262.5,1794.38,978.75,2871.0,35
HCPCS,C1874,STENT SYNERGY MEGATRON 4.5X20,3262.5,1794.38,978.75,2871.0,35
HCPCS,C1874,STENT SYNERGY MEGATRON 4.X20MM,3262.5,1794.38,978.75,2871.0,35
HCPCS,C1874,STENT SYNERGY MEGATRON 4X12MM,3262.5,1794.38,978.75,2871.0,35
HCPCS,C1874,STENT SYNERGY MEGATRON 4X16MM,3262.5,1794.38,978.75,2871.0,35
HCPCS,C1874,STENT SYNERGY MEGATRON 4X24MM,3262.5,1794.38,978.75,2871.0,35
HCPCS,C1874,STENT SYNERGY MEGATRON 4X32MM,3262.5,1794.38,978.75,2871.0,35
HCPCS,C1874,STENT SYNERGY XD MR 2.25X16MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 2.25X20MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 2.25X24MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 2.25X38MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 2.50X12MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 2.50X16MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 2.50X20MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 2.50X24MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 2.50X28MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 2.50X32MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 2.50X38MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 2.50X48MM,3262.5,1794.38,978.75,2871.0,35
HCPCS,C1874,STENT SYNERGY XD MR 2.75X12MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 2.75X16MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 2.75X20MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 2.75X24MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 2.75X32MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 2.75X8MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 3.0X48MM,3262.5,1794.38,978.75,2871.0,35
HCPCS,C1874,STENT SYNERGY XD MR 3.50X16MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 3.50X20MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 3.50X24MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 3.50X28MM,1575.0,866.25,472.5,1386.0,35
HCPCS,C1874,STENT SYNERGY XD MR 3.50X32MM,1575.0,866.25,472.5,1386.0,35
HCPCS,C1874,STENT SYNERGY XD MR 3.50X38MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 3X16MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 3X20MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 3X24MM,1575.0,866.25,472.5,1386.0,35
HCPCS,C1874,STENT SYNERGY XD MR 3X28MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 3X32MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 3X38MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 4X16MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 4X20MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 4X28MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 4X32MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT SYNERGY XD MR 4X8MM,2272.5,1249.88,681.75,1999.8,35
HCPCS,C1874,STENT TRACH BONASTENT 10X20MM,10354.25,5694.84,3106.28,9111.74,35
HCPCS,C1874,STENT TRACH BONASTENT 10X30MM,10354.25,5694.84,3106.28,9111.74,35
HCPCS,C1874,STENT TRACH BONASTENT 12X30MM,10354.25,5694.84,3106.28,9111.74,35
HCPCS,C1874,STENT TRACH Y T20X60 14X35/20,16483.5,9065.93,4945.05,14505.48,35
HCPCS,C1874,STENT TRUNK-IPSILAT 31X14.5 13,33000.0,18150.0,9900.0,29040.0,35
HCPCS,C1874,STENT VBX 7X39MM 6FR135CM,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT VBX 7X79MM 6FR135CM,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT VBX 8X79MM 7FR135CM,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT VBX 9X59MM 7FR135CM,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT VBX 9X79MM 7FR135CM,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT VBX BALLOON 11X59X135,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT VBX BALLOON EXP 10X59X80,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT VBX BALLOON EXP 10X79X80,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT VBX GRAFT RDC 6X29 6FR,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT VBX GRAFT RDC 6X39 6FR,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT VBX GRAFT RDC 7X29 6FR,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT VBX GRAFT RDC 7X59 6FR,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT VBX GRAFT RDC 8X29 7FR,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT VBX GRAFT RDC 8X39 7FR,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT VBX GRAFT RDC 8X59 7FR,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT VBX GRAFT RDC 8X59 8FR,12450.0,6847.5,3735.0,10956.0,70
HCPCS,C1874,STENT VBX GRAFT RDC 8X79 8FR,12450.0,6847.5,3735.0,10956.0,70
HCPCS,C1874,STENT VBX GRAFT RDC 9X39 7FR,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT VBX GRAFT RDC 9X59 7FR,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT VIABAHN 120CM 10CMX11MM,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT VIABAHN 120CM 15CMX10MM,13038.3,7171.07,3911.49,11473.7,35
HCPCS,C1874,STENT VIABAHN 120CM 5CMX11MM,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT VIABAHN 120CM 5CMX9MM,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT VIABAHN 6F 6MMX6MM 120CM,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT VIABAHN 8F 8MMX8MM 120CM,12450.0,6847.5,3735.0,10956.0,35
HCPCS,C1874,STENT WALLFLEX RX 10X40,9989.96,5494.48,2996.99,8791.16,35
HCPCS,C1874,STENT WALLFLEX RX 10X60,9989.96,5494.48,2996.99,8791.16,35
HCPCS,C1874,SYS STENT AXIOS 10.8F L10CM,16442.28,9043.26,4932.68,14469.21,35
HCPCS,C1874,SYS STENT AXIOS 15X10MM,14752.82,8114.06,4425.85,12982.48,35
HCPCS,C1876,GRAFT EXCLUDER 12MMX10CM,14708.1,8089.46,4412.43,12943.13,35
HCPCS,C1876,GRAFT EXCLUDER 12MMX14CM,14708.1,8089.46,4412.43,12943.13,35
HCPCS,C1876,HC BARE METAL STENT,5815.0,3198.25,1744.5,5117.2,35
HCPCS,C1876,HC BIB STENT BALLOON (NON-COVERED) WITH DELIVERY SYSTEM,2835.0,1559.25,850.5,2494.8,35
HCPCS,C1876,HC IR NEUROFORM STENT HUD # H020002,25689.0,14128.95,7706.7,22606.32,35
HCPCS,C1876,HC IR STENT ABSOLUTE PROVASCULAR,1666.5,916.58,499.95,1466.52,35
HCPCS,C1876,HC IR STENT ACCULINK,8322.5,4577.38,2496.75,7323.8,35
HCPCS,C1876,HC IR STENT BALLOON EXPANDABLE,2965.0,1630.75,889.5,2609.2,35
HCPCS,C1876,HC IR STENT CAROTID ENROUTE,11400.0,6270.0,3420.0,10032.0,35
HCPCS,C1876,HC IR STENT CAROTID PRECISE PRO,9130.0,5021.5,2739.0,8034.4,35
HCPCS,C1876,HC IR STENT CAROTID WALLSTENT,9208.0,5064.4,2762.4,8103.04,35
HCPCS,C1876,HC IR STENT CAROTID X ACT,8937.5,4915.63,2681.25,7865.0,35
HCPCS,C1876,HC IR STENT COBALT,2520.0,1386.0,756.0,2217.6,35
HCPCS,C1876,HC IR STENT COMPLETE SE,2965.0,1630.75,889.5,2609.2,35
HCPCS,C1876,HC IR STENT DISSECTION,36750.0,20212.5,11025.0,32340.0,35
HCPCS,C1876,HC IR STENT ENTERPRISE HUD # H060001,26722.5,14697.38,8016.75,23515.8,35
HCPCS,C1876,HC IR STENT EXPRESS SD,4737.5,2605.63,1421.25,4169.0,35
HCPCS,C1876,HC IR STENT GI EVOLUTION NON-COVERED,6184.0,3401.2,1855.2,5441.92,35
HCPCS,C1876,HC IR STENT HERCULINK,4450.0,2447.5,1335.0,3916.0,35
HCPCS,C1876,HC IR STENT LIFE BILIARY,4450.0,2447.5,1335.0,3916.0,35
HCPCS,C1876,HC IR STENT LIFE VASCULAR,3085.0,1696.75,925.5,2714.8,35
HCPCS,C1876,HC IR STENT LVIS HUD # H090222,23077.5,12692.63,6923.25,20308.2,35
HCPCS,C1876,HC IR STENT PROTG,5555.0,3055.25,1666.5,4888.4,35
HCPCS,C1876,HC IR STENT SELF-EXPANDING,3669.5,2018.23,1100.85,3229.16,35
HCPCS,C1876,HC IR STENT SMART,6378.5,3508.18,1913.55,5613.08,35
HCPCS,C1876,HC IR STENT SMART BILIARY,3665.0,2015.75,1099.5,3225.2,35
HCPCS,C1876,HC IR STENT SMART ILIAC,4450.0,2447.5,1335.0,3916.0,35
HCPCS,C1876,HC IR STENT SUPERA,4552.0,2503.6,1365.6,4005.76,35
HCPCS,C1876,HC IR STENT VASCULAR INNOVA,4974.5,2735.98,1492.35,4377.56,35
HCPCS,C1876,HC IR STENT VASCULAR INNOVA LONG,6889.5,3789.23,2066.85,6062.76,35
HCPCS,C1876,"HC IR STENT VENOVO, STENT NON-COATED/NON-COVERED W/ DELIVERY SYSTEM",6225.0,3423.75,1867.5,5478.0,35
HCPCS,C1876,HC IR STENT VISION,3335.5,1834.53,1000.65,2935.24,35
HCPCS,C1876,HC IR STENT WALLFLEX NON-COV,11481.0,6314.55,3444.3,10103.28,35
HCPCS,C1876,HC IR STENT WALLSTENT TRACH BRONCH,5213.5,2867.43,1564.05,4587.88,35
HCPCS,C1876,HC IR STENT WINGSPAN HUD # H050001,24477.0,13462.35,7343.1,21539.76,35
HCPCS,C1876,HC IR STENT XPERT,4866.5,2676.58,1459.95,4282.52,35
HCPCS,C1876,HC IR STENT Z STENT TRACH BRONCH,2416.5,1329.08,724.95,2126.52,35
HCPCS,C1876,HC IR STENT ZILVER,6214.5,3417.98,1864.35,5468.76,35
HCPCS,C1876,"HC IR STENT, ABRE NON-COATED/NON-COVERED W/ DELIVERY SYSTEM",8611.5,4736.33,2583.45,7578.12,35
HCPCS,C1876,HC LIFE STENT STENT 120,22059.0,12132.45,6617.7,19411.92,35
HCPCS,C1876,STENT ABSOLUT PRO 6F 10X40X80,1773.0,975.15,531.9,1560.24,35
HCPCS,C1876,STENT ABSOLUT PRO 6F 10X60X80,1773.0,975.15,531.9,1560.24,35
HCPCS,C1876,STENT ABSOLUT PRO 6F 6X100X135,1773.0,975.15,531.9,1560.24,35
HCPCS,C1876,STENT ABSOLUT PRO 6F 6X40X135,1773.0,975.15,531.9,1560.24,35
HCPCS,C1876,STENT ABSOLUT PRO 6F 8X40X80,1773.0,975.15,531.9,1560.24,35
HCPCS,C1876,STENT ABSOLUT PRO 6F 9X40X80,1687.5,928.13,506.25,1485.0,35
HCPCS,C1876,STENT ACCULINK BMS 6-8X40,8279.25,4553.59,2483.78,7285.74,35
HCPCS,C1876,STENT ACCULINK BMS 7-10X40,8279.25,4553.59,2483.78,7285.74,35
HCPCS,C1876,STENT AERO MINI TRACH 10MMX15M,10582.5,5820.38,3174.75,9312.6,35
HCPCS,C1876,STENT BILIARY EVOLUTION 8X9MM,8142.3,4478.27,2442.69,7165.22,35
HCPCS,C1876,STENT BILIARY FLEX 10X11MMX4CM,8142.3,4478.27,2442.69,7165.22,35
HCPCS,C1876,STENT BILIARY FLEX 10X11MMX6CM,8142.3,4478.27,2442.69,7165.22,35
HCPCS,C1876,STENT BILIARY RX UNCOV 10X40 8,6727.94,3700.37,2018.38,5920.59,35
HCPCS,C1876,STENT BILIARY RX UNCOV 10X60 8,6727.94,3700.37,2018.38,5920.59,35
HCPCS,C1876,STENT COLONIC 25X30MMX8CM,9528.4,5240.62,2858.52,8384.99,35
HCPCS,C1876,STENT COLONIC 30X25MMX6X230CM,9528.4,5240.62,2858.52,8384.99,35
HCPCS,C1876,STENT COLONIC WALLFLEX 25X90CM,9765.7,5371.14,2929.71,8593.82,35
HCPCS,C1876,STENT DUODENAL 22X27MMX9CM,9528.4,5240.62,2858.52,8384.99,35
HCPCS,C1876,STENT DUODENL WALLFLEX 66X230,9765.7,5371.14,2929.71,8593.82,35
HCPCS,C1876,STENT DUODENL WALLFLEX 9X230CM,9765.7,5371.14,2929.71,8593.82,35
HCPCS,C1876,STENT ENDOPRSTH LP 15F 27X14,14708.1,8089.46,4412.43,12943.13,35
HCPCS,C1876,STENT ENROUTE TC 8-6MMX40MM,10370.85,5703.97,3111.26,9126.35,35
HCPCS,C1876,STENT ENROUTE TC 9-7MMX40MM,10370.85,5703.97,3111.26,9126.35,35
HCPCS,C1876,STENT XACT TAPER BMS 6-8X30,8279.25,4553.59,2483.78,7285.74,35
HCPCS,C1876,STENT ZILVER-635 10MMX8X200CM,7046.7,3875.69,2114.01,6201.1,35
HCPCS,C1876,STENT ZILVER-635 6FRX6MMX6CM,7046.7,3875.69,2114.01,6201.1,35
HCPCS,C1877,HC IR STENT PALMAZ 15 MM,4450.0,2447.5,1335.0,3916.0,35
HCPCS,C1877,HC IR STENT PALMAZ 30 MM,4890.5,2689.78,1467.15,4303.64,35
HCPCS,C1877,HC IR STENT PALMAZ 40 MM,6539.5,3596.73,1961.85,5754.76,35
HCPCS,C1877,HC IR STENT PALMAZ 50 MM,7474.0,4110.7,2242.2,6577.12,35
HCPCS,C1877,STENT AERO AIRWAY 14X30,10375.0,5706.25,3112.5,9130.0,35
HCPCS,C1877,STENT AERO MINI TRACH 10MMX10M,10582.5,5820.38,3174.75,9312.6,35
HCPCS,C1877,STENT TRACH BONASTENT 12X50MM,10354.25,5694.84,3106.28,9111.74,35
HCPCS,C1877,STENT TRACH BONASTENT 14X50MM,10354.25,5694.84,3106.28,9111.74,35
HCPCS,C1878,"HC RESTYLANE INJ GEL W/O LIDOCAINE PER 0.1 ML, MATRL FOR VOCAL CORD MEDIALZ",278.0,152.9,83.4,244.64,35
HCPCS,C1880,HC IR IVC FILTER BIRDS NEST,4450.0,2447.5,1335.0,3916.0,35
HCPCS,C1880,HC IR IVC FILTER CONVERTIBLE VENATECH,6587.5,3623.13,1976.25,5797.0,35
HCPCS,C1880,HC IR IVC FILTER COOK CELECT,4450.0,2447.5,1335.0,3916.0,35
HCPCS,C1880,HC IR IVC FILTER OPTION,3668.5,2017.68,1100.55,3228.28,35
HCPCS,C1880,HC IR IVC FILTER RETRIEVABLE BARD,4971.5,2734.33,1491.45,4374.92,35
HCPCS,C1880,HC IR IVC FILTER TULIP,4628.5,2545.68,1388.55,4073.08,35
HCPCS,C1880,HC IR IVC FILTER VENATECH,5634.5,3098.98,1690.35,4958.36,35
HCPCS,C1882,DEFIB COBALT XT HF MRI IS1 DF4C,38500.0,21175.0,11550.0,33880.0,35
HCPCS,C1882,DEFIB COBALT XT HF QUAD DF1C,38500.0,21175.0,11550.0,33880.0,35
HCPCS,C1882,DEFIB COBALT XT HF QUAD DF4C,38500.0,21175.0,11550.0,33880.0,35
HCPCS,C1882,DEFIB MOMENTUM 5.37X8.18CM,48892.5,26890.88,14667.75,43025.4,35
HCPCS,C1883,EXT DBS 50CM,7781.25,4279.69,2334.38,6847.5,35
HCPCS,C1883,EXT SPINE CORD STIM 1X8 40CM,2221.92,1222.06,666.58,1955.29,35
HCPCS,C1883,EXT SPINE CORD STIM 1X8 60CM,2221.92,1222.06,666.58,1955.29,35
HCPCS,C1883,HC IR LEAD EXTENSION KIT,2969.0,1632.95,890.7,2612.72,35
HCPCS,C1883,KIT ACCESSORY,585.0,321.75,175.5,514.8,35
HCPCS,C1883,KIT EXT 8 CONTACT 55 CM,1462.5,804.38,438.75,1287.0,35
HCPCS,C1883,KIT INTERSTIM EXT PERCUTANC,1061.19,583.66,318.36,933.85,35
HCPCS,C1884,FILTER W/WIRE EZ 190 3.5-5.5,4632.06,2547.64,1389.62,4006.73,38
HCPCS,C1884,HC DISTAL EMBOLIZATION PROTECTIVE SYSTEM,6868.0,3777.4,2060.4,6043.84,35
HCPCS,C1884,HC FILTERWIRE EMBOLIZATION PROTECTIVE SYSTEM,6021.5,3311.83,1806.45,5298.92,35
HCPCS,C1884,HC IR DISTAL PROTECTION ENROUTE,12761.0,7018.55,3828.3,11229.68,35
HCPCS,C1884,HC IR EPD ACCUNET DISTAL PROTECTION DEVICE,5638.0,3100.9,1691.4,4961.44,35
HCPCS,C1884,HC IR EPD DISTAL PROTECTION DEVICE,6238.0,3430.9,1871.4,5489.44,35
HCPCS,C1884,HC IR EPD EMBOSHIELD DISTAL PROTCT DEV,5538.0,3045.9,1661.4,4873.44,35
HCPCS,C1884,HC IR EPD FIBERNET DISTAL PROTECTION,4901.0,2695.55,1470.3,4312.88,35
HCPCS,C1884,HC IR EPD FILTERWIRE EZ DISTAL PROTCT DEV,5143.5,2828.93,1543.05,4526.28,35
HCPCS,C1884,HC IR EPD FILTERWIRE EZ RETRIEVAL SHEATH,285.5,157.03,85.65,251.24,35
HCPCS,C1884,HC IR EPD GORE FREEDOM,6251.0,3438.05,1875.3,5500.88,35
HCPCS,C1884,HC IR EPD MOMA PROXIMAL PROTECTION DEVICE,6007.5,3304.13,1802.25,5286.6,35
HCPCS,C1884,HC IR EPD NAV6 DISTAL PROTECTION DEVICE,5886.0,3237.3,1765.8,5179.68,35
HCPCS,C1884,HC IR EPD SPIDER FX DISTAL PROTCT DEV,5760.5,3168.28,1728.15,5069.24,35
HCPCS,C1884,HC SENTINEL CEREBRAL PROTECTION SYSTEM (CPS),8322.0,4577.1,2496.6,7323.36,35
HCPCS,C1884,STENT EMBOSHIELD NAV6 5MM,4793.25,2636.29,1437.98,4146.16,38
HCPCS,C1884,SYS NEUROPROTECT TRANSCAROTID+,12536.7,6895.19,3761.01,10844.25,38
HCPCS,C1884,WIRE FILTER EMBO 4MMX320CMC,4500.0,2475.0,1350.0,3892.5,38
HCPCS,C1884,WIRE FILTER EMBO 5MMX320CM,4500.0,2475.0,1350.0,3892.5,38
HCPCS,C1885,"HC IR CATHETER, LASER ATHRECTOMY",12740.0,7007.0,3822.0,11020.1,38
HCPCS,C1886,CATH ENDO BARRX CHANNEL RFA,8914.2,4902.81,2674.26,7710.78,38
HCPCS,C1886,HC DEVICE NEUROMARK GEN 2,6225.0,3423.75,1867.5,5384.63,38
HCPCS,C1886,HC IR OPTABLATE PROBE DUAL,12783.0,7030.65,3834.9,11057.3,38
HCPCS,C1886,HC IR OPTABLATE PROBE SINGLE,12570.0,6913.5,3771.0,10873.05,38
HCPCS,C1886,HC IR OSTEOCOOL DUAL PROBE,12761.0,7018.55,3828.3,11038.27,38
HCPCS,C1886,HC IR OSTEOCOOL SINGLE PROBE,12740.0,7007.0,3822.0,11020.1,38
HCPCS,C1886,HC IR PROBE RF,6445.5,3545.03,1933.65,5575.36,38
HCPCS,C1886,PROBE OSTEOCOOL RF 17G 15MMC,12439.625,6841.795,3728.78,10769.25,76
HCPCS,C1887,CATH ACUSON ACUNAV ICE VOL 2/1,12450.0,6847.5,3735.0,10769.25,38
HCPCS,C1887,CATH ANGIO MARINER 5F 100CM,292.22,160.73,87.67,252.77,38
HCPCS,C1887,CATH ANGIO V4 5F .035INX65CM,673.7,370.54,202.11,582.75,38
HCPCS,C1887,CATH ANGL 018 135CMC,840.96,462.53,252.29,727.43,38
HCPCS,C1887,CATH ANGL 018 90CMC,840.96,462.53,252.29,727.43,38
HCPCS,C1887,CATH ANGL 035 135CMC,840.96,462.53,252.29,727.43,38
HCPCS,C1887,CATH ANGL 035 90CMC,840.96,462.53,252.29,727.43,38
HCPCS,C1887,CATH ATTAIN CRVD 130DEG 57CM,1174.5,645.98,352.35,1015.94,38
HCPCS,C1887,CATH ATTAIN CRVD 130DEG 65CM,1174.5,645.98,352.35,1015.94,38
HCPCS,C1887,CATH ATTAIN HEMO 50CM LT,1323.0,727.65,396.9,1144.4,38
HCPCS,C1887,CATH ATTAIN SUREVALVE 42CMC,1323.0,727.65,396.9,1144.4,38
HCPCS,C1887,CATH ATTAIN SUREVALVE 50CM96MM,1323.0,727.65,396.9,1144.4,38
HCPCS,C1887,CATH CARAVEL ANGIO 1.9FR 135CM,1912.5,1051.88,573.75,1654.31,38
HCPCS,C1887,CATH CORSAIR PRO XS 135CM,2475.0,1361.25,742.5,2140.88,38
HCPCS,C1887,CATH CXI ANGL TIP 2.3FRX150CM,730.8,401.94,219.24,632.14,38
HCPCS,C1887,CATH CXI SUPPORT 2.6F .018X90,822.15,452.19,246.65,711.16,38
HCPCS,C1887,CATH CXI SUPPORT 4FR .035X135,730.8,401.94,219.24,632.14,38
HCPCS,C1887,CATH DUAL LUMEN CRESCENT 24FRC,9856.25,5420.94,2956.88,8525.66,38
HCPCS,C1887,CATH DUAL LUMEN CRESCENT 28FRC,9856.25,5420.94,2956.88,8525.66,38
HCPCS,C1887,CATH DUAL LUMEN CRESCENT 32FRC,9856.25,5420.94,2956.88,8525.66,38
HCPCS,C1887,CATH FINECROSS M3 2.5FR 130CM,2621.25,1441.69,786.38,2267.38,38
HCPCS,C1887,CATH GLIDECATH ANGL 4FR 100CM,324.88,178.69,97.46,281.02,38
HCPCS,C1887,CATH GLIDECATH ANGL 4FR 120CM,324.88,178.69,97.46,281.02,38
HCPCS,C1887,CATH GLIDECATH ANGL 4FR 150CM,324.88,178.69,97.46,281.02,38
HCPCS,C1887,CATH GLIDECATH ANGL 4FR 65CM,324.88,178.69,97.46,281.02,38
HCPCS,C1887,CATH GLIDECATH MG1 5FRX125CM,324.88,178.69,97.46,281.02,38
HCPCS,C1887,CATH GORE TRI-LUMEN 7.5FR 140C,4410.0,2425.5,1323.0,3814.65,38
HCPCS,C1887,CATH GUIDE LA 5FR 100CM JR4,230.0,126.5,69.0,198.95,38
HCPCS,C1887,CATH GUIDEZILLA 2 145 6FR,1603.13,881.73,480.94,1386.71,38
HCPCS,C1887,CATH GUIDEZILLA 2 145 7FR,1603.13,881.73,480.94,1386.71,38
HCPCS,C1887,CATH HIS BUNDLE DEFLECTABLEC,3127.5,1720.13,938.25,2705.29,38
HCPCS,C1887,CATH INST DAVINCI 5 ION,4387.5,2413.13,1316.25,3795.19,38
HCPCS,C1887,CATH LANGSTON DL PIG 6F 8CM,810.0,445.5,243.0,700.65,38
HCPCS,C1887,CATH MICRO 120DEG 150CM,2592.0,1425.6,777.6,2242.08,38
HCPCS,C1887,CATH MICRO CANTATA 2.8F.25X135,1784.48,981.47,535.34,1543.58,38
HCPCS,C1887,CATH MICRO FLEX 2.9FRX135CM,4959.25,2727.59,1487.78,4289.75,38
HCPCS,C1887,CATH MICRO TRUSELECT 2FRX155CM,3825.0,2103.75,1147.5,3308.63,38
HCPCS,C1887,CATH NEURON GUIDE 5F 130BER,575.0,316.25,172.5,497.38,38
HCPCS,C1887,CATH OPTITORQUE JACKY 6FR,258.75,142.32,77.63,223.82,38
HCPCS,C1887,CATH OPTITORQUE JACKY 6FR LNG,258.75,142.32,77.63,223.82,38
HCPCS,C1887,CATH PROGREAT STR 2.4FR 150CM,401.93,221.07,120.58,347.67,38
HCPCS,C1887,CATH PULMONARY 5FRX100CM,660.96,363.53,198.29,571.73,38
HCPCS,C1887,CATH QUICK CROSS 0.038INX90CM,886.5,487.58,265.95,766.82,38
HCPCS,C1887,CATH RIGHT SITE 7FTXL43CMC,1129.5,621.23,338.85,977.02,38
HCPCS,C1887,CATH SIZING PIG 100CM 20CM,789.57,434.27,236.87,682.98,38
HCPCS,C1887,CATH SIZING STR 5FX100CM,231.67,127.42,69.5,200.39,38
HCPCS,C1887,CATH SWAN GANZ 7.5FR 110CM,546.25,300.44,163.88,472.51,38
HCPCS,C1887,CATH TIGER 4.0 6FR 110CM,258.75,142.32,77.63,223.82,38
HCPCS,C1887,DILAT SOHENDRA,385.25,211.89,115.58,333.24,38
HCPCS,C1887,DIREXION MICROCATHETER NGMC SINGLE 021 SWAN 1RO 130 CATHETER,2880.0,1584.0,864.0,2491.2,38
HCPCS,C1887,DIREXION MICROCATHETERNGMC SINGLE 021 BERN 1RO 155 CATHETER,2880.0,1584.0,864.0,2491.2,38
HCPCS,C1887,GUIDE CATH 7FR AL1 90CM,230.0,126.5,69.0,198.95,38
HCPCS,C1887,GUIDE CATH AL 1 5FR,230.0,126.5,69.0,198.95,38
HCPCS,C1887,GUIDE CATH ANGIO 3DRC 6FR 100C,230.0,126.5,69.0,198.95,38
HCPCS,C1887,GUIDE CATH CORON 6FR 100CM RT,276.0,151.8,82.8,238.74,38
HCPCS,C1887,GUIDE CATH CORON AL1 .071X100,230.0,126.5,69.0,198.95,38
HCPCS,C1887,GUIDE CATH CORON JR4 .071X100,230.0,126.5,69.0,198.95,38
HCPCS,C1887,GUIDE CATH CORON MAC 3.5 .071,230.0,126.5,69.0,198.95,38
HCPCS,C1887,GUIDE CATH EBU 3.5 5FR,230.0,126.5,69.0,198.95,38
HCPCS,C1887,GUIDE CATH EBU LT 8FR 3.75 90C,230.0,126.5,69.0,198.95,38
HCPCS,C1887,GUIDE CATH HSI MULTI 5FRC,230.0,126.5,69.0,198.95,38
HCPCS,C1887,GUIDE CATH IKARI IL3.5 LT,543.38,298.86,163.01,470.02,38
HCPCS,C1887,GUIDE CATH IKARI IL3.75 LT,543.38,298.86,163.01,470.02,38
HCPCS,C1887,GUIDE CATH JL 3.5 5FR,230.0,126.5,69.0,198.95,38
HCPCS,C1887,GUIDE CATH MAC 3.0 5FR,230.0,126.5,69.0,198.95,38
HCPCS,C1887,GUIDEWIRE 0.4MM,1523.34,837.84,457.0,1317.69,38
HCPCS,C1887,GUIDEWIRE SYNCHRO 2 SOFT 200CM,3546.0,1950.3,1063.8,3067.29,38
HCPCS,C1887,"HC  CATHETER, GUIDING, EVOLUT FX DELIVERY SYSTEM",7300.0,4015.0,2190.0,6314.5,38
HCPCS,C1887,HC CANTATA MICROCATHETER,1156.0,635.8,346.8,999.94,38
HCPCS,C1887,"HC CATHETER, GUIDING, LAA DELIVERY SYSTEM",4372.5,2404.88,1311.75,3782.21,38
HCPCS,C1887,HC DIAGNOSTIC CATHETER,151.5,83.33,45.45,131.05,38
HCPCS,C1887,"HC GLIDECATH SIMMONS 2  5 FR, 100CM",325.0,178.75,97.5,281.13,38
HCPCS,C1887,HC GUIDE CATH,237.0,130.35,71.1,205.01,38
HCPCS,C1887,HC GUIDE CATH BERENSTEIN 65 CM,230.0,126.5,69.0,198.95,76
HCPCS,C1887,HC IR CATH ANGIO D SOFT-VU DX,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH BERNSTEIN 4 FR,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH BERNSTEIN 5 FR,278.0,152.9,83.4,240.47,38
HCPCS,C1887,HC IR CATH BERNSTEIN 6 FR,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH COBRA 1 W SH,439.0,241.45,131.7,379.74,38
HCPCS,C1887,HC IR CATH COBRA 1 WO SH,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH COBRA 2 W SH,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH COBRA 2 WO SH,278.0,152.9,83.4,240.47,38
HCPCS,C1887,HC IR CATH DELIVERY SEPTAL OCCLUDER,3642.5,2003.38,1092.75,3150.76,38
HCPCS,C1887,HC IR CATH DX SUPERTORQUE,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH GLIDECATH ANG 4-5 FR,267.5,147.13,80.25,231.39,38
HCPCS,C1887,HC IR CATH GLIDECATH COBRA 2 4/5 FR,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH GLIDECATH JB 1 4/5 FR,267.5,147.13,80.25,231.39,38
HCPCS,C1887,HC IR CATH GLIDECATH SIMMONS 1 4/5 FR,267.5,147.13,80.25,231.39,38
HCPCS,C1887,HC IR CATH GLIDECATH SIMMONS 2 4/5 FR,267.5,147.13,80.25,231.39,38
HCPCS,C1887,HC IR CATH GLIDECATH STRAIGHT 4-5 FR,267.5,147.13,80.25,231.39,38
HCPCS,C1887,HC IR CATH GUID CAPABILITY SHEATH CLOTTRIEVER,12783.0,7030.65,3834.9,11057.3,38
HCPCS,C1887,HC IR CATH HEADHUNTER 1,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH INF BASHIR LYSIS,12761.5,7018.83,3828.45,11038.7,38
HCPCS,C1887,HC IR CATH INF CRAGG MCNAMARA,457.5,251.63,137.25,395.74,38
HCPCS,C1887,HC IR CATH INF MEWI,272.0,149.6,81.6,235.28,38
HCPCS,C1887,HC IR CATH INF MICRO MEWI 2.9 FR,1350.0,742.5,405.0,1167.75,38
HCPCS,C1887,HC IR CATH INF PROINFUSION,374.5,205.98,112.35,323.94,38
HCPCS,C1887,HC IR CATH INF SWIFT NINJA STEERABLE,11400.0,6270.0,3420.0,9861.0,38
HCPCS,C1887,HC IR CATH INF TURBO-TRACKER,612.0,336.6,183.6,529.38,38
HCPCS,C1887,HC IR CATH INF UNIFUSE 4 FR,449.0,246.95,134.7,388.39,38
HCPCS,C1887,HC IR CATH INF UNIFUSE 5 FR,851.0,468.05,255.3,736.12,38
HCPCS,C1887,HC IR CATH INF UNIFUSE 5 FR HP,1867.5,1027.13,560.25,1615.39,38
HCPCS,C1887,HC IR CATH INF VALVED 4 FR,353.5,194.43,106.05,305.78,38
HCPCS,C1887,HC IR CATH INF VALVED 5 FR,362.0,199.1,108.6,313.13,38
HCPCS,C1887,HC IR CATH INF ZEPHYR 165 CM/10,1026.0,564.3,307.8,887.49,38
HCPCS,C1887,HC IR CATH INFINITI 5 FR,8183.5,4500.93,2455.05,7078.73,38
HCPCS,C1887,HC IR CATH KUMPKE,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH MARINER,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH MERCI DAC,4702.5,2586.38,1410.75,4067.66,38
HCPCS,C1887,HC IR CATH MICRO APOLLO,7022.5,3862.38,2106.75,6074.46,38
HCPCS,C1887,HC IR CATH MICRO COURIER,2381.5,1309.83,714.45,2060.0,38
HCPCS,C1887,HC IR CATH MICRO ECHELON,4450.0,2447.5,1335.0,3849.25,38
HCPCS,C1887,HC IR CATH MICRO EXCELSIOR,4974.5,2735.98,1492.35,4302.94,38
HCPCS,C1887,HC IR CATH MICRO FASTRACKER 10,1248.0,686.4,374.4,1079.52,38
HCPCS,C1887,HC IR CATH MICRO HEADWAY,3073.5,1690.43,922.05,2658.58,38
HCPCS,C1887,HC IR CATH MICRO HYDROSPEED MAGIC,2531.5,1392.33,759.45,2189.75,38
HCPCS,C1887,HC IR CATH MICRO MARATHON,2785.0,1531.75,835.5,2409.03,38
HCPCS,C1887,HC IR CATH MICRO MARKSMAN,4899.5,2694.73,1469.85,4238.07,38
HCPCS,C1887,HC IR CATH MICRO MASS TRANSIT,1063.0,584.65,318.9,919.5,38
HCPCS,C1887,HC IR CATH MICRO PENUMBRA REPROFUSION,7713.0,4242.15,2313.9,6671.75,38
HCPCS,C1887,HC IR CATH MICRO PENUMBRA VELOCITY,4971.5,2734.33,1491.45,4300.35,38
HCPCS,C1887,HC IR CATH MICRO PHENOM,4971.5,2734.33,1491.45,4300.35,38
HCPCS,C1887,HC IR CATH MICRO PHENOM PLUS,7250.5,3987.78,2175.15,6271.68,38
HCPCS,C1887,HC IR CATH MICRO PROGREAT KIT,2969.0,1632.95,890.7,2568.19,38
HCPCS,C1887,HC IR CATH MICRO PROWLER 10,1327.5,730.13,398.25,1148.29,38
HCPCS,C1887,HC IR CATH MICRO PROWLER 14,2265.0,1245.75,679.5,1959.23,38
HCPCS,C1887,HC IR CATH MICRO QUICKCROSS,575.0,316.25,172.5,497.38,38
HCPCS,C1887,HC IR CATH MICRO RAPID TRANSIT,1154.0,634.7,346.2,998.21,38
HCPCS,C1887,HC IR CATH MICRO RECRUIT,11400.0,6270.0,3420.0,9861.0,38
HCPCS,C1887,HC IR CATH MICRO RENEGADE 018-1 MARK,1186.0,652.3,355.8,1025.89,38
HCPCS,C1887,HC IR CATH MICRO RENEGADE 018-2 MARK,3413.0,1877.15,1023.9,2952.25,38
HCPCS,C1887,HC IR CATH MICRO RENEGADE ANGLED,1040.5,572.28,312.15,900.03,38
HCPCS,C1887,HC IR CATH MICRO RENEGADE HI-FLO KIT,1570.0,863.5,471.0,1358.05,38
HCPCS,C1887,HC IR CATH MICRO RENEGADE HI-FLO NEURO,2684.5,1476.48,805.35,2322.09,38
HCPCS,C1887,HC IR CATH MICRO SL-10,2571.0,1414.05,771.3,2223.92,38
HCPCS,C1887,HC IR CATH MICRO SL-10 SHAPED,2653.0,1459.15,795.9,2294.85,38
HCPCS,C1887,HC IR CATH MICRO TRACKER EXCEL 14,1387.0,762.85,416.1,1199.76,38
HCPCS,C1887,HC IR CATH MICRO TRUSELECT,3518.0,1934.9,1055.4,3043.07,38
HCPCS,C1887,HC IR CATH MICRO TURBOTRACKER,1057.0,581.35,317.1,914.31,38
HCPCS,C1887,HC IR CATH MIKAELSSON,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH MONT 1,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH MOTARMJEME,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH MULT PURP A,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH MULT PURP B,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH PENUMBRA SIM,395.5,217.53,118.65,342.11,38
HCPCS,C1887,HC IR CATH PIGTAIL 4 FR,230.0,126.5,69.0,198.95,76
HCPCS,C1887,HC IR CATH PIGTAIL 5 FR,233.5,128.43,70.05,201.98,38
HCPCS,C1887,HC IR CATH PIGTAIL 6 FR,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH PIGTAIL MARKING,575.0,316.25,172.5,497.38,38
HCPCS,C1887,HC IR CATH RADIAL,241.5,132.83,72.45,208.9,38
HCPCS,C1887,HC IR CATH RIM 5 FR,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH ROYAL FLUSH BEACON,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH SHETTY,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH SIDEWINDER 2,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH SIMMONS 1 5 FR,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH SIMMONS 2 4 FR,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH SIMMONS 2 5 FR,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH SIZING OMNIFLUSH,278.0,152.9,83.4,240.47,38
HCPCS,C1887,HC IR CATH SLIP BEACON TIP,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH SLIPCATH 4 FR 135 CM ANGLE,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH SLIPCATH 4 FR 135 CM STRAIGHT,275.5,151.53,82.65,238.31,38
HCPCS,C1887,HC IR CATH SOS OMNI SELECTIVE,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH STRAIGHT 4 FR,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH STRAIGHT 5 FR,575.0,316.25,172.5,497.38,38
HCPCS,C1887,HC IR CATH STRAIGHT FLUSH 5 FR,233.5,128.43,70.05,201.98,38
HCPCS,C1887,HC IR CATH TEMPO DIAGNOSTIC,278.0,152.9,83.4,240.47,38
HCPCS,C1887,HC IR CATH TORCON BEACON ADVANTAGE CEREBRAL,575.0,316.25,172.5,497.38,38
HCPCS,C1887,HC IR CATH TURNPIKE,2965.0,1630.75,889.5,2564.73,38
HCPCS,C1887,HC IR CATH VAN ANDEL,275.5,151.53,82.65,238.31,38
HCPCS,C1887,HC IR CATH VANAMAN,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH VANSHIE,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH VERTEBRAL 4 FR,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH VERTEBRAL 5 FR,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH VISCERAL CHG-B 5 FR,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR CATH VTK,367.0,201.85,110.1,317.46,38
HCPCS,C1887,HC IR CATHETER CROSSING,582.0,320.1,174.6,503.43,38
HCPCS,C1887,"HC IR CATHETER, DISTAL ACCESS",13387.0,7362.85,4016.1,11579.76,38
HCPCS,C1887,"HC IR CATHETER,GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",2902.5,1596.38,870.75,2510.66,38
HCPCS,C1887,HC IR DEVICE FRONTRUNNER MICROGUIDE,722.0,397.1,216.6,624.53,38
HCPCS,C1887,HC IR GUIDE CATH 5 FR,4946.5,2720.58,1483.95,4278.72,38
HCPCS,C1887,HC IR GUIDE CATH 6 FR,2965.0,1630.75,889.5,2564.73,38
HCPCS,C1887,HC IR GUIDE CATH 7 FR,439.0,241.45,131.7,379.74,38
HCPCS,C1887,HC IR GUIDE CATH 8 FR,439.0,241.45,131.7,379.74,38
HCPCS,C1887,HC IR GUIDE CATH ARC,7250.5,3987.78,2175.15,6271.68,38
HCPCS,C1887,HC IR GUIDE CATH AXS INFINITY,2832.0,1557.6,849.6,2449.68,38
HCPCS,C1887,HC IR GUIDE CATH BALLOON,5341.0,2937.55,1602.3,4619.97,38
HCPCS,C1887,HC IR GUIDE CATH CAT 5,5320.0,2926.0,1596.0,4601.8,38
HCPCS,C1887,HC IR GUIDE CATH ENVOY,839.0,461.45,251.7,725.74,38
HCPCS,C1887,HC IR GUIDE CATH LUMAX,353.5,194.43,106.05,305.78,38
HCPCS,C1887,HC IR GUIDE CATH MACH 1,380.0,209.0,114.0,328.7,38
HCPCS,C1887,HC IR GUIDE CATH MISC,231.0,127.05,69.3,199.82,38
HCPCS,C1887,HC IR GUIDE CATH MPA,411.0,226.05,123.3,355.52,38
HCPCS,C1887,HC IR GUIDE CATH NEUROPATH,706.0,388.3,211.8,610.69,38
HCPCS,C1887,HC IR GUIDE CATH PENUMBRA,4450.0,2447.5,1335.0,3849.25,38
HCPCS,C1887,HC IR GUIDE CATH PIGTAIL 150 CM,347.5,191.13,104.25,300.59,38
HCPCS,C1887,HC IR GUIDE CATH RADIAL,5376.0,2956.8,1612.8,4650.24,38
HCPCS,C1887,HC IR GUIDE CATH SOFT TIP XF,612.0,336.6,183.6,529.38,38
HCPCS,C1887,HC IR GUIDE CATH STRYKER,7255.0,3990.25,2176.5,6275.58,38
HCPCS,C1887,HC IR GUIDE CATH TORCON NB ADVANTAGE,230.0,126.5,69.0,198.95,38
HCPCS,C1887,HC IR GUIDE CATH VENTURE,2829.5,1556.23,848.85,2447.52,38
HCPCS,C1887,HC IR GUIDE CATH VERIPATH,266.0,146.3,79.8,230.09,38
HCPCS,C1887,HC IR INTRO SET TIPS RING ACCESS SET,2389.5,1314.23,716.85,2066.92,38
HCPCS,C1887,HC IR INTRO SET TIPS STEERABLE,3115.0,1713.25,934.5,2694.48,38
HCPCS,C1887,HC IR MICRO CATH PROGREAT 2.0,3226.5,1774.58,967.95,2790.92,38
HCPCS,C1887,HC IR MICRO CATH SNIPER,21450.0,11797.5,6435.0,18554.25,38
HCPCS,C1887,HC IR MICRO CATH VA,5602.5,3081.38,1680.75,4846.16,38
HCPCS,C1887,HC IR SET TRANSVENOUS BX,2389.5,1314.23,716.85,2066.92,38
HCPCS,C1887,INTRO AGILIS NXT 13FR 27.5MM,5395.0,2967.25,1618.5,4666.68,38
HCPCS,C1887,KIT VASC ACCESS AVALON 210 CM,738.0,405.9,221.4,638.37,38
HCPCS,C1888,ELECTRODE DISP MONOPOLAR 1.8MM,1158.75,637.32,347.63,1002.32,38
HCPCS,C1888,HC IR KIT CLOSURE FAST RFA CATHETER,4552.0,2503.6,1365.6,3937.48,38
HCPCS,C1888,HC IR KIT VENACURE VENOUS LASER ABLT,3412.0,1876.6,1023.6,2951.38,38
HCPCS,C1889,CAGE LUMBAR ANT LG 10DEG 16MM,16500.0,9075.0,4950.0,14520.0,35
HCPCS,C1889,CAGE LUMBAR ANT LG 15DEG 16MM,16500.0,9075.0,4950.0,14520.0,35
HCPCS,C1889,CAGE LUMBAR ANT LG 15DEG 18MM,16500.0,9075.0,4950.0,14520.0,35
HCPCS,C1889,CAGE LUMBAR ANT LG 20DEG 17MM,16500.0,9075.0,4950.0,14520.0,35
HCPCS,C1889,COIL NESTER PLATNIUM 4MMX14CM,525.95,289.28,157.79,462.84,35
HCPCS,C1889,COIL NESTER PLATNIUM 6MMX14CM,525.95,289.28,157.79,462.84,35
HCPCS,C1889,COIL NESTER PLATNIUM 8MMX14CM,525.95,289.28,157.79,462.84,35
HCPCS,C1889,"HC COIL EMBOLIZATION RUBY, IMPL/INSERTABLE DEVICE, NOC",3767.0,2071.85,1130.1,3314.96,35
HCPCS,C1889,"HC CONCERTO COIL EMBOLIZATION DEVICE (NEURO), IMPLANTABLE/INSERT DEVICE",2335.0,1284.25,700.5,2054.8,35
HCPCS,C1889,HC IR DEVICE IFUSE TORQ IMPLANT,12783.0,7030.65,3834.9,11249.04,35
HCPCS,C1889,HC LIMFLOW  SYSTEM IDE G160156,62500.0,34375.0,18750.0,54062.5,38
HCPCS,C1889,IMPL ADV ACF SPACER 8MM,3577.5,1967.63,1073.25,3148.2,35
HCPCS,C1889,IMPL INFUSE BMP MED,21057.3,11581.52,6317.19,18530.42,35
HCPCS,C1889,IMPL INFUSE BMP SM,15381.3,8459.72,4614.39,13535.54,35
HCPCS,C1889,IMPL INFUSE II BMP LG,23446.5,12895.58,7033.95,20632.92,35
HCPCS,C1889,IMPL SUPRA NYLAMID 0.35X9X10CM,363.0,199.65,108.9,319.44,35
HCPCS,C1889,"LUCENT 10MM X 22MM X 11MM, 5 DEGREE",7470.0,4108.5,2241.0,6573.6,35
HCPCS,C1889,PLUG VASC AMPLATZER II 12X9MM,4880.4,2684.22,1464.12,4294.75,35
HCPCS,C1889,PLUG VASC AMPLATZER II 14X10MM,4880.4,2684.22,1464.12,4294.75,35
HCPCS,C1889,PLUG VASC AMPLATZER II 16X10MM,4880.4,2684.22,1464.12,4294.75,35
HCPCS,C1889,PRSTH HA ALTO TI 1.80X3.00MM,1906.65,1048.66,572.0,1677.85,35
HCPCS,C1889,SPACER FORTIF-R 20 UP 25X30 0D,4500.0,2475.0,1350.0,3960.0,35
HCPCS,C1889,SPACER SPINAL H6MM STANDARD ANTERIOR CERVICAL PARALLEL ACIS,4297.91,2363.86,1289.37,3782.16,35
HCPCS,C1889,SPACER SPINAL H7MM STANDARD ANTERIOR CERVICAL PARALLEL ACIS,4297.91,2363.86,1289.37,3782.16,35
HCPCS,C1889,SPCR SPNL 12DEG 12X7.8X55MMC,22849.2,12567.06,6854.76,20107.3,35
HCPCS,C1889,STEM LNG SPECTRIUM GV FEM LG,8300.0,4565.0,2490.0,7304.0,35
HCPCS,C1889,SYS NAVIFLEX DELIVRY 10F 202.5,446.37,245.51,133.91,392.81,35
HCPCS,C1889,SYS NAVIFLEX DELIVRY 7F 202.5,446.37,245.51,133.91,392.81,35
HCPCS,C1889,WASHER ASNIS III 6.5/8.0MM,468.45,257.65,140.54,412.24,35
HCPCS,C1892,HC INTRO SHEATH FIXED PEEL-AWAY,247.5,136.13,74.25,214.09,38
HCPCS,C1892,SHEATH PEELAWAY 14FX30CM,373.69,205.53,112.11,323.24,38
HCPCS,C1892,WIRE LEAD GUIDE W/INTRO 10FR,575.0,316.25,172.5,497.38,38
HCPCS,C1892,WIRE LEAD GUIDE W/INTRO 13FR,275.94,151.77,82.78,238.69,38
HCPCS,C1893,HC GUIDING INTRODUCER,590.0,324.5,177.0,510.35,38
HCPCS,C1893,HC OCCLUDER DELIVERY CATH,1264.0,695.2,379.2,1093.36,38
HCPCS,C1893,HC TRANSEPTAL INTRODUCER SHEATH,658.5,362.18,197.55,569.6,38
HCPCS,C1894,CATH ERCP GLO TIP ULTRA TAPER,356.5,196.08,106.95,308.37,38
HCPCS,C1894,CATH ERCP PRECRV 100CMX.018IN,356.5,196.08,106.95,308.37,38
HCPCS,C1894,CATH INTRO SHEATH PLVW 16-38,252.94,139.12,75.88,218.79,38
HCPCS,C1894,DILAT RENAL AMPLTZ COAX 8-10FR,254.38,139.91,76.31,220.04,38
HCPCS,C1894,HC FAST CATH SHEATH 12 CM,466.5,256.58,139.95,403.52,38
HCPCS,C1894,"HC GORE MAIN BODY DEVICE SHEATH, INTRODUCER/SHEATH, NON-LASER",1447.5,796.13,434.25,1252.09,38
HCPCS,C1894,HC INTRO SET ACCUSTICK SYSTEM,377.5,207.63,113.25,326.54,38
HCPCS,C1894,HC IR INTRO SET NEFF W NITINOL WIRE,386.0,212.3,115.8,333.89,38
HCPCS,C1894,HC IR INTRO SET VASC ACCESS SYSTEM,874.0,480.7,262.2,756.01,38
HCPCS,C1894,HC IR SHEATH ARROWFLEX 35 CM,300.0,165.0,90.0,259.5,38
HCPCS,C1894,HC IR SHEATH ARROWFLEX 45 CM,336.5,185.08,100.95,291.07,38
HCPCS,C1894,HC IR SHEATH ARROWFLEX 65 CM,386.0,212.3,115.8,333.89,38
HCPCS,C1894,HC IR SHEATH ARROWFLEX 90 CM,386.0,212.3,115.8,333.89,38
HCPCS,C1894,HC IR SHEATH AVEIR,2335.0,1284.25,700.5,2019.78,38
HCPCS,C1894,HC IR SHEATH BALKIN,310.0,170.5,93.0,268.15,38
HCPCS,C1894,HC IR SHEATH BRITE TIP,230.0,126.5,69.0,198.95,38
HCPCS,C1894,HC IR SHEATH CHK FLO LRG RB WO GW,575.0,316.25,172.5,497.38,38
HCPCS,C1894,HC IR SHEATH CHK FLO PERFORMER WO GW 30 CM,230.0,126.5,69.0,198.95,38
HCPCS,C1894,HC IR SHEATH CHK FLO PERFORMER WO GW 75 CM,233.5,128.43,70.05,201.98,38
HCPCS,C1894,HC IR SHEATH CHK FLO XL,1646.5,905.58,493.95,1424.22,38
HCPCS,C1894,HC IR SHEATH CROSSING TRIFORCE,1446.5,795.58,433.95,1251.22,38
HCPCS,C1894,HC IR SHEATH CURVED TIP,335.0,184.25,100.5,289.78,38
HCPCS,C1894,HC IR SHEATH DESTINATION SLENDER LONG,1343.0,738.65,402.9,1161.7,38
HCPCS,C1894,HC IR SHEATH DIAG ACT,230.0,126.5,69.0,198.95,38
HCPCS,C1894,HC IR SHEATH ELEMENT,3360.0,1848.0,1008.0,2906.4,38
HCPCS,C1894,HC IR SHEATH FLEX ANSEL,275.5,151.53,82.65,238.31,38
HCPCS,C1894,HC IR SHEATH FLEX RABEE 55/70 CM,275.5,151.53,82.65,238.31,38
HCPCS,C1894,HC IR SHEATH FLEX RABEE 90 CM,422.5,232.38,126.75,365.46,38
HCPCS,C1894,HC IR SHEATH FLEXOR CHK FLO CURV,422.5,232.38,126.75,365.46,38
HCPCS,C1894,HC IR SHEATH GLIDE SLENDER,347.5,191.13,104.25,300.59,38
HCPCS,C1894,HC IR SHEATH GORE DRY SH 12-24 FR,2965.0,1630.75,889.5,2564.73,38
HCPCS,C1894,HC IR SHEATH IN THRILL,6840.0,3762.0,2052.0,5916.6,38
HCPCS,C1894,HC IR SHEATH INTRO VALVED AIR GARD,460.0,253.0,138.0,397.9,38
HCPCS,C1894,HC IR SHEATH INTRODUCER Z STENT,416.0,228.8,124.8,359.84,38
HCPCS,C1894,HC IR SHEATH KELLER-TIMMERMANS,866.0,476.3,259.8,749.09,38
HCPCS,C1894,HC IR SHEATH LONG VASCULAR,230.0,126.5,69.0,198.95,38
HCPCS,C1894,HC IR SHEATH PINNACLE 10 CM,278.0,152.9,83.4,240.47,38
HCPCS,C1894,HC IR SHEATH PINNACLE 25 CM,230.0,126.5,69.0,198.95,38
HCPCS,C1894,HC IR SHEATH PINNACLE 4 CM,230.0,126.5,69.0,198.95,38
HCPCS,C1894,HC IR SHEATH PINNACLE 6 CM,278.0,152.9,83.4,240.47,38
HCPCS,C1894,HC IR SHEATH PINNACLE DESTENTIATION 45 CM,380.0,209.0,114.0,328.7,38
HCPCS,C1894,HC IR SHEATH PINNACLE DESTENTIATION 90 CM,380.0,209.0,114.0,328.7,38
HCPCS,C1894,HC IR SHEATH REINFORCED FEMORAL,575.0,316.25,172.5,497.38,38
HCPCS,C1894,HC IR SHEATH REINFORCED JUGULAR,230.0,126.5,69.0,198.95,38
HCPCS,C1894,HC IR SHEATH SET FLEXOR CHECK FLO,428.0,235.4,128.4,370.22,38
HCPCS,C1894,HC IR SHEATH SHUTTLE,575.0,316.25,172.5,497.38,38
HCPCS,C1894,HC IR SHEATH SHUTTLE 4 FR 110 CM,575.0,316.25,172.5,497.38,38
HCPCS,C1894,HC IR SHEATH SJ FAST 12 CM,230.0,126.5,69.0,198.95,38
HCPCS,C1894,HC IR SHEATH SJ FAST 12 FR/30 CM,230.0,126.5,69.0,198.95,38
HCPCS,C1894,HC IR SHEATH SJ FAST 8 FR,353.5,194.43,106.05,305.78,38
HCPCS,C1894,HC IR SHEATH SJ ULTM 12 FR,275.5,151.53,82.65,238.31,38
HCPCS,C1894,HC IR SHEATH SJ ULTM 16 FR,406.0,223.3,121.8,351.19,38
HCPCS,C1894,HC IR SHEATH SJ ULTM 18 FR,406.0,223.3,121.8,351.19,38
HCPCS,C1894,"HC IR TUBING 20"" EXTENSION SET",278.0,152.9,83.4,240.47,38
HCPCS,C1894,HC SHEATH PROTRIEVE,13600.0,7480.0,4080.0,11764.0,38
HCPCS,C1894,INTRO DRYSEAL FLEX 26FRX33CM,3213.0,1767.15,963.9,2779.25,38
HCPCS,C1894,INTRO FLEXOR 7-8.8FRX55CM,441.89,243.04,132.57,382.23,38
HCPCS,C1894,INTRO SET SHEATH 18FR 13CM,255.93,140.77,76.78,221.38,38
HCPCS,C1894,INTRO SUPRAPUBIC 17F 20CM,521.53,286.85,156.46,451.12,38
HCPCS,C1894,INTRO SUPRAPUBIC 20F 20CM,521.53,286.85,156.46,451.12,38
HCPCS,C1894,INTRO VASC DILAT 18FRX30CM,575.0,316.25,172.5,497.38,38
HCPCS,C1894,KIT CATH ARROWGUARD 9FR 10CM,767.7,422.24,230.31,664.06,38
HCPCS,C1894,KIT MICROINTRODUCER NDL 21GA 7,629.55,346.26,188.87,544.56,38
HCPCS,C1894,NAIL FEMORAL RETROGRADE LONG T2 10x360MM,7930.65,4361.86,2379.2,6860.01,38
HCPCS,C1894,SET INTRO APPEL-BERCI DUCT,575.0,316.25,172.5,497.38,38
HCPCS,C1894,SET INTRO PEELAWAY 22FR,252.94,139.12,75.88,218.79,38
HCPCS,C1894,SET INTRO PEELAWAY 24FR,252.94,139.12,75.88,218.79,38
HCPCS,C1894,SET MICROPUNCT PEDAL .018 7CM,236.9,130.3,71.07,204.92,38
HCPCS,C1894,SET MICROPUNCT STIFF NIT 5F,233.45,128.4,70.04,201.93,38
HCPCS,C1894,SET PERC SUPER-FLEX 7FR,278.88,153.39,83.66,241.23,38
HCPCS,C1894,SHEATH BALKIN RB 12F 038X40,379.39,208.67,113.82,328.17,38
HCPCS,C1894,SHEATH BRITE TIP 7FR 90CM,370.3,203.67,111.09,320.31,38
HCPCS,C1894,SHEATH CHECK FLO 14FRX30CM,575.0,316.25,172.5,497.38,38
HCPCS,C1894,SHEATH DRYSEAL 12FX45CM,3766.5,2071.58,1129.95,3258.02,38
HCPCS,C1894,SHEATH DRYSEAL FLEX 12FX33CM,2362.5,1299.38,708.75,2043.56,38
HCPCS,C1894,SHEATH DRYSEAL FLEX 20FX33CM,3213.0,1767.15,963.9,2779.25,38
HCPCS,C1894,SHEATH DRYSEAL FLEX 22FX33CM,3213.0,1767.15,963.9,2779.25,38
HCPCS,C1894,SHEATH NAVIGAT HD 11-13FRX46CM,575.0,316.25,172.5,497.38,38
HCPCS,C1894,SHEATH NAVIGAT HD 12-14FRX36CM,575.0,316.25,172.5,497.38,38
HCPCS,C1894,SHEATH NAVIGAT HD 12-14FRX46CM,575.0,316.25,172.5,497.38,38
HCPCS,C1894,SHEATH NAVIGAT HD 13-15FRX36CM,575.0,316.25,172.5,497.38,38
HCPCS,C1894,SHEATH PEELAWAY 16FX30CM,373.69,205.53,112.11,323.24,38
HCPCS,C1894,SHEATH URET ACCESS 10.7FR 35CM,696.6,383.13,208.98,602.56,38
HCPCS,C1894,SHEATH URET ACCESS 10.7FR 45CM,696.6,383.13,208.98,602.56,38
HCPCS,C1894,SHEATH URET ACCESS 12FR 35CM,691.65,380.41,207.5,598.28,38
HCPCS,C1894,SHEATH URET ACCESS 12FR 45CM,691.65,380.41,207.5,598.28,38
HCPCS,C1894,SHEATH URET ACCESS 12FR 55CM,691.65,380.41,207.5,598.28,38
HCPCS,C1894,SYS AVEIR DELIVERY CATH,8300.0,4565.0,2490.0,7179.5,38
HCPCS,C1894,SYS AVEIR LEADLESS INTRO 50CM,2700.0,1485.0,810.0,2335.5,38
HCPCS,C1897,HC INTERSTIM TEST STIMULATION LEAD,275.5,151.53,82.65,242.44,35
HCPCS,C1897,HC INTERSTIM TEST STIMULATION LEAD KIT,460.0,253.0,138.0,404.8,35
HCPCS,C1897,HC IR TRIAL LEAD KIT,2969.0,1632.95,890.7,2612.72,35
HCPCS,C1898,LEAD CAPSUREFIX NOVUS MRI 52CM,1602.0,881.1,480.6,1409.76,35
HCPCS,C2596,"Probe, robotic, water-jet",,,13936.0,13936.0,1
HCPCS,C2616,HC IR EMB RADIO SIRSPHERES,40000.0,22000.0,12000.0,35200.0,50
HCPCS,C2616,HC IR EMB RDIO THERSPHRE YTTRIUM 90 HUD # H980006,41250.0,22687.5,12375.0,36300.0,50
HCPCS,C2617,HC IR DRAIN NEPHROURETERAL STENT,575.0,316.25,172.5,506.0,35
HCPCS,C2617,HC IR DRAIN PED URETERAL STENT,353.5,194.43,106.05,311.08,35
HCPCS,C2617,HC IR DRAIN PERCUFLEX NEPHROURETERAL,353.5,194.43,106.05,311.08,35
HCPCS,C2617,HC IR DRAIN PERCUFLEX URETERAL STENT,575.0,316.25,172.5,506.0,35
HCPCS,C2617,HC IR DRAIN URETERAL STENT,575.0,316.25,172.5,506.0,35
HCPCS,C2617,HC MICROVASIVE STENT,602.0,331.1,180.6,529.76,35
HCPCS,C2617,STENT BILIARY DBL PIG 10F 10CM,293.77,161.58,88.13,258.52,35
HCPCS,C2617,STENT BILIARY DBL PIG 10F 12CM,293.77,161.58,88.13,258.52,35
HCPCS,C2617,STENT BILIARY DBL PIG 10FR 3CM,293.77,161.58,88.13,258.52,35
HCPCS,C2617,STENT BILIARY DBL PIG 10FR 5CM,293.77,161.58,88.13,258.52,35
HCPCS,C2617,STENT BILIARY DBL PIG 10FR 7CM,293.77,161.58,88.13,258.52,35
HCPCS,C2617,STENT BILIARY DBL PIG 7FR 10CM,293.77,161.58,88.13,258.52,35
HCPCS,C2617,STENT BILIARY DBL PIG 7FR 3CM1,293.77,161.58,88.13,258.52,35
HCPCS,C2617,STENT BILIARY DBL PIG 7FR 5CM,293.77,161.58,88.13,258.52,35
HCPCS,C2617,STENT BILIARY DBL PIG 7FR 7CM,293.77,161.58,88.13,258.52,35
HCPCS,C2617,STENT PANC B/W 5FR 3CM,356.5,196.08,106.95,313.72,35
HCPCS,C2617,STENT PANC B/W 5FR 5CM,356.5,196.08,106.95,313.72,35
HCPCS,C2617,STENT PANC B/W 5FR 7CM,356.5,196.08,106.95,313.72,35
HCPCS,C2617,STENT PANC B/W 7FR 3CM,345.0,189.75,103.5,303.6,35
HCPCS,C2617,STENT PANCREATC GEENEN 5F 5CM,356.5,196.08,106.95,313.72,35
HCPCS,C2617,STENT PANCREATC GEENEN 5F 7CM,356.5,196.08,106.95,313.72,35
HCPCS,C2617,STENT POLARIS 5X12,651.74,358.46,195.52,573.53,35
HCPCS,C2617,STENT SOF FLEX 4.7F X 14CM,575.0,316.25,172.5,506.0,35
HCPCS,C2617,STENT SOF FLEX 4.7F X 16CM,575.0,316.25,172.5,506.0,35
HCPCS,C2617,STENT URET POLARIS 5FRX24CM,651.74,358.46,195.52,573.53,35
HCPCS,C2617,STENT URET POLARIS 6FRX20CM,651.74,358.46,195.52,573.53,35
HCPCS,C2617,STENT URET POLARIS 6FRX22CM,651.74,358.46,195.52,573.53,35
HCPCS,C2617,STENT URET POLARIS 6FRX26CM,651.74,358.46,195.52,573.53,35
HCPCS,C2617,STENT URET POLARIS 7FRX24CM,651.74,358.46,195.52,573.53,35
HCPCS,C2618,"HC ENDOCARE PERCRYO CRYOPROBE, OBLONG ICE, PROBE/NEEDLE, CRYOABLATION",6225.0,3423.75,1867.5,5384.63,38
HCPCS,C2618,HC IR OCCLUSION BALLOON CATH 10-37MM,2288.5,1258.68,686.55,1979.55,38
HCPCS,C2618,HC IR PROBE VARIAN CRYOABLATION,6847.5,3766.13,2054.25,5923.09,38
HCPCS,C2618,HC MRI NEEDLE ICEROD,8694.5,4781.98,2608.35,7520.74,38
HCPCS,C2618,HC MRI NEEDLE ICESEED,8694.5,4781.98,2608.35,7520.74,38
HCPCS,C2618,HC PROBE GALIL CRYOABLATION,5672.0,3119.6,1701.6,4906.28,38
HCPCS,C2618,"HC PROBE/NEEDLE, CRYOABLATION",7778.5,4278.18,2333.55,6728.4,38
HCPCS,C2623,HC IR BALLOON DRUG COATED,5187.5,2853.13,1556.25,4565.0,35
HCPCS,C2623,HC IR BALLOON DRUG COATED AV 5-7,4450.0,2447.5,1335.0,3916.0,35
HCPCS,C2623,HC IR BALLOON DRUG COATED AV 8-12,6110.5,3360.78,1833.15,5377.24,35
HCPCS,C2623,HC IR BALLOON DRUG COATED LONG,8476.0,4661.8,2542.8,7458.88,35
HCPCS,C2624,"HC CARDIOMEMS, IMPLANT WIRELESS PULM ART PRESSURE SENSOR W/ DELIVERY CATH",48750.0,26812.5,14625.0,42900.0,35
HCPCS,C2624,SYS CARDIOMEMS HF PA SENSOR,53750.0,29562.5,16125.0,47300.0,35
HCPCS,C2625,HC ASCERTA STENT,440.5,242.28,132.15,387.64,35
HCPCS,C2625,HC BS TRIA SOFT URETERAL STENT,885.5,487.03,265.65,779.24,35
HCPCS,C2625,HC DBL J STENT,575.0,316.25,172.5,506.0,35
HCPCS,C2625,HC IR STENT BILIARY ADVANIX,575.0,316.25,172.5,506.0,35
HCPCS,C2625,HC NONCORONARY TEMPORARY STENT W DELIVERY SYSTEM,575.0,316.25,172.5,506.0,35
HCPCS,C2625,HC URETERAL DIVERSION STENT 6 FR SINGLE,332.5,182.88,99.75,292.6,35
HCPCS,C2625,HC URETERAL DIVERSION STENT 7 FR DOUBLE,575.0,316.25,172.5,506.0,35
HCPCS,C2625,STENT ADVANIX 10FRX12CM,575.0,316.25,172.5,506.0,35
HCPCS,C2625,STENT ADVANIX 10FRX5CM,575.0,316.25,172.5,506.0,35
HCPCS,C2625,STENT ADVANIX 7FRX7CM,575.0,316.25,172.5,506.0,35
HCPCS,C2625,STENT ADVANIX CTR BEND 10FX12C,575.0,316.25,172.5,506.0,35
HCPCS,C2625,STENT ADVANIX CTR BEND 10FX15C,575.0,316.25,172.5,506.0,35
HCPCS,C2625,STENT ADVANIX CTR BEND 10FX5CM,575.0,316.25,172.5,506.0,35
HCPCS,C2625,STENT ADVANIX CTR BEND 10FX7CM,575.0,316.25,172.5,506.0,35
HCPCS,C2625,STENT ADVANIX CTR BEND 10FX9CM,575.0,316.25,172.5,506.0,35
HCPCS,C2625,STENT ADVANIX CTR BEND 7FX12CM,575.0,316.25,172.5,506.0,35
HCPCS,C2625,STENT ADVANIX CTR BEND 7FX15CM,575.0,316.25,172.5,506.0,35
HCPCS,C2625,STENT ADVANIX CTR BEND 7FX9CM,575.0,316.25,172.5,506.0,35
HCPCS,C2625,STENT JOHLIN 10FR 22CM LF,580.5,319.28,174.15,510.84,35
HCPCS,C2625,STENT NASAL SINUS DES .62IN,4500.0,2475.0,1350.0,3960.0,35
HCPCS,C2625,STENT NASAL SINUS DES .9IN,4500.0,2475.0,1350.0,3960.0,35
HCPCS,C2625,STENT OPEN END 6FRX75CM,407.1,223.91,122.13,358.25,35
HCPCS,C2625,STENT OPEN END 7FRX70CM,407.1,223.91,122.13,358.25,35
HCPCS,C2625,STENT RESONANCE 6X26,4743.87,2609.13,1423.16,4174.61,35
HCPCS,C2625,STENT SALMAN ENDOSPY,293.25,161.29,87.98,258.06,35
HCPCS,C2625,STENT TRIA URETERAL 6FRX22CM,940.95,517.53,282.29,828.04,35
HCPCS,C2625,STENT TRIA URETERAL 6FRX24CM,940.95,517.53,282.29,828.04,35
HCPCS,C2625,STENT TRIA URETERAL 6FRX26CM,940.95,517.53,282.29,828.04,35
HCPCS,C2625,STENT TRIA URETERAL 6FRX28CM,940.95,517.53,282.29,828.04,35
HCPCS,C2625,STENT TRIA URETERAL 7FRX22CM,940.95,517.53,282.29,828.04,35
HCPCS,C2625,STENT TRIA URETERAL 7FRX24CM,940.95,517.53,282.29,828.04,35
HCPCS,C2625,STENT URET ASCERTA 4.8FRX24CM,458.51,252.19,137.55,403.49,35
HCPCS,C2625,STENT URET ASCERTA 4.8FRX26CM,458.51,252.19,137.55,403.49,35
HCPCS,C2625,STENT URET ASCERTA 4.8FRX28CM,458.51,252.19,137.55,403.49,35
HCPCS,C2625,STENT URET ASCERTA 6FRX22CM,458.51,252.19,137.55,403.49,35
HCPCS,C2625,STENT URET ASCERTA 6FRX24CM,458.51,252.19,137.55,403.49,35
HCPCS,C2625,STENT URET ASCERTA 6FRX26CM,458.51,252.19,137.55,403.49,35
HCPCS,C2625,STENT URET ASCERTA 6FRX28CM,458.51,252.19,137.55,403.49,35
HCPCS,C2625,STENT URET ASCERTA 6FRX30CM,458.51,252.19,137.55,403.49,35
HCPCS,C2625,STENT URET ASCERTA 7FRX20CM,458.51,252.19,137.55,403.49,35
HCPCS,C2625,STENT URET ASCERTA 7FRX24CM,458.51,252.19,137.55,403.49,35
HCPCS,C2625,STENT URET ASCERTA 7FRX26CM,458.51,252.19,137.55,403.49,35
HCPCS,C2625,STENT URET POLARIS 8FRX22CM,651.74,358.46,195.52,573.53,35
HCPCS,C2625,STENT URET POLARIS 8FRX24CM,651.74,358.46,195.52,573.53,35
HCPCS,C2625,STENT URET SET J OPEN 7FRX75MM,575.0,316.25,172.5,506.0,35
HCPCS,C2627,HC CATH SUPRAPUBIC CYSTOSCOPIC,230.0,126.5,69.0,198.95,114
HCPCS,C2628,BALLOON CODA 14FR 140CM,2153.25,1184.29,645.98,1862.56,38
HCPCS,C2628,BALLOON CODA 32MMX120CM,2153.25,1184.29,645.98,1862.56,38
HCPCS,C2628,CATH BALLOON BRIDGE OCCLUSION,4185.0,2301.75,1255.5,3620.03,38
HCPCS,C2628,CATH WEDGE BALLOON 7FR 110CM,846.0,465.3,253.8,731.79,38
HCPCS,C2628,HC IR BALL OCC HYPERFORM HYPERGLIDE,4450.0,2447.5,1335.0,3849.25,38
HCPCS,C2628,HC IR BALL OCC SCEPTER,4450.0,2447.5,1335.0,3849.25,38
HCPCS,C2628,"HC IR BALL OCC SCEPTER, MINI",12570.0,6913.5,3771.0,10873.05,38
HCPCS,C2628,HC IR BALLOON OCCLUSION,6480.0,3564.0,1944.0,5605.2,38
HCPCS,C2628,HC IR DEVICE FRONTRUNNER CATH,4552.0,2503.6,1365.6,3937.48,38
HCPCS,C2628,HC UVUE OCCLUSION CATHETER,230.0,126.5,69.0,198.95,38
HCPCS,C2629,KIT LASER SHEATH 14FR,12450.0,6847.5,3735.0,10769.25,38
HCPCS,C2630,CATH TACTIFLEX DF-CURVE 4X115,12540.0,6897.0,3762.0,10847.1,38
HCPCS,C2630,"HC CELSIUS THERMOCOUPLE CATH, ELECTROPHYS DX/ABLAT, OTH THAN 3D/VECT MAP",4316.0,2373.8,1294.8,3733.34,38
HCPCS,C2634,"HC BRACHYTX NON STRAND HIGH ACTIV I-125, GREATER THAN 1.01 MCI",230.0,126.5,69.0,202.4,50
HCPCS,C2635,"Brachytx, non-str, HA, P-103",,,69.38,71.46,15
HCPCS,C2636,"Brachy linear, non-str,P-103",,,52.91,54.5,15
HCPCS,C2638,HC BRACHYTX STRANDED IODINE 125 PROST,230.0,126.5,37.04,202.4,50
HCPCS,C2639,"Brachytx, non-stranded,I-125",,,35.11,36.16,15
HCPCS,C2640,"Brachytx, stranded, P-103",,,69.69,71.78,15
HCPCS,C2641,"Brachytx, non-stranded,P-103",,,79.77,82.16,15
HCPCS,C2642,"Brachytx, stranded, C-131",,,107.86,111.1,15
HCPCS,C2643,"Brachytx, non-stranded,C-131",,,96.56,99.46,15
HCPCS,C2645,"Brachytx planar, p-103",,,4.69,4.83,15
HCPCS,C2698,HC STRANDED STRONTIUM 90 BRACHYTHERAPY SEEDS PER SOURCE,371.5,204.33,37.04,326.92,50
HCPCS,C2699,"Brachytx, non-stranded, NOS",,,35.11,36.16,15
HCPCS,C5271,"HC APL LO SKIN SUB GFT TR-AR-LG,TOT WND SA UP TO 100SQCM,1ST 25 SQCM/LESS",2061.0,1133.55,618.3,4258.0,159
HCPCS,C5272,"HC APL LO SKIN SUB GFT TR-AR-LG,TOT WND SA UP TO 100SQCM, EA AD 25SQCM (AD)",320.0,176.0,96.0,3533.0,114
HCPCS,C5273,"HC APL LO SKIN SUB GFT TR-AR-LG,TOT WND SA GR TH/EQ 100SQCM, 1ST 100SQCM",5410.0,2975.5,1623.0,6766.0,159
HCPCS,C5274,"HC APL LO SKIN SUB GFT TR-AR-LG,TOT WND SA GR TH/EQ 100SQCM, EA AD 100SQCM",685.0,376.75,205.5,3533.0,76
HCPCS,C5275,"HC APL LO SK SUB GFT FC SCLP EXTR,TOT WND SA UP TO 100SQCM,1ST 25SQCM/LESS",1696.0,932.8,508.8,4258.0,159
HCPCS,C5276,"HC APL LO SK SUB GFT FC SCLP EXTR,TOT WND SA UP TO 100SQCM,EA AD 25SQCM(AD)",320.0,176.0,96.0,3533.0,76
HCPCS,C5277,"HC APL LO SK SUB GFT FC SCLP EXTR,TOT WND SA GR TH/EQ 100SQCM,1ST 100SQCM",2061.0,1133.55,618.3,4258.0,106
HCPCS,C5278,"HC APL LO SK SUB GFT FC SCLP EXTR,TOT WND SA GR TH/EQ 100SQCM,EA AD 100SQCM",685.0,376.75,205.5,3533.0,38
HCPCS,C7500,Deb bone 20 cm2 w/drug dev,,,2453.0,5761.0,7
HCPCS,C7501,Perc bx breast lesions stero,,,2453.0,5761.0,7
HCPCS,C7502,Perc bx breast lesions mr,,,2453.0,5761.0,7
HCPCS,C7503,Open exc cerv node(s) w/ id,,,2453.0,5761.0,7
HCPCS,C7504,Perq cvt&ls inj vert bodies,,,2453.0,8363.0,7
HCPCS,C7505,Perq ls&cvt inj vert bodies,,,2453.0,8363.0,7
HCPCS,C7506,Fusion of finger joints,,,2453.0,18485.0,7
HCPCS,C7507,Perq thor&lumb vert aug,,,2453.0,18485.0,7
HCPCS,C7508,Perq lumb&thor vert aug,,,2453.0,18485.0,7
HCPCS,C7509,Dx bronch w/ navigation,,,2453.0,5761.0,7
HCPCS,C7510,Bronch/lavag w/ navigation,,,2453.0,5761.0,7
HCPCS,C7511,Bronch/bpsy(s) w/ navigation,,,2453.0,5761.0,7
HCPCS,C7512,Bronch/bpsy(s) w/ ebus,,,2453.0,8363.0,7
HCPCS,C7513,Cath/angio dialcir w/aplasty,,,2453.0,17386.0,7
HCPCS,C7514,Cath/angio dial cir w/stents,,,2453.0,17386.0,7
HCPCS,C7515,Cath/angio dial cir w/embol,,,2453.0,19884.0,7
HCPCS,C7516,Cor angio w/ ivus or oct,,,2453.0,8363.0,7
HCPCS,C7517,Cor angio w/ilic/fem angio,,,2453.0,8363.0,7
HCPCS,C7518,Cor/gft angio w/ ivus or oct,,,2453.0,8363.0,7
HCPCS,C7519,Cor/gft angio w/ flow resrv,,,2453.0,8363.0,7
HCPCS,C7520,Cor/gft angio w/ilic/fem ang,,,2453.0,8363.0,7
HCPCS,C7521,R hrt angio w/ ivus or oct,,,2453.0,8363.0,7
HCPCS,C7522,R hrt angio w/flow resrv,,,2453.0,8363.0,7
HCPCS,C7523,L hrt angio w/ ivus or oct,,,2453.0,8363.0,7
HCPCS,C7524,L hrt angio w/flow resrv,,,2453.0,8363.0,7
HCPCS,C7525,L hrt gft ang w/ ivus or oct,,,2453.0,8363.0,7
HCPCS,C7526,L hrt gft ang w/flow resrv,,,2453.0,8363.0,7
HCPCS,C7527,R&l hrt angio w/ ivus or oct,,,2453.0,8363.0,7
HCPCS,C7528,R&l hrt angio w/flow resrv,,,2453.0,8363.0,7
HCPCS,C7529,R&l hrt gft ang w/flow resrv,,,2453.0,8363.0,7
HCPCS,C7530,Cath/aplasty dial cir w/stnt,,,2453.0,19884.0,7
HCPCS,C7531,Angio fem/pop w/ us,,,2453.0,19884.0,7
HCPCS,C7532,Angio w/ us non-coronary,,,2453.0,17386.0,7
HCPCS,C7533,Ptca w/ plcmt brachytx dev,,,2453.0,17386.0,7
HCPCS,C7534,Fem/pop revasc w/arthr & us,,,2453.0,24394.0,7
HCPCS,C7535,Fem/pop revasc w/stent & us,,,2453.0,24394.0,7
HCPCS,C7537,Insrt atril pm w/l vent lead,,,2453.0,19884.0,7
HCPCS,C7538,Insrt vent pm w/l vent lead,,,2453.0,8363.0,7
HCPCS,C7539,Insrt a & v pm w/l vent lead,,,2453.0,24394.0,7
HCPCS,C7540,Rmv&rplc pm dul w/l vnt lead,,,2453.0,19884.0,7
HCPCS,C7541,Ercp w/ pancreatoscopy,,,2453.0,8363.0,7
HCPCS,C7542,Ercp w/bx & pancreatoscopy,,,2453.0,8363.0,7
HCPCS,C7543,"Ercp w/otomy, pancreatoscopy",,,2453.0,8363.0,7
HCPCS,C7544,Ercp rmv calc pancreatoscopy,,,2453.0,13936.0,7
HCPCS,C7545,Exch bil cath w/ rmv calculi,,,2453.0,8363.0,7
HCPCS,C7546,Rep nph/urt cath w/dil stric,,,2453.0,5761.0,7
HCPCS,C7547,Cnvrt neph cath w/ dil stric,,,2453.0,5761.0,7
HCPCS,C7548,Exch neph cath w/ dil stric,,,2453.0,5761.0,7
HCPCS,C7549,Chge urtr stent w/ dil stric,,,2453.0,5761.0,7
HCPCS,C7550,Cysto w/ bx(s) w/ blue light,,,2453.0,5761.0,7
HCPCS,C7551,Exc neuroma w/ implnt nv end,,,2453.0,5761.0,7
HCPCS,C7552,R hrt art/grft ang hrt flow,,,2453.0,8363.0,7
HCPCS,C7553,R&i hrt art/vent ang drg ad,,,2453.0,8363.0,7
HCPCS,C7554,Cystureth blu li cyst fl img,,,2453.0,4602.0,7
HCPCS,C7555,Rmvl thyrd w/autotran parath,,,2453.0,16786.0,7
HCPCS,C7556,Bronch lavage w/ebus,,,8363.0,8363.0,1
HCPCS,C7557,Cor angio/vent w/ffr,,,2453.0,8363.0,7
HCPCS,C7558,OP Surgery - Grouper Table,,,8363.0,8363.0,1
HCPCS,C7560,Ercp remove forgn body&endo,,,2453.0,13936.0,7
HCPCS,C7562,R&l hrt angio w/ffr & 3d map,,,2453.0,8363.0,7
HCPCS,C7563,Trluml ballo angiop all art,,,2453.0,17386.0,7
HCPCS,C7564,Vein mech throm w/intrvas us,,,2453.0,17386.0,7
HCPCS,C7565,Rpr aa hrn < 3 rdc w/ rmvl,,,2453.0,8363.0,7
HCPCS,C7900,"Hopd mntl hlt, 15-29 min",,,30.27,31.18,15
HCPCS,C7901,"Hopd mntl hlt, 30-60 min",,,94.0,96.82,15
HCPCS,C7903,"Hopd mntl hlt, grp",,,30.27,31.18,15
HCPCS,C8001,3d anat seg imaging preop,,,158.99,163.76,15
HCPCS,C8002,"Prep skin cell susp, automtd",,,7367.96,18485.0,16
HCPCS,C8003,Imp extar knee shck absrb,,,12463.0,21512.0,22
HCPCS,C8004,"HC IR SIM ANGIO W/ USE OF PRESS GEN CATH, INCL ALL SUPRV & INTERP, IMG GUID",28810.5,15845.78,359.0,24921.08,53
HCPCS,C8005,Pef bronch ablt 3d nav ebus,,,5761.0,18317.53,16
HCPCS,C8006,Inst pleu-perit shnt w pump,,,6340.83,6531.06,15
HCPCS,C8900,"MRA w/cont, abd",,,362.92,373.8,15
HCPCS,C8901,"MRA w/o cont, abd",,,245.64,253.0,15
HCPCS,C8902,"MRA w/o fol w/cont, abd",,,362.92,373.8,15
HCPCS,C8903,"HC UNILAT, MRI, BREAST, W/ CONTRAST MATERIAL(S)",3541.0,1947.55,180.9,3062.97,159
HCPCS,C8905,"MRI w/o fol w/cont, brst, un",,,362.92,373.8,15
HCPCS,C8906,"HC BILAT, MRI, BREAST, W/ CONTRAST MATERIAL(S)",5698.0,3133.9,362.92,4928.77,318
HCPCS,C8908,"MRI w/o fol w/cont, breast,",,,362.92,373.8,15
HCPCS,C8909,"MRA w/cont, chest",,,362.92,373.8,15
HCPCS,C8910,"MRA w/o cont, chest",,,245.64,253.0,15
HCPCS,C8911,"MRA w/o fol w/cont, chest",,,362.92,373.8,15
HCPCS,C8912,"MRA w/cont, lwr ext",,,362.92,373.8,15
HCPCS,C8913,"MRA w/o cont, lwr ext",,,245.64,253.0,15
HCPCS,C8914,"MRA w/o fol w/cont, lwr ext",,,362.92,373.8,15
HCPCS,C8918,"MRA w/cont, pelvis",,,362.92,373.8,15
HCPCS,C8919,"MRA w/o cont, pelvis",,,245.64,253.0,15
HCPCS,C8920,"MRA w/o fol w/cont, pelvis",,,362.92,373.8,15
HCPCS,C8921,"HC TTE W/ CONTR, OR W/O CONTR F/B CONTR, CONGEN CARD ANOMAL, COMPLETE",2966.0,1631.3,515.0,2565.59,53
HCPCS,C8922,"HC TTE W/ CONTR, OR W/O CONTR F/B CONTR, CONGEN CARD ANOMAL, FOLLOW UP/LTD",2213.0,1217.15,515.0,1914.25,53
HCPCS,C8923,"2D TTE w or w/o fol w/con,co",,,802.86,826.94,15
HCPCS,C8924,"HC TTE W/ CONTR, OR W/O CONTR F/B CONTR, REAL TIME W IMAG DOC (2D), F/U/LTD",1632.0,897.6,362.92,1411.68,53
HCPCS,C8925,"HC TEE W/ CONTR, OR W/O CONTR F/B CONTR, REAL TIME W IMAG DOC (2D),INCL PRB",3513.0,1932.15,515.0,3038.75,53
HCPCS,C8926,"HC TEE W/ CONTR, OR W/O CONTR F/B CONTR, CONGEN CARD ANOMAL, INCL PROBE PLC",3387.0,1862.85,515.0,2929.76,53
HCPCS,C8927,"TEE w or w/o fol w/cont, mon",,,802.86,826.94,15
HCPCS,C8928,"TTE w or w/o fol w/con,stres",,,802.86,826.94,15
HCPCS,C8929,"HC TTE W/ CONTR, OR W/O CONTR F/B CONTR, 2D, COMPL,W/ SPEC/COLR FL DOP ECHO",3708.0,2039.4,515.0,3207.42,53
HCPCS,C8930,"HC TTE W/ CONTR, OR W/O CONTR F/B CONTR, 2D, COMPL,DURING REST-CARDVASC STR",4835.0,2659.25,515.0,4182.28,53
HCPCS,C8931,"MRA, w/dye, spinal canal",,,362.92,373.8,15
HCPCS,C8932,"MRA, w/o dye, spinal canal",,,245.64,253.0,15
HCPCS,C8933,"MRA, w/o&w/dye, spinal canal",,,362.92,373.8,15
HCPCS,C8934,"MRA, w/dye, upper extremity",,,362.92,373.8,15
HCPCS,C8935,"MRA, w/o dye, upper extr",,,245.64,253.0,15
HCPCS,C8936,"MRA, w/o&w/dye, upper extr",,,362.92,373.8,15
HCPCS,C8937,"HC CAD, INCL COMPUTER ALGORITHM ANALYS BREAST MRI IMG FOR LES DETECT (AD)",77.0,42.35,23.1,2524.0,152
HCPCS,C8957,"HC IV INFUS THERAPY/DX, INITIATE PROLONG (MORE THAN 8 HRS), PORT/IMPL PUMP",834.0,458.7,250.2,733.0,477
HCPCS,C9046,cocaine 4 % Solution 4 mL Bottle,449.0,246.95,134.7,388.39,48
HCPCS,C9047,caplacizumab-yhdp 11 MG Kit 1 Each Box,36011.06,19806.09,10803.32,31149.57,48
HCPCS,C9067,Gallium ga-68 dotatoc,,,4.05,4.17,15
HCPCS,C9089,APC,,,0.89,0.92,15
HCPCS,C9101,"Inj, oliceridine 0.1 mg",,,1.13,1.4,6
HCPCS,C9144,"Inj, bupivacaine (posimir)",,,0.43,0.53,21
HCPCS,C9145,"Inj, aponvie, 1 mg",,,1.59,1.97,21
HCPCS,C9173,Lab/Drugs Fee Schedule,,,0.46,0.57,6
HCPCS,C9174,datopotamab deruxtecan-dlnk 20 mg/mL Recon Soln 1 Each Vial,21051.6,11578.38,6315.48,18209.63,38
HCPCS,C9248,clevidipine 25 MG/50ML Emulsion 50 mL Vial,367.6,202.18,110.28,317.97,38
HCPCS,C9250,Artiss fibrin sealant,,,115.48,146.15,21
HCPCS,C9254,Lacosamide 200 MG/20ML Solution 20 mL Vial,508.56,279.71500000000003,122.29,527.2,96
HCPCS,C9257,bevacizumab 25 mg/mL Solution 0.12 mL Syringe,1345.7,740.14,1.58,1164.03,63
HCPCS,C9257,bevacizumab 25 mg/mL Solution 4 mL Vial,3611.23,1986.18,1.58,3123.71,63
HCPCS,C9305,APC,,,32.14,33.1,15
HCPCS,C9306,APC,,,143.99,148.31,15
HCPCS,C9359,MATRIX FIBERGRAFT BG XL 20CC,14483.7,7966.04,4345.11,12745.66,35
HCPCS,C9399,PONATinib 10 MG Tab 30 Each Bottle,1816.2,998.91,544.86,1571.01,48
HCPCS,C9399,PONATinib 30 MG Tab 30 Each Bottle,1816.2,998.91,544.86,1571.01,48
HCPCS,C9399,PONATinib 45 MG Tab 30 Each Bottle,1816.2,998.91,544.86,1571.01,48
HCPCS,C9399,anakinra 100 MG/0.67ML Solution Prefilled Syringe 0.67 mL Syringe,1152.68,633.975,345.8,997.08,96
HCPCS,C9399,azaCITIDine 200 MG Tab 14 Each Bottle,3632.11,1997.67,1089.63,3141.78,48
HCPCS,C9399,azaCITIDine 300 MG Tab 14 Each Bottle,3632.11,1997.67,1089.63,3141.78,48
HCPCS,C9399,brivaracetam 50 MG/5ML Solution 5 mL Vial,393.78,216.58,118.13,340.62,48
HCPCS,C9399,deFIBrotide 200 MG/2.5ML Solution 2.5 mL Vial,6376.2,3506.91,1912.86,5515.41,48
HCPCS,C9399,futibatinib (12 mg daily dose) 4 mg Tablet Therapy Pack 21 Each Box,671.86,369.53,201.56,581.16,48
HCPCS,C9399,futibatinib (16 mg daily dose) 4 mg Tablet Therapy Pack 28 Each Box,505.14,277.83,151.54,436.95,48
HCPCS,C9399,futibatinib (20 mg daily dose) 4 mg Tablet Therapy Pack 35 Each Box,405.11,222.82,121.53,350.42,48
HCPCS,C9399,idaruCIZUmab 2.5 GM/50ML Solution 50 mL Vial,10725.04,5898.78,3217.51,9277.16,48
HCPCS,C9399,lifileucel 72000000000 CELLS Suspension 1 Each Flex Cont,2575000.0,1416250.0,772500.0,2266000.0,48
HCPCS,C9399,posaconazole 300 MG/16.7ML Solution 16.7 mL Vial,2879.39,1583.67,863.82,2490.67,48
HCPCS,C9399,sulbactam/durlobactam 200 mg/mL Recon Soln 3 Each Box,913.2,502.26,273.96,789.92,48
HCPCS,C9399,teduglutide 5 MG Kit 1 Each Box,196959.3,108327.62,59087.79,170369.79,48
HCPCS,C9399,terlipressin 0.85 MG Recon Soln 1 Each Vial,5350.2,2942.61,1605.06,4627.92,48
HCPCS,C9399,uridine triacetate 10 g Pack 20 Each Box,10118.6,5565.23,3035.58,8752.59,48
HCPCS,C9399,uridine triacetate 10 g Pack 4 Each Box,10118.6,5565.23,3035.58,8752.59,48
HCPCS,C9460,cangrelor 200 mcg/mL Injection 250 mL Bag,3808.39,2094.62,16.16,3294.26,63
HCPCS,C9460,cangrelor 50 MG Recon Soln 1 Each Vial,5421.47,2981.81,16.16,4689.57,63
HCPCS,C9462,delafloxacin 300 MG Recon Soln 1 Each Vial,781.26,429.7,234.38,675.79,48
HCPCS,C9482,Sotalol hydrochloride IV,,,19.57,25.8,21
HCPCS,C9507,COVID-19 convalescent plasma,,,425.62,438.39,15
HCPCS,C9600,HC PERCUT TRNSCATH PLC DRUG ELUT STENT SGL BRNCH,28131.0,15472.05,8439.3,24333.32,53
HCPCS,C9601,HC PERCUT TRNSCATH PLC DRUG ELUT STENT EA AD BRNCH,23738.0,13055.9,835.0,21696.0,38
HCPCS,C9602,HC PTC ATHRECT DRUG ELUT STNT ANGPLAST SGL BRNCH,31140.0,17127.0,9342.0,26936.1,53
HCPCS,C9603,HC PTC ATHRECT DRUG ELUT STNT ANGPLAST EA AD BRNCH,30233.0,16628.15,835.0,26151.55,38
HCPCS,C9604,HC PERC TRNSLM RVSC BYP GRFT DRG ELUT STNT SGL VSL,27064.0,14885.2,8119.2,23410.36,53
HCPCS,C9605,HC PERC TRNSLM RVSC BYP GRFT DRUG ELUT STNT INLCD DSTL PROTECTION (ADD ON),18505.0,10177.75,835.0,21696.0,38
HCPCS,C9606,HC PERC TRNSLM RVAS OCCL AMI DRG ELUT STNT SGL VSL,39075.0,21491.25,2453.0,33799.88,38
HCPCS,C9607,HC PERC TRNSLM RVAS CHRONIC OCCL DRG ELUT STNT SGL,29292.0,16110.6,8787.6,25337.58,53
HCPCS,C9608,HC PERC TRNSLM RVAS CHRON OCCL DRG ELUT STNT EA AD,30773.0,16925.15,835.0,26618.65,38
HCPCS,C9610,BALLOON AGENT US MR 2.50 X20MM,18645.0,10254.75,5593.5,16127.93,38
HCPCS,C9725,Place endorectal app,,,926.48,4955.0,21
HCPCS,C9726,Rxt breast appl place/remov,,,835.0,3533.0,6
HCPCS,C9727,Insert palate implants,,,1505.28,6766.0,21
HCPCS,C9728,"Place device/marker, non pro",,,1390.43,5761.0,16
HCPCS,C9733,"HC INDOCYANINE GREEN INJ, NON-OPTHALMIC FLUORESCENT VASC ANGIOGRAPHY",1130.0,621.5,339.0,977.45,53
HCPCS,C9734,"U/S trtmt, not leiomyomata",,,13075.26,19884.0,16
HCPCS,C9738,Blue light cysto imag agent,,,835.0,3533.0,6
HCPCS,C9739,Cystoscopy prostatic imp 1-3,,,5165.97,13936.0,22
HCPCS,C9740,Cysto impl 4 or more,,,9396.95,19884.0,22
HCPCS,C9751,APC,,,3811.26,3925.6,15
HCPCS,C9751,OP Surgery - Grouper Table,,,9733.0,19884.0,7
HCPCS,C9756,Fluorescence lymph map w/ICG,,,835.0,3533.0,6
HCPCS,C9757,Spine device implant surgery,,,10315.0,19884.0,22
HCPCS,C9758,Blind interatrial shunt ide,,,16700.0,28824.0,22
HCPCS,C9759,Transcath intraop microinf,,,835.0,3533.0,6
HCPCS,C9760,Non-blind interatrial shunt,,,19884.0,34485.0,22
HCPCS,C9761,"Cysto, litho, vacuum kidney",,,5480.0,13936.0,22
HCPCS,C9762,Cardiac mri seg dys strain,,,557.18,573.9,15
HCPCS,C9763,Cardiac mri seg dys stress,,,557.18,573.9,15
HCPCS,C9764,"HC REVASC, ENDOVASC, OPEN/PERC, LOWER EXTREM ART, W INTRVASC LITHOTRIPSY",29728.0,16350.4,8918.4,25714.72,106
HCPCS,C9765,HC REVASC/ENDO OPEN/PERCUT VESSEL W/INTRA LITHOTRIP-STENT INCLD ANGIOPLASTY,23105.0,12707.75,6931.5,21512.0,106
HCPCS,C9766,Revasc intra lithotrip-ather,,,12463.0,21512.0,22
HCPCS,C9767,Revasc lithotrip-stent-ather,,,12463.0,24394.0,22
HCPCS,C9769,OP Surgery - Grouper Table,,,13936.0,13936.0,1
HCPCS,C9770,OP Surgery - Grouper Table,,,13936.0,13936.0,1
HCPCS,C9771,OP Surgery - Grouper Table,,,5761.0,5761.0,1
HCPCS,C9772,"HC REVASC, ENDOVASC, OPEN/PERC, TIBIAL/PERONEAL ART, W INTRVASC LITHOTRIPSY",35670.0,19618.5,10701.0,30854.55,53
HCPCS,C9773,"HC REVASC, ENDOVASC, OPEN/PERC, TIB/PERON ART, W/ IVL & TRANSLUM STENC",46298.0,25463.9,12463.0,40047.77,53
HCPCS,C9774,"HC REVASC, ENDOVASC, OPEN/PERC, TIBIAL/PERONEAL ART, W/ IVL & ATHRECTOMY",46298.0,25463.9,12463.0,40047.77,53
HCPCS,C9775,Revasc lith-sten-ath tib/per,,,12463.0,24394.0,22
HCPCS,C9777,Esophag muc integ w/eso egd,,,3866.16,9469.0,21
HCPCS,C9778,"Colpopexy, min/inv, ex-perit",,,5016.42,13936.0,22
HCPCS,C9779,Esd endoscopy or colonoscopy,,,3866.16,9469.0,23
HCPCS,C9780,Insert cv cath inf & sup app,,,8384.16,21512.0,22
HCPCS,C9781,Arthro/shoul surg; w/spacer,,,10315.0,18485.0,22
HCPCS,C9782,Blind myocar trpl bon marrow,,,16700.0,28824.0,22
HCPCS,C9783,Blind cor sinus reducer impl,,,11524.29,21512.0,22
HCPCS,C9784,APC,,,10579.88,10897.28,15
HCPCS,C9784,OP Surgery - Grouper Table,,,10315.0,19884.0,7
HCPCS,C9785,Endo outlet restrict w/tube,,,10315.0,19884.0,22
HCPCS,C9789,HC INSTILLATION OF THERAPEUTIC AGENT INTO RENAL PELVIS ANY METHOD,5717.5,3144.63,1715.25,9469.0,53
HCPCS,C9791,Mri hyperpolarized xenon129,,,1270.76,1308.88,15
HCPCS,C9792,Blind/nonblind trans atrial,,,9908.46,21512.0,22
HCPCS,C9793,Pre 3d mdl w/ccta and/or mri,,,1033.87,1064.89,15
HCPCS,C9796,Rpr intst excl anrect fist,,,2786.82,9469.0,22
HCPCS,C9797,"HC VASC EMBO/OCCLUS W/ USE OF PRESS GEN CATH, TUM, ORG ISCHEMIA/INFARCTION",45619.0,25090.45,12463.0,39460.44,53
HCPCS,C9901,Endo defect closure gi tract,,,10579.88,19884.0,23
HCPCS,E0441,"Stationary O2 contents, gas",,,65.79,67.76,15
HCPCS,E0442,"Stationary O2 contents, liq",,,65.79,67.76,15
HCPCS,E0443,"Portable 02 contents, gas",,,59.06,60.83,15
HCPCS,E0444,"Portable 02 contents, liquid",,,59.06,60.83,15
HCPCS,E0447,"Port o2 cont, liq over 4 lpm",,,88.59,91.25,15
HCPCS,E0491,Oral dv nm mouthpc hw remote,,,103.3,106.4,15
HCPCS,E0783,KIT ACCESSORY ASCENDA,981.0,539.55,294.3,863.28,35
HCPCS,E1037,MAT AIR PT TRANS 39IN HALF DIS,399.05,219.48,119.72,345.18,38
HCPCS,E1037,MAT AIR PT TRANSFER 39IN DISP,466.33,256.49,139.9,403.38,38
HCPCS,E1353,Oxygen supplies regulator,,,39.57,40.76,15
HCPCS,E1355,Oxygen supplies stand/rack,,,29.82,30.71,15
HCPCS,E1701,Repl cushions for jaw motion,,,12.92,13.31,15
HCPCS,E1702,Repl measr scales jaw motion,,,26.79,27.59,15
HCPCS,G0008,HC ADMINISTRATION INFLUENZA VIRUS VACCINE,52.0,28.6,15.6,48.29,4500
HCPCS,G0009,HC ADMINISTRATION PNEUMOCOCCAL VACCINE,96.0,52.8,28.8,83.04,3950
HCPCS,G0010,HC ADMINISTRATION HEPATITIS B VACCINE,112.0,61.6,33.6,96.88,3550
HCPCS,G0011,"Hiv prep counsel, md 15-30m",,,25.2,25.96,15
HCPCS,G0012,Injection of hiv prep drug,,,72.32,74.49,15
HCPCS,G0013,"Hiv prep counsel, clin staff",,,30.27,31.18,15
HCPCS,G0017,Crisis psychotherapy 60m,,,202.54,208.62,15
HCPCS,G0018,Crisis psychotherapy add 30m,,,99.13,102.1,15
HCPCS,G0019,Comm hlth intg svs sdoh 60mn,,,94.0,96.82,15
HCPCS,G0022,Comm hlth intg svs add 30 m,,,46.6,47.99,15
HCPCS,G0023,Pin service 60m per month,,,94.0,96.82,15
HCPCS,G0024,Pin srv add 30 min pr m,,,46.6,47.99,15
HCPCS,G0027,Semen analysis,,,6.32,32.5,23
HCPCS,G0071,APC,,,13.44,13.85,15
HCPCS,G0076,Care manag h vst new pt 20 m,,,46.41,47.8,15
HCPCS,G0077,Care manag h vst new pt 30 m,,,69.11,71.18,15
HCPCS,G0078,Care manag h vst new pt 45 m,,,112.84,116.22,15
HCPCS,G0079,Care manag h vst new pt 60 m,,,148.19,152.64,15
HCPCS,G0080,Care manag h vst new pt 75 m,,,192.55,198.33,15
HCPCS,G0081,Care man h v ext pt 20 mi,,,45.47,46.83,15
HCPCS,G0082,Care man h v ext pt 30 m,,,73.3,75.49,15
HCPCS,G0083,Care man h v ext pt 45 m,,,113.92,117.34,15
HCPCS,G0084,Care man h v ext pt 60 m,,,160.25,165.06,15
HCPCS,G0085,Care man h v ext pt 75 m,,,192.55,198.33,15
HCPCS,G0086,Care man home care plan 30 m,,,68.44,70.49,15
HCPCS,G0087,Care man home care plan 60 m,,,95.94,98.82,15
HCPCS,G0101,CA screen;pelvic/breast exam,,,94.0,96.82,15
HCPCS,G0102,Prostate ca screening; dre,,,21.72,22.37,15
HCPCS,G0103,HC PSA SCREENING,219.0,120.45,18.77,189.44,53
HCPCS,G0104,CA screen;flexi sigmoidscope,,,926.48,4955.0,22
HCPCS,G0105,Colorectal scrn; hi risk ind,,,926.48,4955.0,22
HCPCS,G0108,HC DIAB OUTPT SELF-MGMT EDUC INDIV PER 30 MIN,178.0,97.9,51.21,266.0,53
HCPCS,G0109,HC DIAB MANAGE TRN IND GROUP,77.0,42.35,14.69,266.0,53
HCPCS,G0117,Glaucoma scrn hgh risk direc,,,24.89,25.63,15
HCPCS,G0118,Glaucoma scrn hgh risk direc,,,39.89,41.08,15
HCPCS,G0121,Colon ca scrn not hi rsk ind,,,926.48,4955.0,22
HCPCS,G0123,Screen cerv/vag thin layer,,,19.69,101.3,23
HCPCS,G0124,Screen c/v thin layer by MD,,,22.4,110.58,22
HCPCS,G0127,HC TRIM DYSTROPHIC NAILS ANY NUMBER,188.5,103.68,56.55,799.0,159
HCPCS,G0128,CORF skilled nursing service,,,8.77,9.04,15
HCPCS,G0130,Single energy x-ray study,,,108.06,189.11,16
HCPCS,G0136,Adm of pa/n assess 5-15 m,,,30.27,31.18,15
HCPCS,G0138,Iv cipaglucosidase alfa-atga,,,661.04,680.87,15
HCPCS,G0140,Nav srv peer sup 60 min pr m,,,94.0,96.82,15
HCPCS,G0141,"Scr c/v cyto,autosys and md",,,22.4,110.58,22
HCPCS,G0143,"Scr c/v cyto,thinlayer,rescr",,,26.29,135.25,23
HCPCS,G0144,"Scr c/v cyto,thinlayer,rescr",,,42.73,219.85,23
HCPCS,G0145,"Scr c/v cyto,thinlayer,rescr",,,25.75,132.45,23
HCPCS,G0146,Nav srv peer sup add 30 pr m,,,46.6,47.99,15
HCPCS,G0147,"Scr c/v cyto, automated sys",,,16.82,86.55,23
HCPCS,G0148,"Scr c/v cyto, autosys, rescr",,,31.05,159.7,23
HCPCS,G0166,"Extrnl counterpulse, per tx",,,130.99,134.92,15
HCPCS,G0168,Wound closure by adhesive,,,91.05,3533.0,21
HCPCS,G0175,"OPPS Service,sched team conf",,,432.72,445.7,15
HCPCS,G0179,Md recertification hha pt,,,39.33,40.51,15
HCPCS,G0180,Md certification hha patient,,,49.96,51.46,15
HCPCS,G0181,Home health care supervision,,,97.59,100.52,15
HCPCS,G0182,Hospice care supervision,,,96.56,99.45,15
HCPCS,G0183,Software meas of cardiac vol,,,89.48,92.16,15
HCPCS,G0186,"Dstry eye lesn,fdr vssl tech",,,557.49,4955.0,21
HCPCS,G0235,PET not otherwise specified,,,408.34,420.59,15
HCPCS,G0237,HC THER RESP PX STRNG ENDR RESP MUSC INDV EA 15MIN,153.0,84.15,24.89,684.0,53
HCPCS,G0238,HC OTH THER RESP PROC IMPROVE RESP INDV PER 15 MIN,133.0,73.15,24.89,684.0,53
HCPCS,G0239,HC THER RESP PROC INCR STRNGTH ENDR RESP MUSCL-GRP,350.0,192.5,39.89,684.0,53
HCPCS,G0245,Initial foot exam pt lops,,,130.96,134.89,15
HCPCS,G0246,Followup eval of foot pt lop,,,130.96,134.89,15
HCPCS,G0247,Routine footcare pt w lops,,,201.92,207.98,15
HCPCS,G0248,"HC DEMO, PRIOR TO INITIAT HOME INR MONITOR, PAT W MHV(S), CAF, VEN THRMBLSM",417.0,229.35,125.1,603.0,53
HCPCS,G0249,Provide INR test mater/equip,,,130.96,134.89,15
HCPCS,G0250,MD INR test revie inter mgmt,,,8.1,8.34,15
HCPCS,G0257,HC UNSCHED DIALYSIS ESRD PATIENT HOSP OUTPT DEPT,2798.0,1538.9,469.0,2420.27,53
HCPCS,G0259,Inject for sacroiliac joint,,,835.0,3533.0,6
HCPCS,G0260,Inj for sacroiliac jt anesth,,,703.74,4955.0,22
HCPCS,G0268,HC REM IMPACT CERUMEN UNILAT-BILAT SAME DAY AS AUDIO FUNCT TEST,164.0,90.2,47.52,471.0,53
HCPCS,G0269,Occlusive device in vein art,,,835.0,3533.0,6
HCPCS,G0270,HC MED NUTR THER REASSESS/SBSQ INTRVNT POST 2ND YR NEW DX 1 PT EA 15 MIN,74.0,40.7,22.2,266.0,53
HCPCS,G0271,HC MED NUTR THER REASSESS/SBSQ INTRVNT POST 2ND YR NEW DX 2+ PTS EA 30  MIN,40.0,22.0,12.0,266.0,53
HCPCS,G0276,Pild/placebo control clin tr,,,7259.46,17804.0,21
HCPCS,G0277,HC HYPERBARIC OXYGEN UNDER PRESSURE FULL BODY PER 30 MIN,730.0,401.5,140.13,2561.0,53
HCPCS,G0278,"Iliac art angio,cardiac cath",,,11.41,19.96,16
HCPCS,G0279,"Tomosynthesis, mammo",,,41.09,42.32,15
HCPCS,G0281,Elec stim unattend for press,,,10.88,11.21,15
HCPCS,G0283,Elec stim other than wound,,,11.81,12.17,15
HCPCS,G0288,"Recon, CTA for surg plan",,,41.92,73.36,16
HCPCS,G0289,"Arthro, loose body + chondro",,,74.81,3533.0,21
HCPCS,G0293,"Non-cov surg proc,clin trial",,,39.89,41.08,15
HCPCS,G0294,"Non-cov proc, clinical trial",,,39.89,41.08,15
HCPCS,G0296,HC COUNSEL VISIT DISCUSS NEED LUNG CANCER SCREEN (LDCT) USING LOW DOSE CT,125.0,68.75,37.5,108.13,53
HCPCS,G0302,Pre-op service LVRS complete,,,539.2,555.37,15
HCPCS,G0303,Pre-op service LVRS 10-15dos,,,316.44,325.94,15
HCPCS,G0304,Pre-op service LVRS 1-9 dos,,,539.2,555.37,15
HCPCS,G0305,Post op service LVRS min 6,,,539.2,555.37,15
HCPCS,G0306,CBC/diffwbc w/o platelet,,,7.55,38.85,23
HCPCS,G0307,CBC without platelet,,,6.28,32.35,23
HCPCS,G0308,OP Surgery - Grouper Table,,,5761.0,5761.0,1
HCPCS,G0309,OP Surgery - Grouper Table,,,5761.0,5761.0,1
HCPCS,G0316,Prolong inpt eval add15 m,,,29.45,30.33,15
HCPCS,G0317,Prolong nursin fac eval 15m,,,29.14,30.01,15
HCPCS,G0318,Prolong home eval add 15m,,,28.83,29.69,15
HCPCS,G0323,Care manage beh svs 20mins,,,30.27,31.18,15
HCPCS,G0328,HC FECAL BLOOD SCRN IMMUNOASSAY,194.0,106.7,17.54,167.81,53
HCPCS,G0329,Electromagntic tx for ulcers,,,9.79,10.08,15
HCPCS,G0330,Facility svs dental rehab,,,2453.0,4602.0,21
HCPCS,G0337,Hospice evaluation preelecti,,,64.12,66.05,15
HCPCS,G0339,"Robot lin-radsurg com, first",,,9733.0,16799.0,6
HCPCS,G0340,Robt lin-radsurg fractx 2-5,,,8488.0,14658.0,6
HCPCS,G0341,Percutaneous islet celltrans,,,1445.55,16786.0,16
HCPCS,G0342,Laparoscopy islet cell trans,,,661.94,24394.0,16
HCPCS,G0343,Laparotomy islet cell transp,,,1078.66,24394.0,16
HCPCS,G0372,MD service required for PMD,,,8.08,8.32,15
HCPCS,G0378,HC OUTPATIENT OBSERVATION,112.0,61.6,36.96,6016.0,1596
HCPCS,G0378,HC OUTPATIENT OBSERVATION CARVE-OUT CARDIOLOGY,112.0,61.6,36.96,6016.0,1596
HCPCS,G0378,HC OUTPATIENT OBSERVATION CARVE-OUT RADIOLOGY,112.0,61.6,36.96,6016.0,1596
HCPCS,G0379,HC OBSERVATION DIRECT ADMIT,1486.0,817.3,490.38,6016.0,2173
HCPCS,G0380,Lev 1 hosp type B ED visit,,,85.43,943.0,22
HCPCS,G0381,Lev 2 hosp type B ED visit,,,112.45,1835.0,22
HCPCS,G0382,Lev 3 hosp type B ED visit,,,189.61,3923.0,22
HCPCS,G0383,Lev 4 hosp type B ED visit,,,290.18,5302.0,22
HCPCS,G0384,Lev 5 hosp type B ED visit,,,410.43,6730.0,22
HCPCS,G0390,HC TRAUMA TEAM ACTIV W CRITICAL CARE,11845.0,6514.75,1344.61,34016.0,66
HCPCS,G0396,Alcohol/subs interv 15-30mn,,,30.27,31.18,15
HCPCS,G0397,Alcohol/subs interv >30 min,,,163.27,168.17,15
HCPCS,G0398,Home sleep test/type 2 Porta,,,158.99,4229.0,22
HCPCS,G0399,Home sleep test/type 3 Porta,,,158.99,1803.0,16
HCPCS,G0400,Home sleep test/type 4 Porta,,,316.44,1803.0,16
HCPCS,G0402,Initial preventive exam,,,130.96,134.89,15
HCPCS,G0403,EKG for initial prevent exam,,,13.14,13.54,15
HCPCS,G0404,EKG tracing for initial prev,,,24.89,25.63,15
HCPCS,G0405,EKG interpret & report preve,,,7.46,7.69,15
HCPCS,G0406,Inpt/tele follow up 15,,,37.2,38.32,15
HCPCS,G0407,Inpt/tele follow up 25,,,66.17,68.15,15
HCPCS,G0408,Inpt/tele follow up 35,,,95.92,98.8,15
HCPCS,G0409,CORF related serv 15 mins ea,,,22.09,22.75,15
HCPCS,G0412,Open tx iliac spine uni/bil,,,655.21,17804.0,22
HCPCS,G0413,Pelvic ring fracture uni/bil,,,7259.46,14658.0,22
HCPCS,G0414,Pelvic ring fx treat int fix,,,906.66,17804.0,22
HCPCS,G0415,Open tx post pelvic fxcture,,,1228.1,17804.0,22
HCPCS,G0416,"Prostate biopsy, any mthd",,,315.04,890.65,22
HCPCS,G0420,Ed svc CKD ind per session,,,100.61,103.63,15
HCPCS,G0421,Ed svc CKD grp per session,,,24.23,24.96,15
HCPCS,G0422,HC INTENSIVE CARDIAC REHAB W/WO CONT ECG MONITORING W/ EXERCISE PER SESSION,452.0,248.6,127.95,390.98,53
HCPCS,G0423,HC INTENSIVE CARDIAC REHAB W/WO CONT ECG MONITORING NO EXERCISE PER SESSION,452.0,248.6,127.95,390.98,53
HCPCS,G0425,Inpt/ED teleconsult30,,,84.36,86.89,15
HCPCS,G0426,Inpt/ED teleconsult50,,,119.59,123.18,15
HCPCS,G0427,Inpt/ED teleconsult70,,,170.88,176.01,15
HCPCS,G0428,Collagen Meniscus Implant,,,2453.0,4602.0,6
HCPCS,G0429,Dermal filler injection(s),,,1858.86,1914.63,15
HCPCS,G0432,EIA HIV-1/HIV-2 screen,,,19.02,97.85,23
HCPCS,G0433,ELISA HIV-1/HIV-2 screen,,,17.78,91.45,23
HCPCS,G0435,Oral HIV-1/HIV-2 screen,,,11.65,59.9,23
HCPCS,G0438,"HC ANNUAL WELLNESS VISIT, INCL PPS, INITIAL VISIT",645.0,354.75,153.92,557.93,53
HCPCS,G0439,"HC ANNUAL WELLNESS VISIT, INCL PPS, SUBSEQ VISIT",288.0,158.4,86.4,249.12,53
HCPCS,G0442,Annual alcohol screen 15 min,,,30.27,31.18,15
HCPCS,G0443,Brief alcohol misuse counsel,,,94.0,96.82,15
HCPCS,G0444,"HC ANNUAL DEPRESSION SCREENING, 5 TO 15 MIN",59.0,32.45,30.27,51.04,40
HCPCS,G0445,High inten beh couns STD 30m,,,94.0,96.82,15
HCPCS,G0446,Intens behave ther cardio dx,,,30.27,31.18,15
HCPCS,G0447,Behavior counsel obesity 15m,,,94.0,96.82,15
HCPCS,G0448,Place perm pacing cardiovert,,,2453.0,19884.0,7
HCPCS,G0451,Devlopment test interpt&rep,,,94.0,96.82,15
HCPCS,G0452,Molecular pathology interpr,,,2.96,47.47,22
HCPCS,G0453,Cont intraop neuro monitor,,,29.12,3533.0,21
HCPCS,G0454,MD document visit by NPP,,,8.1,8.34,15
HCPCS,G0455,Fecal microbiota prep instil,,,926.48,954.27,15
HCPCS,G0459,"Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy",,,40.55,41.77,15
HCPCS,G0460,Autolog prp not diab ulcer,,,1858.86,1914.63,15
HCPCS,G0463,Hospital outpt clinic visit,,,130.96,134.89,15
HCPCS,G0465,Autolog prp diab wound ulcer,,,1858.86,1914.63,15
HCPCS,G0471,ven blood coll SNF/HHA,,,11.09,52.85,17
HCPCS,G0472,Hep c screen high risk/other,,,45.05,231.75,23
HCPCS,G0473,Group behave couns 2-10,,,30.27,31.18,15
HCPCS,G0475,Hiv combination assay,,,23.41,120.4,23
HCPCS,G0476,Hpv combo assay ca screen,,,34.11,175.45,23
HCPCS,G0480,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,111.23,572.15,23
HCPCS,G0481,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,152.21,782.95,23
HCPCS,G0482,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,193.18,993.7,23
HCPCS,G0483,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,240.0,1234.6,23
HCPCS,G0498,Chemo extend iv infus w/pump,,,337.06,347.18,15
HCPCS,G0499,Hepb screen high risk indiv,,,27.48,141.35,23
HCPCS,G0500,Mod sedat endo service &gt;5yrs,,,52.16,53.72,15
HCPCS,G0506,Comp asses care plan ccm svc,,,58.39,60.15,15
HCPCS,G0508,Crit care telehea consult 60,,,189.16,194.84,15
HCPCS,G0509,Crit care telehea consult 50,,,173.88,179.1,15
HCPCS,G0511,APC,,,52.15,53.71,15
HCPCS,G0512,APC,,,133.32,137.32,15
HCPCS,G0513,"Prolong prev svcs, first 30m",,,58.41,60.16,15
HCPCS,G0514,"Prolong prev svcs, addl 30m",,,58.41,60.16,15
HCPCS,G0516,"insert drug implant,>=4",,,405.5,4258.0,22
HCPCS,G0517,Remove drug implant,,,405.5,4258.0,22
HCPCS,G0518,Remove w insert drug implant,,,405.5,4258.0,22
HCPCS,G0537,Risk ascvd tst once pr 12 mo,,,30.27,31.18,15
HCPCS,G0538,Ascvd rsk mng clin stf pr mo,,,94.0,96.82,15
HCPCS,G0539,Initial care training 30 m,,,50.62,52.14,15
HCPCS,G0540,Train for caregiver add 15,,,25.0,25.75,15
HCPCS,G0541,No pt prsnt train initial 30,,,50.62,52.14,15
HCPCS,G0542,No pt prsnt train add 15,,,25.0,25.75,15
HCPCS,G0543,Group train w/o patient,,,21.17,21.8,15
HCPCS,G0544,Post d/c phone follow up,,,94.0,96.82,15
HCPCS,G0545,Inherent visit to inpt,,,41.19,42.43,15
HCPCS,G0546,Phone/internet ehr assess,,,16.29,16.77,15
HCPCS,G0547,Phone/internet svs 11-20 m,,,32.88,33.87,15
HCPCS,G0548,Phone/inter svs 21-30 m,,,49.58,51.07,15
HCPCS,G0549,Phone/inter for treat>31m,,,66.49,68.48,15
HCPCS,G0550,Phone/inter for dx/treat >5m,,,31.12,32.05,15
HCPCS,G0551,Phn/intr svs fr dx treat 30m,,,32.67,33.65,15
HCPCS,G0552,Supply of digital device,,,130.96,134.89,15
HCPCS,G0553,Monthly tx for dmht 20mins,,,130.96,134.89,15
HCPCS,G0554,Add 20 m of monthly tx,,,38.11,39.26,15
HCPCS,G0555,Replacment pt electronic sys,,,1033.87,1064.89,15
HCPCS,G0556,Adv prim care mgmt lvl 1,,,30.27,31.18,15
HCPCS,G0557,Adv prim care mgmt lvl 2,,,30.27,31.18,15
HCPCS,G0558,Adv prim care mgmt lvl 3,,,94.0,96.82,15
HCPCS,G0559,Unrelat prac follow up visit,,,7.97,8.21,15
HCPCS,G0560,Safety plan interven,,,40.53,41.75,15
HCPCS,G0561,"Temp tube delivery, unil",,,835.0,3533.0,6
HCPCS,G0562,Complex simulation w/pet-ct,,,1982.1,2041.56,15
HCPCS,G0563,Sbrt w/positron emission del,,,3811.26,3925.6,15
HCPCS,G0564,OP Surgery - Grouper Table,,,8488.0,14658.0,7
HCPCS,G0565,OP Surgery - Grouper Table,,,8488.0,14658.0,7
HCPCS,G0566,3d bn img algor drvd fr mri,,,158.99,163.76,15
HCPCS,G0659,Drug test def simple all cl,,,60.4,310.7,23
HCPCS,G2000,Blinded conv. tx mdd clin tr,,,539.2,555.37,15
HCPCS,G2001,Post D/C H Vst new pt 20 m,,,46.41,47.8,15
HCPCS,G2002,Post-D/C H Vst new pt 30 m,,,69.11,71.18,15
HCPCS,G2003,Post-d/c h vst new pt 45 m,,,112.84,116.22,15
HCPCS,G2004,Post-d/c h vst new pt 60 m,,,148.19,152.64,15
HCPCS,G2005,Post-d/c h vst new pt 75 m,,,192.55,198.33,15
HCPCS,G2006,Post-d/c h vst ext pt 20 m,,,45.47,46.83,15
HCPCS,G2007,Post-d/c h vst ext pt 30 m,,,73.3,75.49,15
HCPCS,G2008,Post-d/c h vst ext pt 45 m,,,113.92,117.34,15
HCPCS,G2009,Post-d/c h vst ext pt 60 m,,,160.25,165.06,15
HCPCS,G2010,Remot image submit by pt,,,11.5,11.85,15
HCPCS,G2011,Alcohol/sub misuse assess,,,24.89,25.63,15
HCPCS,G2013,Post-d/c h vst ext pt 75 m,,,192.55,198.33,15
HCPCS,G2014,Post-d/c care plan overs 30m,,,68.44,70.49,15
HCPCS,G2015,Post-d/c care plan overs 60m,,,95.94,98.82,15
HCPCS,G2023,Lab/Pathology,,,117.3,117.3,1
HCPCS,G2023,Laboratory,,,117.3,117.3,1
HCPCS,G2024,Lab/Pathology,,,127.3,127.3,1
HCPCS,G2024,Laboratory,,,127.3,127.3,1
HCPCS,G2025,Dis site tele svcs RHC/FQHC,,,90.37,93.08,15
HCPCS,G2082,Visit esketamine 56m or less,,,1169.14,1204.21,15
HCPCS,G2083,"Visit esketamine, > 56m",,,1474.0,1518.22,15
HCPCS,G2086,Off base opioid tx 70min,,,163.27,168.17,15
HCPCS,G2087,"Off base opioid tx, 60 m",,,163.27,168.17,15
HCPCS,G2088,"Off base opioid tx, add30",,,53.26,54.86,15
HCPCS,G2170,OP Surgery - Grouper Table,,,24394.0,24394.0,1
HCPCS,G2171,OP Surgery - Grouper Table,,,24394.0,24394.0,1
HCPCS,G2211,Complex E/M visit add on,,,14.91,15.36,15
HCPCS,G2212,Prolong outpt/office vis,,,29.76,30.65,15
HCPCS,G2213,Initiat med assist tx in er,,,55.73,57.4,15
HCPCS,G2214,Init/sub psych care m 1st 30,,,94.0,96.82,15
HCPCS,G2250,"Remot img sub by pt, non E/M",,,11.5,11.85,15
HCPCS,G2251,"Brief chkin, 5-10, non-E/M",,,13.25,13.65,15
HCPCS,G2252,"Brief chkin by md/qhp, 11-20",,,24.54,25.28,15
HCPCS,G3002,Chronic pain mgmt 30 mins,,,76.15,78.44,15
HCPCS,G3003,Chronic pain mgmt addl 15m,,,28.06,28.9,15
HCPCS,G6001,APC,,,164.57,169.51,15
HCPCS,G6001,Other Radiology,,,288.0,288.0,1
HCPCS,G6002,APC,,,70.2,72.31,15
HCPCS,G6002,Other Radiology,,,122.86,122.86,1
HCPCS,G6003,APC,,,140.34,144.55,15
HCPCS,G6004,APC,,,113.71,117.13,15
HCPCS,G6005,APC,,,113.71,117.13,15
HCPCS,G6006,APC,,,113.1,116.49,15
HCPCS,G6007,APC,,,201.94,208.0,15
HCPCS,G6008,APC,,,156.54,161.24,15
HCPCS,G6009,APC,,,157.78,162.51,15
HCPCS,G6010,APC,,,155.3,159.96,15
HCPCS,G6011,APC,,,206.38,212.57,15
HCPCS,G6012,APC,,,206.69,212.89,15
HCPCS,G6013,APC,,,207.62,213.85,15
HCPCS,G6014,APC,,,206.38,212.57,15
HCPCS,G6015,APC,,,321.85,331.51,15
HCPCS,G6016,APC,,,321.43,331.07,15
HCPCS,G9037,APC,,,38.37,39.52,15
HCPCS,G9038,APC,,,47.75,49.19,15
HCPCS,G9143,Warfarin respon genetic test,,,117.33,603.6,23
HCPCS,G9157,Transesoph doppl cardiac mon,,,85.67,88.24,15
HCPCS,G9187,Bpci home visit,,,43.91,45.23,15
HCPCS,G9481,Remote e/m new pt 10mins,,,16.06,16.54,15
HCPCS,G9482,Remote E/M new pt 20mins,,,30.83,31.76,15
HCPCS,G9483,Remote E/M new pt 30mins,,,47.65,49.07,15
HCPCS,G9484,Remote E/M new pt 45mins,,,81.17,83.61,15
HCPCS,G9485,Remote E/M new pt 60mins,,,106.18,109.36,15
HCPCS,G9486,Remote E/M est. pt 10mins,,,16.06,16.54,15
HCPCS,G9487,Remote E/M est. pt 15mins,,,32.45,33.42,15
HCPCS,G9488,Remote E/M est. pt 25mins,,,50.13,51.63,15
HCPCS,G9489,Remote E/M est. pt 40mins,,,70.5,72.61,15
HCPCS,G9490,CMMI mod home visit,,,43.91,45.23,15
HCPCS,G9685,Acute nursing facility care,,,170.99,176.12,15
HCPCS,G9868,CMMI asyntelehealth <10min,,,25.88,26.65,15
HCPCS,G9869,CMMI asyntelehealth 10-20min,,,34.61,35.65,15
HCPCS,G9870,CMMI asyntelehealth >20min,,,43.34,44.64,15
HCPCS,G9978,Remote E/M new pt 10mins,,,45.47,46.83,15
HCPCS,G9979,Remote E/M new pt 20mins,,,66.74,68.74,15
HCPCS,G9980,Remote E/M new pt 30 mins,,,97.48,100.41,15
HCPCS,G9981,Remote E/M new pt 45mins,,,149.58,154.07,15
HCPCS,G9982,Remote E/M new pt 60mins,,,193.78,199.6,15
HCPCS,G9983,Remote E/M est. pt 10mins,,,45.47,46.83,15
HCPCS,G9984,Remote E/M est. pt  15mins,,,74.24,76.46,15
HCPCS,G9985,Remote E/M est. pt 25mins,,,105.85,109.02,15
HCPCS,G9986,Remote E/M est. pt 40mins,,,145.41,149.77,15
HCPCS,G9987,BPCI Advanced In home visit,,,43.91,45.23,15
HCPCS,H0002,HC SBIRT (SCREEN BRIEF INTRVTN & REFRL FOR TX) TO DETERMINE ELIG FOR ADMIN,205.0,112.75,61.5,177.33,38
HCPCS,H0049,HC SBIRT (SCREENING BRIEF INTERVENTION & REFERRAL FOR TREATMENT) ALCOH/DRUG,205.0,112.75,61.5,177.33,38
HCPCS,H0050,HC SBIRT (SCREENING BRIEF INTERVENTION & REFERRAL FOR TREATMENT) PER 15 MIN,90.0,49.5,27.0,77.85,38
HCPCS,J0121,"Inj., omadacycline, 1 mg",,,3.37,27.07,23
HCPCS,J0122,"Inj., eravacycline, 1 mg",,,1.04,8.71,8
HCPCS,J0129,abatacept 25 mg/mL Recon Soln 1 Each Vial,8188.82,4503.86,37.61,7083.33,63
HCPCS,J0130,Abciximab injection,,,479.64,592.14,6
HCPCS,J0131,"Inj, acetaminophen (nos)",,,0.05,0.34,8
HCPCS,J0132,acetylcysteine 200 MG/ML Solution 30 mL Vial,614.94,338.22,0.47,531.92,48
HCPCS,J0133,acyclovir 50 mg/mL Solution 10 mL Vial,142.2,78.21,0.05,123.0,48
HCPCS,J0134,acetaminophen 10 mg/mL Solution 100 mL Flex Cont,82.6,45.43,0.04,71.45,48
HCPCS,J0136,"Inj, acetaminophen (b braun)",,,0.05,0.34,8
HCPCS,J0137,"Inj, acetaminophen (hikma)",,,0.05,0.34,8
HCPCS,J0138,Inj acetaminoph 10mg/ibu 3mg,,,0.04,1.49,23
HCPCS,J0139,"Inj, adalimumab, 1 mg",,,78.76,97.23,21
HCPCS,J0153,adenosine 10 mcg/mL 6 MG/2ML Solution 2 mL Syringe,124.0,68.2,0.28,107.26,48
HCPCS,J0153,adenosine 10 mcg/mL 6 MG/2ML Solution 2 mL Vial,67.0,36.85,0.28,57.96,48
HCPCS,J0153,adenosine 6 MG/2ML Solution 2 mL Syringe,124.0,68.2,0.28,107.26,48
HCPCS,J0153,adenosine 6 MG/2ML Solution 2 mL Vial,67.0,36.85,0.28,57.96,48
HCPCS,J0153,adenosine diagnostic 3 MG/ML Solution 20 mL Vial,405.0,222.75,0.28,350.33,48
HCPCS,J0153,adenosine diagnostic 3 MG/ML Solution 30 mL Vial,1073.35,590.35,0.28,928.45,48
HCPCS,J0153,adenosine diagnostic 3 MG/ML Solution 40 mL Vial,2366.59,1301.63,0.28,2047.1,48
HCPCS,J0153,n,95.5,52.525000000000006,0.28,107.26,96
HCPCS,J0165,EPINEPHrine 1 MG/ML Solution 1 mL Vial,117.24,64.49,3.6,101.41,48
HCPCS,J0165,EPINEPHrine 1 MG/ML Solution 30 mL Vial,682.51,375.39,3.6,590.37,48
HCPCS,J0165,EPINEPHrine 1 mg/10 mL Solution Prefilled Syringe 10 mL Syringe,77.815,42.805,3.6,81.27,96
HCPCS,J0165,EPINEPHrine 1 mg/mL Solution 30 mL Vial,1368.02,752.42,3.6,1183.34,48
HCPCS,J0166,EPINEPHrine 1 mg/mL Solution 1 mL Ampule,91.5,50.33,11.4,79.15,48
HCPCS,J0167,Inj epinephrine (hospira),,,3.7,5.0,2
HCPCS,J0168,Epinephrine (intl med sys),,,10.9,14.72,2
HCPCS,J0169,Inj epinephrine (adrenalin),,,11.3,15.26,2
HCPCS,J0171,Lab/Drugs Fee Schedule,,,0.66,0.81,6
HCPCS,J0172,APC,,,5.98,6.16,15
HCPCS,J0172,Drugs,,,29.9,40.37,2
HCPCS,J0172,Lab/Drugs Fee Schedule,,,5.14,6.34,6
HCPCS,J0173,EPINEPHrine (preservative free) 1 MG/ML Solution 1 mL Ampule,91.5,50.33,2.04,79.15,48
HCPCS,J0174,lecanemab-irmb 500 MG/5ML Solution 5 mL Vial,3506.69,1928.68,1.32,3033.29,53
HCPCS,J0175,"Injection, donanemab-azbt, 2 mg",,,3.52,27.95,23
HCPCS,J0177,aflibercept 8 MG/0.07ML Solution 0.07 mL Vial,11255.5,6190.53,282.53,9736.01,63
HCPCS,J0178,aflibercept 2 MG/0.05ML Solution Prefilled Syringe 0.05 mL Syringe,10254.75,5640.12,687.8,8870.36,63
HCPCS,J0179,"Inj, brolucizumab-dbll, 1 mg",,,290.97,2336.78,23
HCPCS,J0180,Agalsidase beta 35 MG Recon Soln 1 Each Vial,32885.37,18086.96,191.92,28445.85,63
HCPCS,J0180,agalsidase beta 5 mg/mL Recon Soln 1 Each Vial,6052.31,3328.78,191.92,5235.25,63
HCPCS,J0184,"Inj, amisulpride, 1 mg",,,7.79,9.9,21
HCPCS,J0185,"Inj., aprepitant, 1 mg",,,1.46,11.95,23
HCPCS,J0202,alemtuzumab 12 MG/1.2ML Solution 1.2 mL Vial,123698.91,68034.41,2072.11,106999.56,63
HCPCS,J0205,Lab/Drugs Fee Schedule,,,25.82,31.88,6
HCPCS,J0206,Inj allopurinol sodium 1 mg,,,3.77,30.65,23
HCPCS,J0207,amifostine 500 MG Recon Soln 1 Each Vial,5800.6,3190.33,698.99,5017.52,48
HCPCS,J0208,"Inj, pedmark, 100 mg",,,82.42,101.76,21
HCPCS,J0209,sodium thiosulfate 250 MG/ML Solution 50 mL Vial,30.0,16.5,0.8,25.95,48
HCPCS,J0210,Methyldopate hcl injection,,,42.93,53.0,6
HCPCS,J0211,"Inj, nithiodote, 3mg / 125mg",,,1.86,2.3,21
HCPCS,J0215,Lab/Drugs Fee Schedule,,,21.66,26.74,6
HCPCS,J0216,"Inj, alfentanil hcl, 500mcg",,,3.88,4.79,6
HCPCS,J0217,Inj velmanase alfa-tycv 1 mg,,,378.48,3139.09,23
HCPCS,J0218,Inj olipudase alfa-rpcp 1mg,,,327.62,2658.29,23
HCPCS,J0219,Inj aval alfa-nqpt 4mg,,,66.85,545.06,23
HCPCS,J0221,Lumizyme injection,,,173.13,1394.69,23
HCPCS,J0222,patisiran sodium 10 MG/5ML Solution 5 mL Vial,40133.5,22073.43,84.85,34715.48,63
HCPCS,J0223,Inj givosiran 0.5 mg,,,99.14,791.03,23
HCPCS,J0224,"Inj. lumasiran, 0.5 mg",,,273.04,2221.43,23
HCPCS,J0225,vutrisiran 25 MG/0.5ML Solution Prefilled Syringe 0.5 mL Syringe,486685.0,267676.75,4222.39,420982.53,63
HCPCS,J0248,remdesivir 5 mg/mL Recon Soln 1 Each Vial,3443.19,1893.76,5.45,2978.36,63
HCPCS,J0256,"alpha-1-proteinase inhibitor (human) 1000 MG Recon Soln 1,000 mg Vial",3309.0,1819.95,2.6,2862.29,63
HCPCS,J0256,"alpha-1-proteinase inhibitor (human) 1000 MG Solution 1,000 mg Vial",3201.0,1760.55,2.6,2768.87,63
HCPCS,J0257,"alpha-1-proteinase inhibitor (human) 1000 MG/50ML Solution 1,000 mg Vial",3579.0,1968.45,2.85,3095.84,63
HCPCS,J0270,Alprostadil for injection,,,0.41,0.5,6
HCPCS,J0278,amikacin 25 mg/mL Solution 2 mL Vial,63.61,34.99,0.46,55.02,48
HCPCS,J0278,amikacin sulfate 500 MG/2ML Solution 2 mL Vial,79.25,43.59,0.46,70.07,96
HCPCS,J0278,amikacin sulfate 500 mg/2 mL Solution 2 mL Vial,81.0,44.55,0.46,70.07,48
HCPCS,J0280,aminophylline 25 MG/ML Solution 20 mL Vial,103.59,56.98,4.44,89.61,48
HCPCS,J0281,aminocaproic acid 250 MG/ML Solution 20 mL Vial,93.88,51.64,7.5,81.21,48
HCPCS,J0282,amiodarone 150 MG/3ML Solution 3 mL Vial,40.01,22.01,0.33,34.61,48
HCPCS,J0282,amiodarone 450 MG/9ML Solution 9 mL Vial,79.18,43.55,0.33,68.49,48
HCPCS,J0282,amiodarone 900 MG/18ML Solution 18 mL Vial,117.23,64.48,0.33,101.4,48
HCPCS,J0283,"Inj, amiodarone (nexterone)",,,2.16,17.62,8
HCPCS,J0285,amphotericin B - conventional Recon Soln 1 Each Vial,303.0,166.65,42.98,262.1,48
HCPCS,J0285,amphotericin B 100 mcg/mL Recon Soln 1 Each Vial,303.0,166.65,42.98,262.1,48
HCPCS,J0285,amphotericin B 500 mcg/mL Recon Soln 1 Each Vial,303.0,166.65,42.98,262.1,48
HCPCS,J0287,amphotericin B lipid complex 5 mg/mL Suspension 20 mL Vial,582.0,320.1,8.85,503.43,63
HCPCS,J0288,Lab/Drugs Fee Schedule,,,60.82,75.09,6
HCPCS,J0289,amphotericin B liposome 4 mg/mL Solution 1 Each Vial,1733.87,953.63,20.59,1499.8,63
HCPCS,J0289,amphotericin B liposome 50 MG Recon Susp 1 Each Vial,1733.87,953.63,20.59,1499.8,63
HCPCS,J0290,ampicillin 1 g Recon Soln 1 Each Vial,73.3,40.32,0.61,63.4,48
HCPCS,J0290,ampicillin 2 g Recon Soln 1 Each Vial,107.1,58.91,0.61,92.64,48
HCPCS,J0290,ampicillin Recon Soln 1 Each Vial,51.4,28.27,0.61,44.46,48
HCPCS,J0291,"Inj., plazomicin, 5 mg",,,3.06,24.1,23
HCPCS,J0295,ampicillin/sulbactam 1.5 (1-0.5) g Recon Soln 1 Each Vial,53.175,29.255,1.41,52.69,96
HCPCS,J0295,ampicillin/sulbactam 3 (2-1) g Recon Soln 1 Each Vial,72.34,39.79,1.41,71.09,96
HCPCS,J0300,amobarbital Recon Soln 1 Each Vial,5141.35,2827.75,9.72,4447.27,48
HCPCS,J0330,succinylcholine 20 MG/ML Solution 10 mL Vial,144.67,79.57,1.35,125.14,48
HCPCS,J0348,Anidulafungin injection,,,0.44,3.24,8
HCPCS,J0349,rezafungin 200 MG Recon Soln 1 Each Vial,4921.81,2707.0,8.96,4257.37,63
HCPCS,J0360,hydrALAZINE 20 MG/ML Solution 1 mL Vial,113.08,62.2,3.5,97.81,48
HCPCS,J0364,Apomorphine hydrochloride,,,45.53,56.21,6
HCPCS,J0365,Lab/Drugs Fee Schedule,,,2.23,2.75,6
HCPCS,J0380,Lab/Drugs Fee Schedule,,,0.84,1.03,6
HCPCS,J0391,"Inj, artesunate, 1mg",,,44.51,54.94,21
HCPCS,J0400,Aripiprazole injection,,,0.28,0.34,6
HCPCS,J0401,ARIPiprazole ER 300 mg/1.5 mL Suspension Reconstituted ER 1 Each Vial,9158.99,5037.45,6.07,7922.53,63
HCPCS,J0401,ARIPiprazole ER 400 mg/2 mL Suspension Reconstituted ER 1 Each Vial,12208.65,6714.76,6.07,10560.48,63
HCPCS,J0402,"Inj, abilify asimtufii, 1 mg",,,5.09,40.7,23
HCPCS,J0456,azithromycin Recon Soln 1 Each Vial,68.4,37.62,1.83,59.17,48
HCPCS,J0457,aztreonam Recon Soln 1 Each Vial,371.7,204.44,1.77,393.45,144
HCPCS,J0458,Aztreonam/avibactam 10 mg,,,1.68,1.73,15
HCPCS,J0461,atropine 0.4 MG/ML Solution 1 mL Syringe,81.0,44.55,0.1,70.07,48
HCPCS,J0461,atropine 0.4 MG/ML Solution 1 mL Vial,93.0,51.15,0.1,80.45,48
HCPCS,J0461,atropine 0.4 MG/ML Solution 2.5 mL Syringe,93.95,51.68,0.1,81.27,48
HCPCS,J0461,atropine 0.4 MG/ML Solution 3 mL Syringe,75.09,41.305,0.1,76.4,96
HCPCS,J0461,atropine 1 MG/10ML Solution Prefilled Syringe 10 mL Syringe,94.43,51.94,0.1,81.68,48
HCPCS,J0461,atropine 1 MG/ML Solution 1 mL Vial,101.64,55.91,0.1,87.92,48
HCPCS,J0470,Dimecaprol injection,,,55.11,68.03,6
HCPCS,J0475,"baclofen 1,000 mcg/mL (20000 mcg/20 mL) Solution 20 mL Vial",2796.54,1538.1,149.26,2419.01,63
HCPCS,J0475,baclofen 2000 mcg/mL (40 mg/20 mL) Solution 20 mL Ampule,5118.76,2815.32,149.26,4427.73,126
HCPCS,J0475,baclofen 2000 mcg/mL (40 mg/20 mL) Solution 20 mL Vial,5578.08,3067.95,149.26,4825.04,63
HCPCS,J0475,baclofen 2000 mcg/mL (80 mg/40 mL) Solution 20 mL Ampule,5118.76,2815.32,149.26,4427.73,63
HCPCS,J0475,baclofen 500 mcg/mL (10 mg/20 mL) Solution 20 mL Ampule,1291.02,710.07,149.26,1186.79,63
HCPCS,J0476,baclofen 0.05 MG/ML Solution 1 mL Ampule,212.82,117.06,34.97,453.6,48
HCPCS,J0480,basiliximab Recon Soln 1 Each Vial,19158.51,10537.19,3999.0,31539.17,63
HCPCS,J0485,belatacept 25 mg/mL Recon Soln 1 Each Vial,5252.35,2888.8,3.38,4543.28,63
HCPCS,J0490,belimumab 400 mg Recon Soln 1 Each Vial,8895.94,4892.77,47.14,7694.99,63
HCPCS,J0490,belimumab 80 mg/mL Recon Soln 1 Each Vial,3442.65,1893.46,47.14,2977.89,63
HCPCS,J0491,anifrolumab-fnia 300 MG/2ML Solution 2 mL Vial,22412.63,12326.95,15.26,19386.92,63
HCPCS,J0500,dicyclomine 10 MG/ML Solution 2 mL Ampule,519.35,285.65,12.79,449.24,48
HCPCS,J0515,benztropine mesylate 1 MG/ML Solution 2 mL Vial,297.0,163.35,14.5,256.91,48
HCPCS,J0517,benralizumab 30 MG/ML Solution Prefilled Syringe 1 mL Syringe,24567.61,13512.19,142.43,21250.98,63
HCPCS,J0558,PenG benzathine/procaine inj,,,14.91,117.25,23
HCPCS,J0561,penicillin G benzathine 1200000 UNIT/2ML Suspension Prefilled Syringe 2 mL Syringe,2007.82,1104.31,23.03,1736.76,63
HCPCS,J0561,penicillin G benzathine 2400000 UNIT/4ML Suspension Prefilled Syringe 4 mL Syringe,4098.59,2254.23,23.03,3545.28,63
HCPCS,J0561,penicillin G benzathine 600000 UNIT/ML Suspension Prefilled Syringe 1 mL Syringe,1165.61,641.09,23.03,1008.25,63
HCPCS,J0565,"Inj, bezlotoxumab, 10 mg",,,34.23,268.85,23
HCPCS,J0567,"Inj., cerliponase alfa 1 mg",,,120.36,123.97,15
HCPCS,J0571,Buprenorphine oral 1mg,,,1.2,1.48,6
HCPCS,J0572,Bupren/nal up to 3mg bupreno,,,6.13,7.57,6
HCPCS,J0573,Bupren/nal 3.1 to 6mg bupren,,,9.69,11.97,6
HCPCS,J0574,Bupren/nal 6.1 to 10mg bupre,,,9.93,12.25,6
HCPCS,J0575,Bupren/nal over 10mg bupreno,,,15.89,19.61,6
HCPCS,J0577,"Inj, brixadi, 7 days or less",,,368.05,2854.1,23
HCPCS,J0578,"Inj brixadi, more than 7 day",,,1472.18,9204.71,23
HCPCS,J0583,bivalirudin Recon Soln 1 Each Vial,444.51,244.49,0.14,384.5,48
HCPCS,J0584,burosumab-twza 10 mg/mL Solution 1 mL Vial,19161.24,10538.69,403.31,16574.47,63
HCPCS,J0584,burosumab-twza 20 mg/mL Solution 1 mL Vial,36516.93,20084.32,403.31,31587.14,63
HCPCS,J0584,burosumab-twza 30 mg/mL Solution 1 mL Vial,54767.88,30122.34,403.31,47374.22,63
HCPCS,J0585,HC ONABOTULINUMTOXINA INJ 1 UNIT EYE,20.5,11.28,5.77,43.88,126
HCPCS,J0585,onabotulinumtoxin A - cosmetic 50 units Recon Soln 1 Each Vial,1969.8,1083.39,5.77,1703.88,63
HCPCS,J0585,onabotulinumtoxinA (Cosmetic) 100 units Recon Soln 1 Each Vial,1579.4,868.67,5.77,1366.18,63
HCPCS,J0585,onabotulinumtoxinA 100 units Recon Soln 1 Each Vial,3503.4,1926.87,5.77,3030.44,63
HCPCS,J0585,onabotulinumtoxinA 2.5 units Injection 0.12 mL Syringe,143.63,79.0,5.77,124.24,63
HCPCS,J0585,onabotulinumtoxinA 2.5 units Injection 0.2 mL Syringe,205.2,112.86,5.77,177.5,63
HCPCS,J0585,onabotulinumtoxinA 2.5 units Injection 0.3 mL Syringe,275.58,151.57,5.77,238.38,63
HCPCS,J0585,onabotulinumtoxinA 2.5 units Injection 0.4 mL Syringe,395.4,217.47,5.77,342.02,63
HCPCS,J0585,onabotulinumtoxinA 200 units Recon Soln 1 Each Vial,6991.8,3845.49,5.77,6047.91,63
HCPCS,J0585,onabotulinumtoxinA 5   units Injection 0.2 mL Syringe,395.4,217.47,5.77,342.02,63
HCPCS,J0585,onabotulinumtoxinA 5   units Injection 0.8 mL Syringe,1384.44,761.45,5.77,1197.54,63
HCPCS,J0586,abobotulinumtoxinA 300 units Recon Soln 1 Each Vial,2868.9,1577.9,7.6,2481.6,63
HCPCS,J0586,abobotulinumtoxinA 500 units Recon Soln 1 Each Vial,4769.7,2623.34,7.6,4125.79,63
HCPCS,J0587,rimabotulinumtoxinB 10000 UNIT/2ML Solution 2 mL Vial,6873.86,3780.63,11.57,5945.89,63
HCPCS,J0587,rimabotulinumtoxinB 2500 UNIT/0.5ML Solution 0.5 mL Vial,1729.72,951.35,11.57,1496.21,63
HCPCS,J0587,rimabotulinumtoxinB 5000 UNIT/ML Solution 1 mL Vial,3444.43,1894.44,11.57,2979.43,63
HCPCS,J0588,HC INCOBOTULINUMTOXINA INJ 1 UNIT,24.5,13.48,4.73,35.84,63
HCPCS,J0588,incobotulinumtoxinA 100 units Recon Soln 1 Each Vial,2774.4,1525.92,4.73,2399.86,63
HCPCS,J0588,incobotulinumtoxinA 200 units Recon Soln 1 Each Vial,5533.8,3043.59,4.73,4786.74,63
HCPCS,J0588,incobotulinumtoxinA 50 units Recon Soln 1 Each Vial,1462.2,804.21,4.73,1264.8,63
HCPCS,J0589,Inj daxibotulinumtoxina-lanm,,,2.69,20.99,23
HCPCS,J0592,buprenorphine 0.3 MG/ML Solution 1 mL Vial,108.53,59.7,3.69,93.88,96
HCPCS,J0593,"Inj., lanadelumab-flyo, 1 mg",,,87.28,586.85,23
HCPCS,J0594,busulfan 6 MG/ML Solution 10 mL Vial,1887.25,1037.99,0.88,1632.47,63
HCPCS,J0595,butorphanol 2 MG/ML Solution 1 mL Vial,110.18,60.6,4.88,95.31,48
HCPCS,J0596,"Injection, ruconest",,,29.77,248.0,23
HCPCS,J0597,C1 esterase inhibitor (Human) 500 units Kit 1 Each Box,17950.76,9872.92,62.22,15527.41,63
HCPCS,J0598,"C-1 esterase, cinryze",,,55.01,443.68,23
HCPCS,J0599,"Inj., haegarda 10 units",,,11.73,15.32,21
HCPCS,J0600,calcium disodium versenate 1 GM/5ML Solution 5 mL Ampule,22628.95,12445.93,5223.82,43568.35,63
HCPCS,J0601,Sevelamer carbonate 20 mg,,,0.1,0.12,6
HCPCS,J0602,Sevelamer carbonate pdr 20mg,,,0.26,0.32,6
HCPCS,J0603,Sevelamer hydrochloride 20mg,,,0.17,0.21,6
HCPCS,J0604,"Cinacalcet, esrd on dialysis",,,0.86,1.05,6
HCPCS,J0605,Sucroferric oxyhydroxide 5mg,,,0.18,0.22,6
HCPCS,J0606,"Inj, etelcalcetide, 0.1 mg",,,4.05,5.0,6
HCPCS,J0607,Lanthanum carbonate oral 5mg,,,0.08,0.1,6
HCPCS,J0608,Lanthanum carbonate pwdr 5mg,,,0.06,0.08,6
HCPCS,J0609,Ferric citrate orl 3 mg iron,,,0.03,0.03,6
HCPCS,J0612,calcium gluconate 0.465 mEq/mL Solution 10 mL Vial,85.13,46.83,0.04,73.64,48
HCPCS,J0612,calcium gluconate 0.465 mEq/mL Solution 100 mL Vial,339.0,186.45,0.04,293.24,48
HCPCS,J0612,calcium gluconate 0.465 mEq/mL Solution 50 mL Vial,177.0,97.35,0.04,153.11,48
HCPCS,J0612,calcium gluconate 10 % Solution 10 mL Vial,85.13,46.83,0.04,73.64,48
HCPCS,J0612,calcium gluconate 10 % Solution 100 mL Vial,339.0,186.45,0.04,293.24,48
HCPCS,J0612,calcium gluconate 10 % Solution 50 mL Vial,177.0,97.35,0.04,153.11,48
HCPCS,J0613,calcium gluconate 1 g/50 mL Solution 50 mL Flex Cont,118.75,65.32,0.1,102.72,96
HCPCS,J0614,"Inj, treosulfan, 50 mg",,,32.33,33.3,15
HCPCS,J0615,"Calcium acetate, oral, 23 mg",,,0.03,0.03,6
HCPCS,J0616,metoprolol 5 MG/5ML Solution 5 mL Vial,40.4,22.22,0.65,34.95,48
HCPCS,J0618,calcium chloride 1.4 mEq/ML Solution 10 mL Vial,47.5,26.13,14.25,41.09,48
HCPCS,J0618,calcium chloride 10 % Solution 10 mL Syringe,100.015,55.01,29.4,88.26,96
HCPCS,J0618,calcium chloride 10 % Solution 10 mL Vial,47.5,26.13,14.25,41.09,48
HCPCS,J0620,Calcium glycer & lact/10 ML,,,9.44,11.66,6
HCPCS,J0630,calcitonin (salmon) 200 UNIT/ML Solution 2 mL Vial,4335.0,2384.25,484.97,3749.78,63
HCPCS,J0636,Inj calcitriol per 0.1 mcg,,,0.92,1.13,6
HCPCS,J0637,Caspofungin acetate,,,4.34,15.32,8
HCPCS,J0638,Canakinumab injection,,,116.67,951.75,23
HCPCS,J0640,leucovorin 20 mg /mL Recon Soln 1 Each Vial,124.0,68.2,3.57,107.26,96
HCPCS,J0640,leucovorin 20 mg/mL Recon Soln 1 Each Vial,107.035,58.87,3.57,103.0,96
HCPCS,J0640,leucovorin Recon Soln 1 Each Vial,95.0,52.25,3.57,82.18,48
HCPCS,J0641,Inj levoleucovorin nos 0.5mg,,,0.04,0.27,8
HCPCS,J0642,"Injection, khapzory, 0.5 mg",,,1.16,7.56,8
HCPCS,J0650,levothyroxine 100 mcg/mL Recon Soln 1 Each Vial,2865.71,1576.15,4.63,2478.84,48
HCPCS,J0651,levothyroxine 100 MCG/5ML Solution 5 mL Vial,547.14,300.93,3.29,473.28,63
HCPCS,J0652,"Inj, levothyroxine, hikma",,,4.42,34.7,23
HCPCS,J0665,BUPivacaine (PF) 0.25 % Solution 10 mL Vial,42.78,23.53,0.01,37.0,48
HCPCS,J0665,BUPivacaine (PF) 0.25 % Solution 30 mL Vial,42.55,23.41,0.01,36.81,48
HCPCS,J0665,BUPivacaine (PF) 0.5 % Solution 10 mL Vial,53.555,29.46,0.01,53.05,96
HCPCS,J0665,BUPivacaine (PF) 0.5 % Solution 30 mL Vial,44.35,24.4,0.01,38.36,48
HCPCS,J0665,BUPivacaine (PF) 0.75 % Solution 10 mL Vial,47.05,25.88,0.01,40.7,48
HCPCS,J0665,BUPivacaine (PF) 0.75 % Solution 30 mL Vial,61.0,33.55,0.01,52.77,48
HCPCS,J0665,BUPivacaine 0.125 % Solution 200 mL Bag,78.76,43.32,0.01,68.13,48
HCPCS,J0665,BUPivacaine 0.25 % Solution 50 mL Vial,51.63,28.4,0.01,44.66,48
HCPCS,J0665,BUPivacaine 0.5 % Solution 50 mL Vial,47.13,25.93,0.01,40.77,48
HCPCS,J0665,BUPivacaine 0.75% in dextrose 8.25% (intrathecal) 0.75-8.25 % Solution 2 mL Ampule,46.38,25.51,0.01,40.12,48
HCPCS,J0666,BUPivacaine liposome 1.3 % Suspension 10 mL Vial,1317.97,724.89,1.25,1140.04,63
HCPCS,J0666,BUPivacaine liposome 1.3 % Suspension 20 mL Vial,2167.87,1192.33,1.25,1875.21,63
HCPCS,J0668,"Instill, bupivac and meloxic",,,0.82,0.84,15
HCPCS,J0670,mepivacaine (PF) 1.5 % Solution 30 mL Vial,118.28,65.06,3.04,102.31,48
HCPCS,J0670,mepivacaine (PF) 2 % (PF) Solution 20 mL Vial,100.34,55.19,3.04,86.79,48
HCPCS,J0675,"Inj, carboprost, 0.1 mg",,,51.05,52.58,15
HCPCS,J0681,Inj ceftobipole medocarl 3mg,,,1.09,1.12,15
HCPCS,J0687,Inj cefazolin (wg crit care),,,0.95,6.75,23
HCPCS,J0688,"Inj cefazolin sodium, hikma",,,0.86,6.14,23
HCPCS,J0689,ceFAZolin 1 g/50 mL Solution 50 mL Flex Cont,56.5,31.08,1.05,48.87,48
HCPCS,J0690,CEFAZOLIN IV,792.6,435.93,0.69,685.6,48
HCPCS,J0690,ceFAZolin 1 g Recon Soln 1 Each Vial,40.94,22.52,0.69,35.41,48
HCPCS,J0690,ceFAZolin 10 g Recon Soln 1 Each Vial,91.83,50.51,0.69,79.43,48
HCPCS,J0690,ceFAZolin 1g Recon Soln 1 Each Vial,40.94,22.52,0.69,35.41,48
HCPCS,J0690,ceFAZolin 2 g/100 ml Solution 2 g Bag,93.8,51.59,0.69,81.14,48
HCPCS,J0690,ceFAZolin 2 g/20 ml Solution 2 g Syringe,57.1,31.41,0.69,49.39,48
HCPCS,J0690,ceFAZolin 3 g/30 ml Solution 3 g Syringe,61.9,34.05,0.69,53.54,48
HCPCS,J0690,ceFAZolin 3 g/50 mL Solution 1 Each Flex Cont,71.98,39.59,0.69,62.26,48
HCPCS,J0691,Inj lefamulin 1 mg,,,0.7,0.87,6
HCPCS,J0692,cefepime Recon Soln 1 Each Vial,64.9,35.7,1.06,96.75,288
HCPCS,J0692,cefepime Recon Soln 1 g Flex Cont,74.84,41.17,1.06,64.74,48
HCPCS,J0694,cefOXitin 1 g Recon Soln 1 Each Vial,67.0,36.85,3.83,57.96,48
HCPCS,J0694,cefOXitin 2 g Recon Soln 1 Each Vial,149.68,82.33,3.83,129.47,48
HCPCS,J0695,ceftolozane-tazobactam 1.5 (1-0.5) g Recon Soln 1 Each Vial,956.54,526.1,7.0,827.41,63
HCPCS,J0696,cefTRIAXone 1 g Recon Soln 1 Each Vial,46.07,25.34,0.39,39.91,96
HCPCS,J0696,cefTRIAXone 2 g Recon Soln 1 Each Vial,47.09,25.905,0.39,41.09,96
HCPCS,J0696,cefTRIAXone 500 MG Recon Soln 1 Each Vial,37.72,20.75,0.39,32.63,48
HCPCS,J0696,cefTRIAXone Recon Soln 1 Each Vial,39.129999999999995,21.525,0.39,36.47,144
HCPCS,J0697,cefuroxime 1 MG/ML Solution 1 Each Syringe,92.87,51.08,1.62,80.33,48
HCPCS,J0697,cefuroxime 1.5 g Recon Soln 1 Each Vial,64.45,35.45,1.62,57.02,96
HCPCS,J0697,cefuroxime 750 mg Recon Soln 1 Each Vial,46.92,25.81,1.62,40.59,48
HCPCS,J0698,Cefotaxime sodium injection,,,5.18,6.4,6
HCPCS,J0699,cefiderocol sulfate tosylate 1 g Recon Soln 1 Each Vial,1272.34,699.79,1.96,1100.57,63
HCPCS,J0701,Inj. cefepime hcl (baxter),,,4.92,39.62,8
HCPCS,J0702,betamethasone (as acetate-sod phos) 6 (3-3) MG/ML Suspension 5 mL Vial,276.96,152.33,6.44,239.57,48
HCPCS,J0702,betamethasone (as acetate-sod phos) 6 (3-3) mg/mL Suspension 5 mL Vial,276.96,152.33,6.44,239.57,48
HCPCS,J0703,"Inj, cefepime hcl (b braun)",,,4.23,34.22,8
HCPCS,J0706,caffeine citrate 60 MG/3ML Solution 3 mL Vial,98.0,53.9,1.73,84.77,48
HCPCS,J0712,ceftaroline 600 mg Recon Soln 1 Each Vial,1405.28,772.91,3.39,1215.57,63
HCPCS,J0713,cefTAZidime 1g Recon Soln 1 Each Vial,56.95,31.33,1.42,49.26,48
HCPCS,J0713,cefTAZidime 2 g Recon Soln 1 Each Vial,91.68,50.43,1.42,79.46,96
HCPCS,J0714,cefTAZidime-avibactam 2.5 (2-0.5) g Recon Soln 1 Each Vial,2257.97,1241.89,86.48,1953.14,63
HCPCS,J0716,Centruroides immune f(ab),,,4120.52,5087.05,21
HCPCS,J0717,certolizumab pegol 2 x 200 mg/mL Prefilled Syringe Kit 1 Each Box,25207.61,13864.19,3.35,21804.58,63
HCPCS,J0717,certolizumab pegol 200 mg/mL Kit 1 Each Box,25207.61,13864.19,3.35,21804.58,63
HCPCS,J0720,chloramphenicol Recon Soln 1 Each Vial,306.9,168.8,50.12,265.47,48
HCPCS,J0725,chorionic gonadotropin 10000 units Recon Soln 1 Each Vial,642.8,353.54,16.89,556.02,48
HCPCS,J0735,cloNIDine 100 MCG/ML Solution 1 mL Syringe,43.75,24.07,13.13,119.27,48
HCPCS,J0735,cloNIDine 100 MCG/ML Solution 10 mL Vial,182.5,100.38,14.37,157.86,48
HCPCS,J0736,clindamycin 900 mg Solution 6 mL Vial,57.0,31.35,1.83,49.31,48
HCPCS,J0736,clindamycin phosphate 600 mg Solution 4 mL Vial,47.08,25.9,1.83,40.72,48
HCPCS,J0736,clindamycin phosphate 600 mg/50 mL Solution 50 mL Flex Cont,73.5,40.43,1.83,63.58,48
HCPCS,J0736,clindamycin phosphate in D5W 900 mg Solution 50 mL Flex Cont,85.25,46.89,1.83,73.74,48
HCPCS,J0737,"Inj, clindamycin (baxter)",,,2.24,11.61,8
HCPCS,J0738,"Hiv prep, inj, lenacapavir",,,16.13,16.62,15
HCPCS,J0739,cabotegravir 600 mg/3 mL Suspension Extended Release 3 mL Vial,16915.92,9303.76,5.91,14632.27,63
HCPCS,J0740,cidofovir 75 MG/ML Solution 5 mL Vial,4011.0,2206.05,258.53,3573.32,63
HCPCS,J0741,cabotegravir & rilpivirine ER 400 mg/2 mL & 600 mg/2 mL Suspension Extended Release 4 mL Box,19019.92,10460.96,19.89,16452.23,63
HCPCS,J0741,cabotegravir & rilpivirine ER 600 mg/3 mL & 900 mg/3 mL Suspension Extended Release 6 mL Box,28524.88,15688.69,19.89,24674.02,63
HCPCS,J0742,Inj imip 4 cilas 4 releb 2mg,,,2.15,17.62,23
HCPCS,J0743,imipenem/cilastatin 500mg Recon Soln 1 Each Vial,92.97,51.14,6.18,80.42,48
HCPCS,J0743,imipenem/cilastatin Recon Soln 1 Each Vial,131.09,72.1,6.18,113.39,48
HCPCS,J0744,ciprofloxacin 200 mg/100 mL Solution 100 mL Flex Cont,49.6,27.28,0.71,42.9,48
HCPCS,J0744,ciprofloxacin 400 mg/200 mL Solution 200 mL Flex Cont,67.0,36.85,0.71,57.96,48
HCPCS,J0745,Inj codeine phosphate /30 MG,,,0.84,1.03,6
HCPCS,J0750,emtricitabine/tenofovir DF 200/300 mg Tab 1 Each Blister,12.84,7.07,1.57,11.75,63
HCPCS,J0751,emtricitabine/tenofovir AF 200/25 mg Tab 30 Each Box,181.18,99.65,54.35,481.07,63
HCPCS,J0752,"Hiv prep, oral lenacapavir",,,449.03,462.5,15
HCPCS,J0759,"Inj, clevidipine, 1 mg",,,2.85,2.93,15
HCPCS,J0770,colistimethate 150 MG Recon Soln 1 Each Vial,182.94,100.62,10.44,158.24,48
HCPCS,J0770,colistimethate 4.1 mg/mL Recon Soln 1 Each Vial,182.94,100.62,10.44,158.24,48
HCPCS,J0775,collagenase clostridium histolyticum 0.9 MG Recon Soln 1 Each Vial,29863.68,16425.03,63.16,25832.08,63
HCPCS,J0780,prochlorperazine 10 MG/2ML Solution 2 mL Vial,60.765,33.425,2.54,53.72,96
HCPCS,J0791,crizanlizumab 100 MG/10ML Solution 10 mL Vial,10312.35,5671.8,110.48,8920.18,63
HCPCS,J0795,Lab/Drugs Fee Schedule,,,3.61,4.46,6
HCPCS,J0801,Inj. acthar gel to 40 units,,,3286.58,28265.15,8
HCPCS,J0802,"Inj. (ani), up to 40 units",,,2978.35,23944.41,8
HCPCS,J0834,cosyntropin Recon Soln 1 Each Vial,590.53,324.8,28.71,510.81,48
HCPCS,J0840,crotalidae polyval immune fab Recon Soln 1 Each Vial,13441.6,7392.88,1528.0,12562.63,63
HCPCS,J0841,Inj crotalidae im f(ab')2 eq,,,881.93,7047.95,23
HCPCS,J0850,cytomegalovirus immune globulin 5 % Solution 50 mL Vial,9501.99,5226.1,1557.59,12213.72,63
HCPCS,J0870,imetelstat sodium 188 MG Recon Soln 1 Each Vial,41755.13,22965.33,47.63,36118.19,63
HCPCS,J0870,imetelstat sodium 47 MG Recon Soln 1 Each Vial,10964.06,6030.24,47.63,9483.91,63
HCPCS,J0872,Daptomycin (xellia) unrefrig,,,0.04,0.34,23
HCPCS,J0873,Inj daptomycin (xellia),,,0.04,0.27,23
HCPCS,J0875,dalbavancin 500 mg Recon Soln 1 Each Vial,9622.3,5292.27,13.4,8323.29,63
HCPCS,J0877,"Inj, daptomycin (hospira)",,,0.04,0.41,8
HCPCS,J0878,DAPTOmycin 5 mg/mL Recon Soln 1 Each Vial,195.0,107.25,0.04,168.68,48
HCPCS,J0878,DAPTOmycin 500 mg Recon Soln 1 Each Vial,210.0,115.5,0.04,194.63,96
HCPCS,J0879,"Difelikefalin, esrd on dialy",,,0.06,0.14,21
HCPCS,J0881,darbepoetin alfa 100 MCG/0.5ML Solution Prefilled Syringe 0.5 mL Syringe,4194.6,2307.03,2.56,3628.33,63
HCPCS,J0881,darbepoetin alfa 100 MCG/ML Solution 1 mL Vial,4194.6,2307.03,2.56,3628.33,63
HCPCS,J0881,darbepoetin alfa 150 mcg/0.3 mL Solution Prefilled Syringe 0.3 mL Syringe,6284.4,3456.42,2.56,5436.01,63
HCPCS,J0881,darbepoetin alfa 200 MCG/0.4ML Solution Prefilled Syringe 0.4 mL Syringe,8374.2,4605.81,2.56,7243.68,63
HCPCS,J0881,darbepoetin alfa 300 MCG/0.6ML Solution Prefilled Syringe 0.6 mL Syringe,9762.4,5369.32,2.56,8444.48,63
HCPCS,J0881,darbepoetin alfa 500 MCG/ML Solution Prefilled Syringe 1 mL Syringe,16264.0,8945.2,2.56,14068.36,63
HCPCS,J0881,darbepoetin alfa 60 MCG/0.3ML Solution Prefilled Syringe 0.3 mL Syringe,2522.76,1387.52,2.56,2182.19,63
HCPCS,J0882,"Darbepoetin alfa, esrd use",,,2.56,20.25,23
HCPCS,J0883,argatroban 50 mg/50 mL Solution 50 mL Vial,1203.0,661.65,0.69,1040.6,63
HCPCS,J0884,Argatroban esrd dialysis 1mg,,,0.69,5.0,8
HCPCS,J0885,epoetin alfa 10000 UNIT/ML Solution 1 mL Vial,910.32,500.68,5.55,787.43,63
HCPCS,J0885,"epoetin alfa 20,000 units/mL Solution 1 mL Vial",2901.3,1595.72,5.55,2509.62,189
HCPCS,J0885,epoetin alfa 20000 UNIT/ML Solution 1 mL Vial,2901.3,1595.72,5.55,2509.62,63
HCPCS,J0885,"epoetin alfa 40,000 units/mL Solution 1 mL Vial",5787.6,3183.18,5.55,5006.27,63
HCPCS,J0885,epoetin alfa 4000 UNIT/ML Solution 1 mL Vial,412.92,227.11,5.55,357.18,63
HCPCS,J0885,epoetin alfa 40000 units/mL Solution 1 mL Vial,5787.6,3183.18,5.55,5006.27,63
HCPCS,J0887,Epoetin beta esrd use,,,1.04,9.52,8
HCPCS,J0888,Epoetin beta non esrd,,,1.04,9.52,23
HCPCS,J0891,Argatroban nonesrd (accord),,,1.57,1.93,21
HCPCS,J0892,Argatroban dialysis (accord),,,4.09,5.04,6
HCPCS,J0893,"Inj, decitabine (sun pharma)",,,3.9,39.14,8
HCPCS,J0894,decitabine 10 mg/mL Recon Soln 1 Each Vial,2725.0,1498.75,2.0,2357.13,48
HCPCS,J0894,decitabine 5 mg/mL Recon Soln 1 Each Vial,960.6,528.33,2.0,1631.82,144
HCPCS,J0895,deferoxamine Recon Soln 1 Each Vial,259.35,142.65,7.68,224.34,48
HCPCS,J0896,luspatercept-aamt 50 mg/mL Recon Soln 1 Each Vial,33882.81,18635.55,35.44,43958.57,126
HCPCS,J0897,denosumab 120 MG/1.7ML Solution 1.7 mL Vial,14498.91,7974.41,23.75,12541.56,63
HCPCS,J0897,denosumab 60 MG/ML Solution Prefilled Syringe 1 mL Syringe,8464.44,4655.45,23.75,7321.74,63
HCPCS,J0898,Argatroban nonesrd (auromed),,,1.22,9.79,23
HCPCS,J0899,"Argatroban dialysis, auromed",,,4.53,9.79,8
HCPCS,J0901,Vadadustat oral 1mg for esrd,,,0.14,0.18,6
HCPCS,J0911,Inst tauro 1.35mg/hep 100u,,,6.41,9.18,21
HCPCS,J0945,Brompheniramine maleate inj,,,0.28,0.34,6
HCPCS,J1000,Depo-estradiol cypionate inj,,,33.18,316.64,8
HCPCS,J1010,methylPREDNISolone acetate 40 MG/ML Suspension 1 mL Vial,93.84,51.62,0.11,81.17,63
HCPCS,J1010,methylPREDNISolone acetate 80 MG/ML Suspension 1 mL Vial,126.08,69.35,0.11,109.06,63
HCPCS,J1010,methylPREDNISolone acetate 80 MG/ML Suspension 5 mL Vial,607.14,333.93,0.11,525.18,63
HCPCS,J1050,medroxyPROGESTERone 150 MG/ML Suspension 1 mL Vial,330.78,181.93,0.43,286.12,48
HCPCS,J1050,medroxyPROGESTERone 150 MG/ML Suspension Prefilled Syringe 1 mL Syringe,182.5,100.38,0.43,157.86,48
HCPCS,J1050,medroxyPROGESTERone acetate 104 MG/0.65ML Suspension Prefilled Syringe 0.65 mL Syringe,330.78,181.93,0.43,286.12,48
HCPCS,J1071,testosterone cypionate 200 MG/ML Solution 1 mL Vial,257.9,141.85,0.03,223.08,48
HCPCS,J1071,testosterone cypionate 200 MG/ML Solution 10 mL Vial,577.77,317.78,0.03,499.77,48
HCPCS,J1072,"Inj, testosterone, azmiro",,,1.33,8.98,17
HCPCS,J1094,Lab/Drugs Fee Schedule,,,0.28,0.34,6
HCPCS,J1095,"Injection, dexamethasone 9%",,,2.32,2.87,6
HCPCS,J1096,Dexametha opth insert 0.1 mg,,,96.98,685.06,23
HCPCS,J1097,Phenylep Ketorolac opth soln,,,83.15,102.65,21
HCPCS,J1100,dexAMETHasone 10 MG/ML Solution 1 mL Vial,41.435,22.795,0.1,35.85,96
HCPCS,J1100,dexAMETHasone 100 MG/10ML Solution 10 mL Vial,55.0,30.25,0.1,47.58,48
HCPCS,J1100,dexAMETHasone 12 mg Solution 50 mL Bag,63.68,35.03,0.1,55.08,48
HCPCS,J1100,dexAMETHasone 120 MG/30ML Solution 30 mL Vial,293.46,161.41,0.1,253.84,48
HCPCS,J1100,dexAMETHasone 20 MG/5ML Solution 5 mL Vial,38.76,21.32,0.1,33.53,48
HCPCS,J1100,dexAMETHasone 20 mg Solution 50 mL Bag,56.5,31.08,0.1,48.87,48
HCPCS,J1100,dexAMETHasone 4 MG/ML Solution 1 mL Vial,36.225,19.93,0.1,31.35,96
HCPCS,J1100,dexAMETHasone preservative-free 10 MG/ML Solution 1 mL Vial,77.5,42.63,0.1,67.04,48
HCPCS,J1105,"Dexmedetomidine film, 1 mcg",,,0.56,0.73,21
HCPCS,J1110,dihydroergotamine 1 MG/ML Solution 1 mL Ampule,412.8,227.04,35.24,655.22,48
HCPCS,J1120,acetaZOLAMIDE Recon Soln 1 Each Vial,241.38,132.76,18.57,241.13,96
HCPCS,J1160,digoxin 0.25 MG/ML Solution 2 mL Ampule,63.5,34.93,7.58,54.93,48
HCPCS,J1162,digoxin immune fab 40 MG Recon Soln 1 Each Vial,20900.8,11495.44,4353.08,33537.92,126
HCPCS,J1163,dilTIAZem 125 MG/25ML Solution 25 mL Vial,88.7,48.79,0.2,76.73,48
HCPCS,J1163,dilTIAZem 25 MG/5ML Solution 5 mL Vial,50.65,27.86,0.2,43.81,48
HCPCS,J1165,phenytoin 50 MG/ML Solution 2 mL Vial,41.12,22.62,0.41,35.57,96
HCPCS,J1165,phenytoin 50 MG/ML Solution 5 mL Vial,45.96,25.28,0.41,39.76,48
HCPCS,J1171,HYDROmorphone 1 MG/ML Solution 1 mL Crtrdg-NDL,59.94,32.97,0.08,51.85,48
HCPCS,J1171,HYDROmorphone 2 MG/ML Solution 1 mL Crtrdg-NDL,73.81,40.6,0.08,63.85,48
HCPCS,J1171,HYDROmorphone 2 MG/ML Solution 1 mL Vial,50.394999999999996,27.72,0.08,43.6,96
HCPCS,J1171,HYDROmorphone 2 MG/ML Solution 20 mL Vial,234.4,128.92,0.08,202.76,96
HCPCS,J1171,HYDROmorphone 50 MG/5ML Solution 5 mL Ampule,88.9,48.9,0.08,76.9,48
HCPCS,J1171,HYDROmorphone 500 MG/50ML Solution 50 mL Vial,734.5,403.98,0.08,635.34,48
HCPCS,J1171,HYDROmorphone PF 1 MG/ML Solution 1 mL Ampule,60.14,33.08,0.08,52.02,48
HCPCS,J1171,HYDROmorphone PF 2 MG/ML Solution 1 mL Vial,69.0,37.95,0.08,59.69,48
HCPCS,J1190,dexrazoxane 10 mg/mL Recon Soln 1 Each Vial,1496.0,822.8,63.06,1294.04,63
HCPCS,J1190,dexrazoxane 500 MG Recon Soln 1 Each Vial,2976.95,1637.33,63.06,2575.06,63
HCPCS,J1200,diphenhydrAMINE 50 MG/ML Solution 1 mL Vial,43.480000000000004,23.915,0.62,41.16,96
HCPCS,J1201,Inj. cetirizine hcl 0.5mg,,,13.5,110.7,23
HCPCS,J1202,Miglustat oral 65 mg,,,34.0,41.98,6
HCPCS,J1203,"Inj, cipaglucosidase, 5 mg",,,76.74,606.15,23
HCPCS,J1205,chlorothiazide Recon Soln 1 Each Vial,998.79,549.335,51.91,1403.53,96
HCPCS,J1212,dimethyl sulfoxide 50 % Solution 50 mL Vial,3955.65,2175.61,614.23,5014.58,63
HCPCS,J1230,methadone 10 MG/ML Solution 1 mL Syringe,253.39,139.37,17.74,219.18,48
HCPCS,J1230,methadone 10 MG/ML Solution 20 mL Vial,3298.74,1814.31,17.74,2853.41,48
HCPCS,J1240,Dimenhydrinate injection,,,7.44,52.25,8
HCPCS,J1245,Dipyridamole injection,,,3.32,26.06,8
HCPCS,J1250,DOBUTamine 1-5 MG/ML-% Solution 250 mL Flex Cont,306.0,168.3,6.35,264.69,48
HCPCS,J1250,DOBUTamine 12.5 MG/ML Solution 20 mL Vial,73.58,40.47,6.35,63.65,48
HCPCS,J1260,Dolasetron mesylate,,,3.05,3.77,6
HCPCS,J1265,DOPamine 1.6-5 MG/ML-% Solution 250 mL Plas Cont,91.25,50.19,0.67,78.93,48
HCPCS,J1265,DOPamine 40 MG/ML Solution 5 mL Vial,55.04,30.28,0.67,47.61,48
HCPCS,J1267,Lab/Drugs Fee Schedule,,,0.56,0.69,6
HCPCS,J1270,"Injection, doxercalciferol",,,0.32,2.5,8
HCPCS,J1271,doxycycline Recon Soln 1 Each Vial,172.98,95.14,0.6,149.63,48
HCPCS,J1290,Ecallantide injection,,,483.48,3914.93,23
HCPCS,J1299,eculizumab 300 MG/30ML Solution 30 mL Vial,26759.26,14717.6,44.82,23146.76,63
HCPCS,J1300,Lab/Drugs Fee Schedule,,,192.47,237.61,6
HCPCS,J1301,"Injection, edaravone, 1 mg",,,18.61,127.17,23
HCPCS,J1302,"Inj, sutimlimab-jome, 10 mg",,,15.57,122.24,23
HCPCS,J1303,ravulizumab-cwvz 1100 MG/11ML Solution 11 mL Vial,98213.94,54017.67,189.41,84955.06,63
HCPCS,J1303,ravulizumab-cwvz 300 MG/3ML Solution 3 mL Vial,26796.53,14738.1,189.41,23179.0,63
HCPCS,J1304,Inj tofersen intrathec 1 mg,,,133.37,1048.55,23
HCPCS,J1305,Evinacumab-dgnb 1200 MG/8ML Solution 8 mL Vial,105292.29,57910.76,159.97,91077.83,63
HCPCS,J1305,evinacumab-dgnb 345 MG/2.3ML Solution 2.3 mL Vial,52982.67,29140.47,159.97,45830.01,63
HCPCS,J1306,inclisiran 284 MG/1.5ML Solution Prefilled Syringe 1.5 mL Syringe,14498.91,7974.41,10.55,12541.56,63
HCPCS,J1307,"Inj, crovalimab-akkz, 10 mg",,,460.13,568.06,21
HCPCS,J1308,famotidine 20 MG/2ML Solution 2 mL Vial,37.2,20.46,0.05,32.18,48
HCPCS,J1308,famotidine 200 MG/20ML Solution 20 mL Vial,88.0,48.4,0.05,76.12,48
HCPCS,J1322,"Elosulfase alfa, injection",,,252.36,2070.9,23
HCPCS,J1323,elranatamab-bcmm 44 MG/1.1ML Solution 1.1 mL Vial,32684.25,17976.34,152.53,28271.88,63
HCPCS,J1323,elranatamab-bcmm 76 mg/1.9 mL Solution 1.9 mL Vial,56443.71,31044.05,152.53,48823.81,63
HCPCS,J1324,Enfuvirtide injection,,,0.69,0.85,6
HCPCS,J1325,epoprostenol 0.5 mg Recon Soln 1 Each Vial,172.70499999999998,94.99000000000001,14.12,156.37,96
HCPCS,J1325,epoprostenol 1.5 mg Recon Soln 1 Each Vial,314.28,172.85500000000002,14.12,299.77,96
HCPCS,J1326,zolbetuximab-clzb 100 MG Recon Soln 1 Each Vial,8655.0,4760.25,33.71,7486.58,63
HCPCS,J1327,eptifibatide 20 MG/10ML Solution 10 mL Vial,784.37,431.405,21.75,824.99,96
HCPCS,J1327,eptifibatide 75 mg in 100 mL 75 MG/100ML Solution 100 mL Vial,615.0,338.25,21.75,531.98,48
HCPCS,J1335,ertapenem 1 g Recon Soln 1 Each Vial,375.0,206.25,9.45,324.38,48
HCPCS,J1364,erythromycin Recon Soln 1 Each Vial,607.61,334.19,53.35,525.58,48
HCPCS,J1364,erythromycin lactobionate 500 mg Recon Soln 1 Each Vial,607.61,334.19,53.35,947.18,144
HCPCS,J1380,estradiol valerate 20 mg/mL Oil 5 mL Vial,765.98,421.29,6.82,662.57,48
HCPCS,J1410,estrogens (conjugated) 5 mg/mL Recon Soln 1 Each Vial,2050.15,1127.59,328.76,2637.5,63
HCPCS,J1411,"Inj, hemgenix, per tx dose",,,3185406.0,3932600.0,21
HCPCS,J1412,Inj roctavian ml 2x10^13vc g,,,10018.13,12930.32,21
HCPCS,J1413,Inj delandistrogene mox rokl,,,2852081.6,3521088.4,21
HCPCS,J1414,"Inj, beqvez, per tx dose",,,3185406.0,3932600.0,6
HCPCS,J1426,"Injection, casimersen, 10 mg",,,164.85,203.52,21
HCPCS,J1427,Inj. viltolarsen,,,58.11,71.74,6
HCPCS,J1428,"Inj, eteplirsen, 10 mg",,,164.85,203.52,21
HCPCS,J1429,Inj golodirsen 10 mg,,,164.85,203.52,6
HCPCS,J1430,Ethanolamine oleate 100 mg,,,422.14,3506.76,23
HCPCS,J1434,"Inj, focinvez, 1mg",,,2.68,19.37,23
HCPCS,J1435,Injection estrone per 1 MG,,,0.28,0.34,6
HCPCS,J1437,ferric derisomaltose 1000 MG/10ML Solution 10 mL Vial,14759.18,8117.55,17.84,12766.69,63
HCPCS,J1438,etanercept 25 MG/0.5ML Solution Prefilled Syringe 0.5 mL Syringe,5521.38,3036.76,678.97,4775.99,63
HCPCS,J1439,ferric carboxymaltose 750 MG/15ML Solution 15 mL Vial,7967.01,4381.86,0.95,6891.46,63
HCPCS,J1440,"fecal microbiota, live-jslm 150 ML Suspension 150 mL Box",38377.0,21107.35,54.61,33196.11,63
HCPCS,J1442,filgrastim (G-CSF) 300 mcg/0.5mL Solution Prefilled Syringe 0.5 mL Syringe,1817.01,999.36,0.85,1571.71,63
HCPCS,J1442,filgrastim (G-CSF) 300 mcg/mL Solution 1 mL Vial,1715.08,943.3,0.85,1483.54,63
HCPCS,J1442,filgrastim (G-CSF) 480 mcg/0.8 mL Solution Prefilled Syringe 0.8 mL Syringe,2884.71,1586.6,0.85,2495.27,63
HCPCS,J1442,filgrastim (G-CSF) 480 mcg/1.6mL Solution 1.6 mL Vial,2722.18,1497.2,0.85,2354.69,126
HCPCS,J1442,filgrastim Solution 1 mL Vial,1715.1,943.31,0.85,1483.56,63
HCPCS,J1447,tbo-filgrastim 300 mcg/0.5 mL Solution Prefilled Syringe 0.5 mL Syringe,1364.24,750.34,0.28,1180.07,63
HCPCS,J1447,tbo-filgrastim 480 mcg/0.8 mL Solution Prefilled Syringe 0.8 mL Syringe,2174.41,1195.93,0.28,1880.86,63
HCPCS,J1448,trilaciclib Dihydrochloride 15 mg/mL Recon Soln 1 Each Vial,7182.66,3950.47,4.61,6213.0,63
HCPCS,J1449,Inj eflapegrastim-xnst 0.1mg,,,19.01,142.56,23
HCPCS,J1450,fluconazole 2 mg/mL Solution 200 mL Plas Cont,124.0,68.2,2.05,107.26,48
HCPCS,J1450,fluconazole 400 mg/200 mL Solution 200 mL Flex Cont,67.0,36.85,2.05,57.96,48
HCPCS,J1450,fluconazole 800 mg/400 ml Solution 200 mL Flex Cont,60.8,33.44,2.05,52.59,48
HCPCS,J1450,fluconazole in NS 200-0.9 MG/100ML-% Solution 100 mL Flex Cont,79.0,43.45,2.05,68.34,48
HCPCS,J1451,fomepizole 1 gm/mL Solution 1.5 mL Vial,8115.0,4463.25,5.29,7019.48,63
HCPCS,J1453,fosaprepitant (EMEND) 150 mg in NaCl 0.9% 150 mL 150 mg Solution 150 mL Flex Cont,295.8,162.69,0.11,255.87,48
HCPCS,J1453,fosaprepitant 150 MG Recon Soln 1 Each Vial,183.0,100.65,0.11,158.3,48
HCPCS,J1454,"Inj fosnetupitant, palonoset",,,565.05,4092.86,23
HCPCS,J1455,foscarnet 2.4 mg/0.1 mL Solution 0.1 mL Syringe,45.36,24.95,13.61,105.17,63
HCPCS,J1455,foscarnet 24 mg/mL Solution 250 mL Glass Cont,808.0,444.4,16.08,698.92,63
HCPCS,J1455,foscarnet 6000 MG/250ML Solution 250 mL Glass Cont,2286.0,1257.3,16.08,1977.39,63
HCPCS,J1456,"Inj, fosaprepitant (teva)",,,0.38,7.63,23
HCPCS,J1457,Lab/Drugs Fee Schedule,,,1.11,1.37,6
HCPCS,J1458,Galsulfase injection,,,416.36,3412.19,8
HCPCS,J1459,immune globulin 10% 10 g/100 mL Solution 100 mL Vial,10182.12,5600.17,42.32,8807.53,63
HCPCS,J1459,immune globulin 10% 20 g/200 mL Solution 200 mL Vial,15825.52,8704.04,42.32,13689.07,63
HCPCS,J1459,immune globulin 10% 40 g/400 mL Solution 400 mL Vial,31641.04,17402.58,42.32,27369.5,63
HCPCS,J1459,immune globulin 10% 5 g/50 mL Solution 50 mL Vial,5098.56,2804.21,42.32,4410.25,63
HCPCS,J1459,immune globulin 10% Solution 100 mL Vial,10182.12,5600.17,42.32,8807.53,63
HCPCS,J1459,immune globulin 10% Solution 200 mL Vial,15825.52,8704.04,42.32,13689.07,63
HCPCS,J1459,immune globulin 10% Solution 50 mL Vial,5098.56,2804.21,42.32,4410.25,63
HCPCS,J1460,Gamma globulin 1 CC inj,,,42.44,326.84,23
HCPCS,J1551,Inj cutaquig 100 mg,,,12.46,95.92,8
HCPCS,J1552,"Inj, alyglo, 500 mg",,,126.12,885.06,23
HCPCS,J1554,Inj. asceniv,,,424.98,3351.44,23
HCPCS,J1555,"Inj cuvitru, 100 mg",,,14.27,118.73,23
HCPCS,J1556,"Inj, imm glob bivigam, 500mg",,,65.8,521.57,8
HCPCS,J1557,Gammaplex injection,,,48.74,421.67,23
HCPCS,J1558,"Inj. xembify, 100 mg",,,12.25,100.64,23
HCPCS,J1559,Hizentra injection,,,11.71,95.31,23
HCPCS,J1560,Gamma globulin > 10 CC inj,,,170.48,1127.66,23
HCPCS,J1561,immune globulin 10 % Solution 100 mL Vial,7899.0,4344.45,42.08,6832.64,63
HCPCS,J1561,immune globulin 10 % Solution 200 mL Vial,12274.0,6750.7,42.08,10617.01,63
HCPCS,J1561,immune globulin 10 % Solution 50 mL Vial,3957.0,2176.35,42.08,3422.81,63
HCPCS,J1561,immune globulin 10% 10 g/100 mL Solution 100 mL Vial,7899.0,4344.45,42.08,6832.64,63
HCPCS,J1561,immune globulin 10% 20 g/200 mL Solution 200 mL Vial,12274.0,6750.7,42.08,10617.01,63
HCPCS,J1561,immune globulin 10% 40 g/400 mL Solution 400 mL Vial,24538.0,13495.9,42.08,21225.37,63
HCPCS,J1561,immune globulin 10% 5 g/50 mL Solution 50 mL Vial,3957.0,2176.35,42.08,3422.81,63
HCPCS,J1562,Lab/Drugs Fee Schedule,,,7.78,9.6,6
HCPCS,J1566,immune globulin 10 % Recon Soln 10 g Vial,9570.04,5263.53,69.92,8278.08,63
HCPCS,J1566,immune globulin 10 % Recon Soln 5 g Vial,23910.1,13150.56,69.92,20682.24,63
HCPCS,J1566,immune globulin 5 % Recon Soln 10 g Vial,9570.04,5263.53,69.92,8278.08,63
HCPCS,J1566,immune globulin 5 % Recon Soln 5 g Vial,23910.1,13150.56,69.92,20682.24,63
HCPCS,J1568,Octagam injection,,,42.33,326.57,23
HCPCS,J1569,immune globulin 10% 10 g/100 mL Solution 100 mL Glass Cont,9443.94,5194.17,39.9,8169.01,63
HCPCS,J1569,immune globulin 10% 20 g/200 mL Solution 200 mL Glass Cont,14677.24,8072.49,39.9,12695.81,63
HCPCS,J1569,immune globulin 10% 30 g/300 mL Solution 300 mL Glass Cont,22010.86,12105.98,39.9,19039.39,63
HCPCS,J1569,immune globulin 10% 5 g/50 mL Solution 50 mL Vial,4729.47,2601.21,39.9,4090.99,63
HCPCS,J1569,immune globulin 10% Solution 100 mL Glass Cont,9443.94,5194.17,39.9,8169.01,63
HCPCS,J1569,immune globulin 10% Solution 200 mL Glass Cont,14677.24,8072.49,39.9,12695.81,63
HCPCS,J1569,immune globulin 10% Solution 300 mL Glass Cont,22010.86,12105.98,39.9,19039.39,63
HCPCS,J1569,immune globulin 10% Solution 50 mL Vial,4729.47,2601.21,39.9,4090.99,63
HCPCS,J1570,ganciclovir 50 mg/mL Recon Soln 1 Each Vial,487.17,267.95,24.67,421.4,48
HCPCS,J1570,ganciclovir Recon Soln 1 Each Vial,487.17,267.95,24.67,421.4,48
HCPCS,J1571,Hepagam b im injection,,,56.62,483.71,23
HCPCS,J1572,APC,,,55.76,57.43,15
HCPCS,J1572,Lab/Drugs Fee Schedule,,,38.24,47.21,6
HCPCS,J1573,hepatitis B immune globulin Solution 5 mL Vial,4820.68,2651.38,56.62,4169.89,63
HCPCS,J1574,"Inj, ganciclovir (exela)",,,51.52,63.6,6
HCPCS,J1575,Hyqvia 100mg immuneglobulin,,,15.19,124.13,23
HCPCS,J1576,"Inj, panzyga, 500 mg",,,59.34,502.61,23
HCPCS,J1580,gentamicin 10 mg/ml Solution 2 mL Vial,68.19,37.51,2.12,58.98,48
HCPCS,J1580,gentamicin 100 mg/100 mL Solution 100 mL Flex Cont,60.1,33.06,2.12,51.99,48
HCPCS,J1580,gentamicin 120 mg/100 mL Solution 100 mL Flex Cont,59.4,32.67,2.12,51.38,48
HCPCS,J1580,gentamicin 14.4 mg/30 mL Solution 30 mL Syringe,501.9,276.05,2.12,434.14,48
HCPCS,J1580,gentamicin 40 MG/ML Solution 2 mL Vial,52.09,28.65,2.12,45.06,48
HCPCS,J1580,gentamicin 40 MG/ML Solution 20 mL Vial,214.92,118.21,2.12,185.91,48
HCPCS,J1580,gentamicin 40 mg/mL Solution 2 mL Vial,51.55,28.36,2.12,44.59,48
HCPCS,J1580,gentamicin neonatal 40 MG/ML Solution 2 mL Vial,52.09,28.65,2.12,45.06,48
HCPCS,J1580,gentamicin neonatal 40 MG/ML Solution 20 mL Vial,214.92,118.21,2.12,185.91,48
HCPCS,J1595,Injection glatiramer acetate,,,147.3,181.86,21
HCPCS,J1596,glycopyrrolate 0.2 MG/ML Solution 1 mL Vial,45.4,24.97,0.46,39.27,126
HCPCS,J1596,glycopyrrolate 0.2 MG/ML Solution 5 mL Vial,91.24,50.19,0.46,78.92,63
HCPCS,J1596,glycopyrrolate 1 MG/5ML Solution 5 mL Vial,91.24,50.19,0.46,78.92,63
HCPCS,J1597,"Inj glycopyrrolate, glyrx-pf",,,1.68,2.08,6
HCPCS,J1598,Inj glycopyrrolate fres kabi,,,1.34,12.49,23
HCPCS,J1600,Gold sodium thiomaleate inj,,,11.39,14.06,6
HCPCS,J1602,Golimumab for iv use 1mg,,,9.05,74.45,23
HCPCS,J1610,Glucagon hydrochloride/1 MG,,,158.14,1321.58,23
HCPCS,J1611,glucagon 1 mg Recon Soln 1 Each Vial,1379.47,758.71,96.08,1193.24,63
HCPCS,J1612,Inj glucagon (gvoke) 0.01 mg,,,3.45,3.55,15
HCPCS,J1626,granisetron 1 MG/ML Solution 1 mL Vial,88.0,48.4,0.2,76.12,48
HCPCS,J1627,"Inj, granisetron, xr, 0.1 mg",,,4.29,33.48,23
HCPCS,J1628,guselkumab 200 MG/20ML Solution 20 mL Vial,61189.05,33653.98,63.13,52928.53,63
HCPCS,J1630,haloperidol lactate 5 MG/ML Solution 1 mL Vial,66.93,36.82,1.04,57.89,48
HCPCS,J1631,haloperidol decanoate 100 MG/ML Solution 5 mL Vial,1010.22,555.63,4.76,873.84,48
HCPCS,J1632,"Inj., brexanolone, 1 mg",,,76.75,94.76,6
HCPCS,J1640,hemin 350 MG Recon Soln 1 Each Vial,45960.06,25278.04,28.44,39755.45,63
HCPCS,J1642,heparin (porcine) lock flush 10 units/mL 5 mL Solution 5 mL Syringe,34.8,19.14,0.02,30.1,48
HCPCS,J1642,heparin (porcine) lock flush 100 UNIT/ML Solution 5 mL Vial,45.92,25.26,0.02,39.72,48
HCPCS,J1642,heparin lock 100 units/mL Solution 5 mL Syringe,35.32,19.43,0.02,30.55,48
HCPCS,J1643,"Inj heparin, pfizer, 1000u",,,3.02,20.32,8
HCPCS,J1644,heparin 1000 UNIT/ML Solution 10 mL Vial,75.89,41.74,0.17,65.64,48
HCPCS,J1644,heparin 1000 UNIT/ML Solution 30 mL Vial,74.98,41.24,0.17,64.86,96
HCPCS,J1644,"heparin 25,000 units in 500 mL D5W 50 UNIT/ML Solution 500 mL Flex Cont",156.0,85.8,0.17,134.94,48
HCPCS,J1644,heparin 5000 UNIT/ML Solution 1 mL Vial,50.215,27.619999999999997,0.17,48.61,192
HCPCS,J1644,heparin 5000 UNIT/ML Solution 1.5 mL Syringe,68.68,37.78,0.17,59.41,48
HCPCS,J1644,heparin 5000 UNIT/ML Solution 10 mL Vial,115.25999999999999,63.400000000000006,0.17,115.08,96
HCPCS,J1645,Dalteparin sodium,,,11.9,121.77,8
HCPCS,J1650,enoxaparin 100 mg/mL Solution Prefilled Syringe 1 mL Syringe,90.24,49.64,0.48,78.06,48
HCPCS,J1650,enoxaparin 120 mg/0.8mL Solution Prefilled Syringe 0.8 mL Syringe,92.09,50.65,0.48,79.66,48
HCPCS,J1650,enoxaparin 150 mg/mL Solution Prefilled Syringe 1 mL Syringe,138.495,76.175,0.48,143.81,96
HCPCS,J1650,enoxaparin 30 mg/0.3mL Solution Prefilled Syringe 0.3 mL Syringe,45.77,25.18,0.48,39.59,48
HCPCS,J1650,enoxaparin 40 mg/0.4mL Solution Prefilled Syringe 0.4 mL Syringe,52.6,28.93,0.48,45.5,48
HCPCS,J1650,enoxaparin 60 mg/0.6mL Solution Prefilled Syringe 0.6 mL Syringe,62.59,34.43,0.48,54.14,48
HCPCS,J1650,enoxaparin 80 mg/0.8mL Solution Prefilled Syringe 0.8 mL Syringe,100.07499999999999,55.045,0.48,106.7,96
HCPCS,J1652,fondaparinux 10 MG/0.8ML Solution 0.8 mL Syringe,363.6,199.98,0.58,314.51,48
HCPCS,J1652,fondaparinux 2.5 MG/0.5ML Solution 0.5 mL Syringe,179.25,98.59,0.58,155.05,48
HCPCS,J1652,fondaparinux 5 MG/0.4ML Solution 0.4 mL Syringe,346.8,190.74,0.58,299.98,48
HCPCS,J1652,fondaparinux 7.5 MG/0.6ML Solution 0.6 mL Syringe,363.0,199.65,0.58,314.0,48
HCPCS,J1655,Lab/Drugs Fee Schedule,,,3.05,3.77,6
HCPCS,J1670,tetanus immune globulin 250 UNIT/ML Solution Prefilled Syringe 1 mL Syringe,3520.52,1936.29,491.18,3895.09,63
HCPCS,J1675,Histrelin acetate,,,0.84,1.03,6
HCPCS,J1720,hydrocortisone sodium succinate PF 100 mg Recon Soln 1 Each Vial,173.56,95.46,17.98,150.13,96
HCPCS,J1720,hydrocortisone sodium succinate PF 250 mg Recon Soln 1 Each Vial,282.18,155.2,17.98,244.09,48
HCPCS,J1726,"Makena, 10 mg",,,11.87,14.65,6
HCPCS,J1729,Inj hydroxyprogst capoat nos,,,29.3,36.18,6
HCPCS,J1730,Diazoxide injection,,,84.43,104.23,6
HCPCS,J1738,Inj. meloxicam 1 mg,,,3.23,3.99,6
HCPCS,J1740,ibandronate 3 MG/3ML Solution 3 mL Syringe,1338.01,735.91,21.77,1157.38,48
HCPCS,J1741,Ibuprofen injection,,,2.56,20.52,8
HCPCS,J1742,ibutilide 1 MG/10ML Solution 10 mL Vial,3038.08,1670.95,160.53,2627.94,63
HCPCS,J1743,Idursulfase injection,,,465.55,3770.28,23
HCPCS,J1744,icatibant 30 mg/3 mL Solution Prefilled Syringe 3 mL Syringe,7324.9,4028.7,115.96,6336.04,63
HCPCS,J1745,inFLIXimab 100 mg Recon Soln 1 Each Vial,6321.23,3476.68,26.21,5467.86,63
HCPCS,J1745,inFLIXimab Recon Soln 1 Each Vial,6321.23,3476.68,26.21,5467.86,63
HCPCS,J1746,ibalizumab-uiyk 200 mg/1.33 mL Solution 1.33 mL Vial,8247.3,4536.02,66.22,7133.91,63
HCPCS,J1747,spesolimab-sbzo 450 MG/7.5ML Solution 7.5 mL Vial,117203.77,64462.08,52.75,101381.26,63
HCPCS,J1748,"Inj, zymfentra, 10 mg",,,224.29,276.9,6
HCPCS,J1749,"Inj, iloprost, 0.1 mcg",,,5.67,38.54,8
HCPCS,J1750,iron dextran complex 50 MG/ML Solution 2 mL Vial,238.7,131.29,14.94,206.48,63
HCPCS,J1756,iron sucrose 20 MG/ML Solution 5 mL Vial,393.36,216.35,0.2,340.26,48
HCPCS,J1756,iron sucrose 300mg/250 mL Solution 250 mL Bag,1111.0,611.05,0.2,961.02,48
HCPCS,J1786,imiglucerase 400 units Recon Soln 1 Each Vial,9379.3,5158.62,37.24,8113.09,63
HCPCS,J1790,droPERidol 2.5 MG/ML Solution 0.25 mL Syringe,40.63,22.35,10.47,36.18,48
HCPCS,J1790,droPERidol 2.5 MG/ML Solution 2 mL Vial,89.1,49.01,10.47,77.07,48
HCPCS,J1800,propranolol 1 MG/ML Solution 1 mL Vial,81.0,44.55,8.68,70.07,48
HCPCS,J1805,esmolol 100 MG/10ML Solution 10 mL Vial,58.0,31.9,0.18,50.17,48
HCPCS,J1805,"esmolol in sodium chloride 2,000 mg/100 mL Solution 100 mL Flex Cont",1773.65,975.51,0.18,1534.21,48
HCPCS,J1806,"esmolol in water 2,000 mg/100 mL Solution 100 mL Flex Cont",533.0,293.15,0.31,461.05,48
HCPCS,J1807,"Inj, ethacrynate sod, 1 mg",,,20.97,21.6,15
HCPCS,J1808,folic acid 5 MG/ML Solution 10 mL Vial,398.52,219.19,0.3,344.72,48
HCPCS,J1809,"Inj, fosdenopterin, 0.1mg",,,16.97,17.48,15
HCPCS,J1811,Fiasp for insulin pump use,,,6.78,52.38,23
HCPCS,J1812,Inj. insulin (fiasp),,,1.66,2.04,6
HCPCS,J1813,Lyumjev for insulin pump use,,,13.29,103.07,8
HCPCS,J1814,Inj. insulin (lyumjev),,,1.72,2.12,6
HCPCS,J1815,Insulin injection,,,0.48,0.59,6
HCPCS,J1817,Insulin for insulin pump use,,,2.04,21.87,8
HCPCS,J1823,inebilizumab-cdon 100 MG/10ML Solution 10 mL Vial,196357.9,107996.85,415.9,169849.58,63
HCPCS,J1826,Interferon Beta-1A inj,,,1891.62,2335.33,21
HCPCS,J1830,Interferon beta-1b / .25 MG,,,420.53,519.18,6
HCPCS,J1833,isavuconazonium sulfate 372 MG Recon Soln 1 Each Vial,1984.16,1091.29,0.86,1716.3,63
HCPCS,J1834,"Inj, isoniazid, 1 mg",,,0.32,0.33,15
HCPCS,J1835,Itraconazole injection,,,780.97,964.15,6
HCPCS,J1836,metroNIDAZOLE 500 mg in 100 mL Solution 100 mL Flex Cont,44.7,24.59,0.03,39.88,96
HCPCS,J1836,metroNIDAZOLE Solution 1 mL Flex Cont,30.16,16.59,0.03,26.09,48
HCPCS,J1885,ketorolac 15 MG/ML Solution 1 mL Vial,53.05,29.18,0.31,45.89,63
HCPCS,J1885,ketorolac 30 MG/ML Solution 1 mL Vial,64.9,35.7,0.31,56.14,63
HCPCS,J1885,ketorolac 60 MG/2ML Solution 2 mL Vial,82.4,45.32,0.31,71.28,63
HCPCS,J1920,labetalol 5 MG/ML Solution 20 mL Vial,54.7,30.09,0.25,47.32,48
HCPCS,J1920,labetalol 5 MG/ML Solution 4 mL Cartridge,88.56,48.71,0.25,76.6,48
HCPCS,J1920,labetalol 5 MG/ML Solution 40 mL Vial,163.0,89.65,0.25,141.0,48
HCPCS,J1921,"Inj labetalol hcl hikma, 5mg",,,1.18,9.32,8
HCPCS,J1930,lanreotide acetate 120 MG/0.5ML Solution 0.5 mL Syringe,40170.4,22093.72,34.05,34747.4,63
HCPCS,J1930,lanreotide acetate 60 MG/0.2ML Solution 0.2 mL Syringe,25579.6,14068.78,34.05,22126.35,63
HCPCS,J1930,lanreotide acetate 90 MG/0.3ML Solution 0.3 mL Syringe,34063.6,18734.98,34.05,29465.01,63
HCPCS,J1931,laronidase 2.9 MG/5ML Solution 5 mL Vial,6027.25,3314.99,33.17,5213.57,63
HCPCS,J1932,"Inj, lanreotide, (cipla) 1mg",,,26.34,165.04,23
HCPCS,J1938,furosemide 10 MG/ML Solution 10 mL Vial,46.0,25.3,0.1,39.79,96
HCPCS,J1938,furosemide 10 MG/ML Solution 2 mL Vial,38.0,20.9,0.1,32.87,48
HCPCS,J1938,furosemide 10 MG/ML Solution 4 mL Vial,46.99,25.85,0.1,40.65,48
HCPCS,J1939,bumetanide 0.2 mg/mL Solution 50 mL Bag,120.0,66.0,0.37,103.8,63
HCPCS,J1939,bumetanide 0.25 MG/ML Solution 10 mL Vial,43.53,23.95,0.37,37.65,63
HCPCS,J1939,bumetanide 0.25 MG/ML Solution 4 mL Vial,47.65,26.21,0.37,41.22,63
HCPCS,J1940,Lab/Drugs Fee Schedule,,,0.33,0.41,6
HCPCS,J1941,"Inj, furoscix, 20 mg",,,244.04,301.28,6
HCPCS,J1943,"Inj., Aristada Initio, 1 mg",,,2.69,22.01,23
HCPCS,J1944,ARIPiprazole lauroxil ER 1064 mg/3.9 mL Prefilled Syringe 3.9 mL Syringe,16132.16,8872.69,2.77,13954.32,63
HCPCS,J1944,ARIPiprazole lauroxil ER 441 mg/1.6 mL Prefilled Syringe 1.6 mL Syringe,8606.4,4733.52,2.77,7444.54,63
HCPCS,J1944,ARIPiprazole lauroxil ER 662 mg/2.4 mL Prefilled Syringe 2.4 mL Syringe,10040.9,5522.5,2.77,8685.38,63
HCPCS,J1944,ARIPiprazole lauroxil ER 882 mg/3.2 mL Prefilled Syringe 3.2 mL Syringe,13374.36,7355.9,2.77,11568.82,63
HCPCS,J1945,Lab/Drugs Fee Schedule,,,124.7,153.95,6
HCPCS,J1950,leuprolide acetate (3 month) 11.25 MG Kit 1 Each Box,22704.15,12487.29,1431.1,19639.09,63
HCPCS,J1950,leuprolide acetate 3.75 MG Kit 1 Each Box,9740.99,5357.55,1431.1,11725.43,126
HCPCS,J1951,Inj fensolvi 0.25 mg,,,117.18,947.9,23
HCPCS,J1952,"Leuprolide inj, camcevi, 1mg",,,48.0,347.02,23
HCPCS,J1953,levETIRAcetam 500 MG/5ML Solution 5 mL Vial,54.18,29.8,0.05,46.87,48
HCPCS,J1954,Inj leu acet lutr dpt 7.5 mg,,,202.01,1490.0,23
HCPCS,J1955,levOCARNitine 200 MG/ML Solution 5 mL Vial,248.25,136.54,21.94,214.74,48
HCPCS,J1956,levoFLOXacin 250 MG/50ML Solution 50 mL Flex Cont,61.0,33.55,1.62,52.77,48
HCPCS,J1956,levoFLOXacin 500 MG/100ML Solution 100 mL Flex Cont,61.6,33.88,1.62,53.28,48
HCPCS,J1956,levoFLOXacin 750 MG/150ML Solution 150 mL Flex Cont,74.75,41.12,1.62,64.66,48
HCPCS,J1960,Levorphanol tartrate inj,,,2.49,3.08,6
HCPCS,J1961,lenacapavir 463.5 MG/1.5ML Solution 1.5 mL Vial,40960.0,22528.0,18.87,35430.4,63
HCPCS,J1980,Hyoscyamine sulfate inj,,,7.78,9.6,6
HCPCS,J1990,Chlordiazepoxide injection,,,17.22,21.25,6
HCPCS,J2002,"Inj, lidocaine in d5w, 1 mg",,,0.01,0.07,23
HCPCS,J2003,"Inj, lidocaine hcl, 1 mg",,,0.05,0.06,6
HCPCS,J2004,"Inj, lidocaine w epinephrine",,,0.03,0.03,6
HCPCS,J2010,lincomycin HCl 300 MG/ML Solution 10 mL Vial,923.6,507.98,5.78,798.91,48
HCPCS,J2020,linezolid 600 MG/300ML Solution 300 mL Flex Cont,114.5,62.98,2.56,99.04,48
HCPCS,J2021,"Inj, linezolid (hospira)",,,7.1,42.8,8
HCPCS,J2060,LORazepam 2 MG/ML Solution 1 mL Vial,54.7,30.09,1.16,47.32,48
HCPCS,J2062,Loxapine for inhalation 1 mg,,,15.45,19.08,21
HCPCS,J2150,mannitol 25 % Solution 50 mL Vial,61.6,33.88,2.18,53.28,48
HCPCS,J2170,Mecasermin injection,,,144.99,179.0,6
HCPCS,J2175,meperidine 100 MG/ML Solution 1 mL Vial,67.7,37.24,5.98,105.91,48
HCPCS,J2175,meperidine 25 MG/ML Solution 1 mL Syringe,80.4,44.22,5.98,105.91,48
HCPCS,J2175,meperidine 50 MG/ML Solution 1 mL Syringe,95.5,52.53,5.98,105.91,48
HCPCS,J2175,meperidine 50 MG/ML Solution 1 mL Vial,64.35,35.4,5.98,105.91,48
HCPCS,J2180,Meperidine/promethazine inj,,,6.39,7.89,6
HCPCS,J2182,mepolizumab 100 MG Recon Soln 1 Each Vial,14845.16,8164.84,26.35,12841.06,63
HCPCS,J2183,Inj meropenem (wg crit care),,,1.42,10.94,23
HCPCS,J2184,"Inj, meropenem (b. braun)",,,1.77,14.04,8
HCPCS,J2185,meropenem 1 g Recon Soln 1 Each Vial,78.9,43.4,0.33,79.15,96
HCPCS,J2185,meropenem 1000 mg Recon Soln 1 Each Vial,154.62,85.05,0.33,133.75,48
HCPCS,J2185,meropenem 500 MG Recon Soln 1 Each Vial,216.34,118.99,0.33,187.13,48
HCPCS,J2185,meropenem 500 mg Recon Soln 1 Each Vial,44.65,24.56,0.33,38.62,48
HCPCS,J2185,meropenem Recon Soln 1 Each Vial,417.68,229.73,0.33,361.29,48
HCPCS,J2186,meropenem/vaborbactam 2 (1-1) g Recon Soln 1 Each Vial,1216.5,669.08,1.81,1052.27,63
HCPCS,J2210,methylergonovine 0.2 MG/ML Solution 1 mL Vial,202.68,111.48,18.74,175.32,48
HCPCS,J2212,methylnaltrexone 12 MG/0.6ML Solution 0.6 mL Vial,932.62,512.95,1.55,806.72,48
HCPCS,J2246,"Inj, micafungin (baxter)",,,0.8,3.44,8
HCPCS,J2247,"Inj, micafungin (par pharm)",,,0.27,2.43,8
HCPCS,J2248,micafungin 100 MG Recon Soln 1 Each Vial,1024.8,563.64,0.24,886.45,48
HCPCS,J2248,micafungin 50 MG Recon Soln 1 Each Vial,576.0,316.8,0.24,498.24,48
HCPCS,J2249,"Inj, remimazolam, 1 mg",,,2.16,2.67,6
HCPCS,J2250,midazolam 50 MG/10ML Solution 10 mL Vial,94.27,51.85,0.12,81.54,48
HCPCS,J2250,midazolam PF 2 MG/2ML Solution 2 mL Vial,58.88,32.39,0.12,50.93,48
HCPCS,J2250,midazolam PF 5 MG/ML Solution 1 mL Vial,58.58,32.22,0.12,50.67,48
HCPCS,J2250,midazolam PF 5 mg/5 mL Solution 5 mL Vial,58.2,32.015,0.12,50.38,96
HCPCS,J2251,midazolam (1 mg/mL) Solution 100 mL Flex Cont,170.0,93.5,0.14,147.05,48
HCPCS,J2252,Inj midazolam in 0.8% nacl,,,0.06,0.08,6
HCPCS,J2260,milrinone 1 MG/ML Solution 10 mL Vial,68.75,37.82,1.13,59.47,48
HCPCS,J2260,milrinone 20 MG/100ML Solution 100 mL Flex Cont,96.0,52.8,1.13,83.04,48
HCPCS,J2265,minocycline HCl 100 MG Recon Soln 1 Each Vial,1410.9,776.0,2.23,1220.43,63
HCPCS,J2267,mirikizumab-mrkz 300 MG/15ML Solution 15 mL Vial,33586.27,18472.45,38.97,29052.12,63
HCPCS,J2270,morphine 10 MG/ML Solution 1 mL Vial,63.15,34.74,3.93,54.62,48
HCPCS,J2270,morphine sulfate 10 MG/ML Solution 1 mL Cartridge,60.03,33.02,3.93,51.93,48
HCPCS,J2270,morphine sulfate 2 mg/mL Solution 1 mL Cartridge,57.69,31.73,3.93,49.9,96
HCPCS,J2270,morphine sulfate 4 mg/mL Solution 1 mL Cartridge,55.325,30.435000000000002,3.93,47.88,96
HCPCS,J2272,Morphine Sulfate (PF) 10 MG/ML Solution 1 mL Vial,69.65,38.31,3.48,60.25,48
HCPCS,J2274,morphine (PF) 1 MG/ML Solution 1 mL Syringe,44.82,24.66,9.92,72.83,48
HCPCS,J2274,morphine (PF) 1 MG/ML Solution 10 mL Ampule,309.6,170.28,9.92,267.8,48
HCPCS,J2277,"Inj, motixafortide, 0.25 mg",,,21.65,170.24,23
HCPCS,J2278,Ziconotide injection,,,8.4,68.38,23
HCPCS,J2280,moxifloxacin 400 mg/250 mL Solution 250 mL Flex Cont,240.0,132.0,7.43,207.6,48
HCPCS,J2281,Inj moxifloxacin (fres kabi),,,5.3,52.38,8
HCPCS,J2290,nafcillin 1 g Recon Soln 1 Each Vial,96.05,52.83,0.24,83.08,48
HCPCS,J2290,nafcillin 2 g Recon Soln 1 Each Vial,101.25,55.69,0.24,87.58,48
HCPCS,J2290,nafcillin 2 g/100 mL Solution 100 mL Flex Cont,142.0,78.1,0.24,122.83,48
HCPCS,J2290,nafcillin Recon Soln 1 Each Vial,614.51,337.99,0.24,531.55,48
HCPCS,J2300,nalbuphine 10 MG/ML Solution 1 mL Ampule,58.45,32.15,2.95,50.56,48
HCPCS,J2305,nitroglycerin 25 mg in D5W 250 mL 100 MCG/ML Solution 250 mL Glass Cont,122.5,67.38,1.21,105.96,48
HCPCS,J2305,nitroglycerin 5 MG/ML Solution 10 mL Vial,121.08,66.6,1.21,104.73,48
HCPCS,J2305,nitroglycerin 50 mg in D5W 250 mL 200-5 MCG/ML-% Solution 250 mL Glass Cont,132.5,72.88,1.21,114.61,48
HCPCS,J2310,Lab/Drugs Fee Schedule,,,7.47,9.22,6
HCPCS,J2311,Lab/Drugs Fee Schedule,,,1.29,1.59,6
HCPCS,J2312,naloxone 0.4 MG/ML Solution 1 mL Vial,95.0,52.25,0.35,82.18,96
HCPCS,J2312,naloxone 0.4 MG/ML Solution 10 mL Vial,636.0,349.8,0.35,550.14,48
HCPCS,J2312,naloxone 2 MG/2ML Solution Prefilled Syringe 2 mL Syringe,208.05,114.43,0.35,184.25,96
HCPCS,J2312,naloxone 4 MG/10ML Solution 10 mL Vial,636.0,349.8,0.35,550.14,96
HCPCS,J2313,"Inj, naloxone (zimhi) 0.01mg",,,0.1,0.14,2
HCPCS,J2315,naltrexone 380 MG Recon Susp 1 Each Vial,9142.84,5028.57,3.54,7908.56,63
HCPCS,J2320,Nandrolone decanoate 50 MG,,,3.33,4.11,6
HCPCS,J2323,natalizumab 300 MG/15ML Conc 15 mL Vial,35868.4,19727.62,20.5,31026.17,63
HCPCS,J2325,Nesiritide injection,,,24.99,30.86,6
HCPCS,J2326,nusinersen 12 MG/5ML Solution 5 mL Vial,599840.74,329912.41,1280.25,518862.24,63
HCPCS,J2327,risankizumab-rzaa 600 MG/10ML Solution 10 mL Vial,43575.34,23966.44,12.94,37692.67,63
HCPCS,J2329,"Inj ublituximab-xiiy, 1 mg",,,59.27,485.33,23
HCPCS,J2350,ocrelizumab 300 MG/10ML Solution 10 mL Vial,86702.03,47686.12,50.46,74997.26,63
HCPCS,J2351,ocrelizumab-hyaluronidase-ocsq 920-23000 mg-unit/23 mL Solution 23 mL Vial,173394.06,95366.74,47.23,149985.86,63
HCPCS,J2353,octreotide 10 MG Kit 1 Each Box,14808.41,8144.63,187.49,12809.27,63
HCPCS,J2353,octreotide 20 MG Kit 1 Each Box,19398.46,10669.16,187.49,16779.67,63
HCPCS,J2353,octreotide 30 MG Kit 1 Each Box,29042.75,15973.52,187.49,25121.98,63
HCPCS,J2354,"Octreotide inj, non-depot",,,0.69,4.12,8
HCPCS,J2355,Oprelvekin injection,,,205.52,253.72,6
HCPCS,J2356,Tezepelumab-ekko 210 MG/1.91ML Solution Prefilled Syringe 1.91 mL Syringe,18359.64,10097.81,15.6,15881.09,63
HCPCS,J2357,omalizumab 150 MG Recon Soln 1 Each Vial,7662.05,4214.13,32.43,6627.67,63
HCPCS,J2357,omalizumab 150 mg/mL Solution Prefilled Syringe 1 mL Syringe,7662.05,4214.13,32.43,6627.67,63
HCPCS,J2357,omalizumab 300 mg/2 mL Solution Prefilled Syringe 2 mL Syringe,11905.41,6547.98,32.43,10298.18,63
HCPCS,J2357,omalizumab 75 MG/0.5ML Solution Prefilled Syringe 0.5 mL Syringe,3838.52,2111.19,32.43,3320.32,63
HCPCS,J2358,Olanzapine long-acting inj,,,2.51,19.71,23
HCPCS,J2359,OLANZapine 10 MG Recon Soln 1 Each Vial,150.0,82.5,0.65,129.75,48
HCPCS,J2360,Orphenadrine injection,,,12.02,63.79,8
HCPCS,J2371,phenylephrine 10 MG/ML Solution 1 mL Vial,49.0,26.95,0.01,42.39,48
HCPCS,J2371,phenylephrine 10 MG/ML Solution 5 mL Vial,163.0,89.65,0.01,141.0,48
HCPCS,J2371,phenylephrine 4 mg/40 mL Solution 40 mL Syringe,65.8,36.19,0.01,56.92,48
HCPCS,J2372,phenylephrine 0.1 mg/mL Solution 5 mL Ampule,62.5,34.38,0.14,54.06,48
HCPCS,J2373,"Inj, immphentiv, 20 mcg",,,0.13,0.88,23
HCPCS,J2401,chloroprocaine PF 2 % Solution 20 mL Vial,177.95,97.88,0.03,153.93,48
HCPCS,J2401,chloroprocaine PF 3 % Solution 20 mL Vial,165.47,91.01,0.03,143.13,48
HCPCS,J2402,Chloroprocaine (clorotekal),,,0.32,0.39,6
HCPCS,J2403,"Chloroprocaine opht gel, 1mg",,,0.53,4.05,23
HCPCS,J2404,niCARdipine 2.5 MG/ML Solution 10 mL Vial,158.06,86.94,0.06,136.72,48
HCPCS,J2405,ondansetron 16 mg Solution 50 mL Bag,60.36,33.2,0.08,52.21,48
HCPCS,J2405,ondansetron 4 MG/2ML Solution 2 mL Vial,33.68,18.53,0.08,29.13,48
HCPCS,J2405,ondansetron 40 MG/20ML Solution 20 mL Vial,63.5,34.93,0.08,54.93,48
HCPCS,J2406,"Injection, oritavancin 10 mg",,,37.2,279.45,23
HCPCS,J2407,"Injection, oritavancin",,,24.5,192.51,23
HCPCS,J2410,Oxymorphone hcl injection,,,1.94,2.4,6
HCPCS,J2425,palifermin 5.16 mg Recon Soln 1 Each Vial,15123.44,8317.9,29.19,13081.78,63
HCPCS,J2426,paliperidone palmitate ER 117 mg/0.7 mL Suspension Prefilled Syringe 0.75 mL Syringe,9651.57,5308.37,12.65,8348.61,63
HCPCS,J2426,paliperidone palmitate ER 156 mg/mL Suspension Prefilled Syringe 1 mL Syringe,10003.86,5502.13,12.65,8653.34,63
HCPCS,J2426,paliperidone palmitate ER 234 mg/1.5 mL Suspension Prefilled Syringe 1.5 mL Syringe,15000.43,8250.24,12.65,12975.37,63
HCPCS,J2427,"Inj, invega hafyera/trinza",,,10.84,87.48,23
HCPCS,J2428,"Inj, erzofri, 1 mg",,,16.76,17.27,15
HCPCS,J2430,pamidronate 30 MG/10ML Solution 10 mL Vial,113.86,62.63,10.8,98.49,48
HCPCS,J2430,pamidronate 90 MG/10ML Solution 10 mL Vial,239.88,131.94,10.8,207.5,48
HCPCS,J2440,Papaverin hcl injection,,,39.45,48.7,6
HCPCS,J2468,"Inj, palonosetron (posfrea)",,,51.29,397.17,23
HCPCS,J2469,palonosetron 0.25 MG/5ML Solution 5 mL Vial,225.0,123.75,0.51,194.63,48
HCPCS,J2470,pantoprazole 40 mg Recon Soln 1 Each Vial,58.38,32.11,8.4,50.5,48
HCPCS,J2471,Inj pantoprazole(hikma) 40mg,,,6.7,8.27,6
HCPCS,J2472,"Inj, pantoprazole sodium chl",,,8.23,10.15,6
HCPCS,J2501,paricalcitol 5 MCG/ML Solution 1 mL Vial,118.48,65.17,0.77,102.49,48
HCPCS,J2502,"Inj, pasireotide long acting",,,458.06,3805.58,23
HCPCS,J2504,Lab/Drugs Fee Schedule,,,132.76,163.9,6
HCPCS,J2506,pegfilgrastim 6 MG/0.6ML Prefilled Syringe Kit 0.6 mL Syringe,26965.56,14831.06,17.15,23325.21,63
HCPCS,J2506,pegfilgrastim 6 MG/0.6ML Solution Prefilled Syringe 0.6 mL Syringe,26965.56,14831.06,17.15,23325.21,63
HCPCS,J2507,Pegloticase 8 MG/ML Solution 1 mL Vial,126104.29,69357.36,3048.08,109080.21,63
HCPCS,J2508,pegunigalsidase alfa-iwxj 20 mg/10 mL Solution 10 mL Vial,18610.54,10235.8,194.72,16098.12,63
HCPCS,J2510,Penicillin g procaine inj,,,40.52,50.02,21
HCPCS,J2515,PENTobarbital 50 MG/ML Solution 0.5 mL Syringe,92.09,50.65,27.63,79.66,48
HCPCS,J2515,PENTobarbital 50 MG/ML Solution 1 mL Syringe,164.18,90.3,49.25,142.02,48
HCPCS,J2515,PENTobarbital 50 MG/ML Solution 2 mL Syringe,281.18,154.65,57.97,243.22,48
HCPCS,J2515,PENTobarbital 50 MG/ML Solution 20 mL Vial,6550.19,3602.61,57.97,5665.91,48
HCPCS,J2540,penicillin G potassium 2 million units/50 mL Solution 50 mL Plas Cont,71.75,39.47,0.65,62.06,48
HCPCS,J2540,penicillin G potassium 3 million units/50 mL Solution 50 mL Plas Cont,73.75,40.57,0.65,63.79,48
HCPCS,J2540,penicillin G potassium 4 million units/100 mL Solution 100 mL Bag,97.0,53.35,0.65,83.91,48
HCPCS,J2540,penicillin G potassium 5 million unit Recon Soln 1 Each Vial,102.69,56.48,0.65,88.83,48
HCPCS,J2540,penicillin G potassium Recon Soln 1 Each Vial,208.815,114.85,0.65,272.42,96
HCPCS,J2543,piperacillin/tazobactam 2.25 (2-0.25) g Recon Soln 1 Each Vial,50.76,27.92,0.98,43.91,48
HCPCS,J2543,piperacillin/tazobactam 3.375 g/50 mL Solution 50 mL Plas Cont,121.5,66.83,0.98,105.1,48
HCPCS,J2543,piperacillin/tazobactam 4.5 (4-0.5) g Recon Soln 1 Each Vial,70.5,38.78,0.98,60.98,48
HCPCS,J2543,piperacillin/tazobactam 4.5 g/100 mL Solution 100 mL Plas Cont,147.0,80.85,0.98,127.16,96
HCPCS,J2543,piperacillin/tazobactam Recon Soln 1 Each Vial,63.5,34.93,0.98,54.93,48
HCPCS,J2545,Pentamidine non-comp unit,,,68.17,556.0,8
HCPCS,J2547,"Injection, peramivir",,,1.44,1.78,21
HCPCS,J2550,promethazine 25 MG/ML Solution 1 mL Vial,44.78,24.63,3.06,38.73,48
HCPCS,J2560,PHENobarbital 65 MG/ML Solution 1 mL Vial,172.08,94.65,26.42,184.68,48
HCPCS,J2561,"Inj, sezaby, 1 mg",,,0.56,1.23,21
HCPCS,J2562,plerixafor 24 MG/1.2ML Solution 1.2 mL Vial,23905.97,13148.285,25.33,36222.64,126
HCPCS,J2590,oxytocin 10 UNIT/ML Solution 1 mL Vial,50.88,27.99,1.73,44.01,48
HCPCS,J2590,oxytocin 10 UNIT/ML Solution 10 mL Vial,111.0,61.05,1.73,96.02,48
HCPCS,J2597,desmopressin 4 MCG/ML Solution 10 mL Vial,2148.0,1181.4,3.52,1858.02,63
HCPCS,J2598,vasopressin 20 UNIT/ML Solution 1 mL Vial,183.0,100.65,1.4,158.3,48
HCPCS,J2598,vasopressin 20 units in 0.9% NaCl 100 mL 0.2 units/mL Solution 100 mL Bag,457.37,251.56,1.4,395.63,48
HCPCS,J2598,vasopressin 20 units in 100 mL 0.2 units/mL Solution 100 mL Vial,272.5,149.88,1.4,235.71,48
HCPCS,J2599,Inj vasopressin (am reg) 1 u,,,1.03,3.24,8
HCPCS,J2601,"Inj, vasopressin (baxter)",,,2.01,19.85,23
HCPCS,J2675,Inj progesterone per 50 MG,,,0.77,4.25,8
HCPCS,J2679,Inj fluphenazine hcl 1.25 mg,,,6.61,50.15,23
HCPCS,J2680,fluPHENAZine decanoate 25 MG/ML Solution 5 mL Vial,668.4,367.62,8.07,578.17,48
HCPCS,J2690,procainamide 100 MG/ML Solution 10 mL Vial,525.0,288.75,157.15,1311.66,63
HCPCS,J2700,Oxacillin sodium injeciton,,,0.92,5.54,8
HCPCS,J2704,propofol (10 mg/mL) Emulsion 100 mL Vial,195.0,107.25,0.06,168.68,48
HCPCS,J2704,propofol (10 mg/mL) Emulsion 50 mL Vial,117.5,64.63,0.06,101.64,48
HCPCS,J2704,propofol 10 MG/ML Emulsion 20 mL Vial,67.0,36.85,0.06,57.96,48
HCPCS,J2704,propofol 10 MG/ML Emulsion 50 mL Vial,117.5,64.63,0.06,101.64,48
HCPCS,J2704,propofol 200 MG/20ML Emulsion 20 mL Vial,67.0,36.85,0.06,57.96,48
HCPCS,J2710,Neostigmine methylslfte inj,,,1.42,1.76,6
HCPCS,J2720,protamine 10 MG/ML Solution 25 mL Vial,332.4,182.82,0.98,287.53,48
HCPCS,J2720,protamine 10 MG/ML Solution 5 mL Vial,120.62,66.35,0.98,104.34,48
HCPCS,J2724,Protein c concentrate,,,7.5,15.93,23
HCPCS,J2730,pralidoxime Recon Soln 1 Each Vial,535.2,294.36,89.33,462.95,48
HCPCS,J2760,phentolamine Recon Soln 1 Each Vial,2281.92,1255.06,338.83,2946.44,63
HCPCS,J2765,metoclopramide 5 MG/ML Solution 2 mL Vial,50.14,27.58,0.88,43.37,48
HCPCS,J2770,Quinupristin/dalfopristin,,,3.66,4.52,21
HCPCS,J2777,faricimab-svoa 6 mg/0.05mL Solution Prefilled Syringe 0.05 mL Syringe,9626.53,5294.6,30.27,8326.95,63
HCPCS,J2778,Ranibizumab 0.5 MG/0.05ML Solution Prefilled Syringe 0.05 mL Syringe,10545.0,5799.75,86.38,9121.43,63
HCPCS,J2778,ranibizumab 0.3 MG/0.05ML Solution 0.05 mL Vial,6333.0,3483.15,86.38,5478.05,63
HCPCS,J2779,"Inj, Susvimo 0.1 mg",,,69.08,529.4,23
HCPCS,J2781,"Inj, pegcetacoplan, 1mg",,,125.68,957.89,23
HCPCS,J2782,Inj avacincaptad pegol 0.1mg,,,93.33,714.83,23
HCPCS,J2783,rasburicase 1.5 MG Recon Soln 1 Each Vial,5904.42,3247.44,317.66,5107.32,63
HCPCS,J2785,regadenoson 0.4 MG/5ML Solution 5 mL Syringe,150.0,82.5,3.28,129.75,48
HCPCS,J2786,reslizumab 10 mg/mL Solution 10 mL Vial,6030.6,3316.83,8.87,5216.47,63
HCPCS,J2787,"HC RIBOFLAVIN 5-PHOSPHATE, OPHTHALMIC SOLUTION, 3 ML",5675.0,3121.25,1702.5,4908.88,48
HCPCS,J2787,riboflavin 5'-phosphate 0.146 &0.146-20 % Solution Prefilled Syringe 6 mL Box,13690.0,7529.5,2349.13,11841.85,48
HCPCS,J2788,Rho d immune globulin 50 mcg,,,21.09,188.06,8
HCPCS,J2790,Rho (D) immune globulin 300 mcg (1500 units) Solution Prefilled Syringe 1 Each Syringe,679.2,373.56,71.57,587.51,48
HCPCS,J2791,Rhophylac injection,,,4.19,33.55,8
HCPCS,J2792,"Rho(D) immune globulin h, sd",,,25.46,207.7,23
HCPCS,J2793,Rilonacept injection,,,23.18,28.62,6
HCPCS,J2794,risperiDONE Microspheres ER 12.5 mg/2 mL Suspension Reconstituted ER 1 Each Vial,1757.47,966.61,9.44,1520.21,63
HCPCS,J2794,risperiDONE microspheres ER 25 mg/2 mL Suspension Reconstituted ER 1 Each Vial,3499.57,1924.77,9.44,3027.13,63
HCPCS,J2794,risperiDONE microspheres ER 37.5 mg/2 mL Suspension Reconstituted ER 1 Each Vial,5242.04,2883.13,9.44,4534.36,63
HCPCS,J2794,risperiDONE microspheres ER 50 mg/2 mL Suspension Reconstituted ER 1 Each Vial,6984.62,3841.55,9.44,6041.7,63
HCPCS,J2795,ROPivacaine 0.2 % 0.2 % Solution 20 mL Ampule,92.76,51.02,0.05,80.24,48
HCPCS,J2795,ROPivacaine 0.2 % Solution 100 mL Cartridge,571.96,314.58,0.05,496.42,144
HCPCS,J2795,ROPivacaine 0.2 % Solution 100 mL Glass Cont,259.2,142.56,0.05,224.21,48
HCPCS,J2795,ROPivacaine 0.2 % Solution 20 mL Vial,62.5,34.38,0.05,54.06,48
HCPCS,J2795,ROPivacaine 0.2 % Solution 200 mL Vial,503.4,276.87,0.05,435.44,48
HCPCS,J2795,ROPivacaine 0.5 % Solution 30 mL Vial,166.84,91.77,0.05,144.32,48
HCPCS,J2795,ROPivacaine 0.5% 0.5 % Solution 30 mL Vial,161.18,88.65,0.05,139.42,48
HCPCS,J2795,ROPivacaine 1 % 1 % Solution 20 mL Ampule,167.55,92.16,0.05,144.93,48
HCPCS,J2795,ROPivacaine 10 MG/ML Solution 20 mL Ampule,167.55,92.16,0.05,144.93,48
HCPCS,J2798,"Inj., Perseris, 0.5 mg",,,10.47,81.95,23
HCPCS,J2799,"Inj, uzedy, 1 mg",,,21.22,169.29,23
HCPCS,J2800,methocarbamol 1000 MG/10ML Solution 10 mL Vial,183.0,100.65,5.63,158.3,48
HCPCS,J2801,"Inj, rykindo, 0.5 mg",,,11.19,13.81,21
HCPCS,J2802,romiPLOStim 125 MCG Recon Soln 1 Each Vial,7448.26,4096.55,9.05,6442.74,63
HCPCS,J2802,romiPLOStim 250 MCG Recon Soln 1 Each Vial,11572.68,6364.98,9.05,10010.37,63
HCPCS,J2802,romiPLOStim 500 MCG Recon Soln 1 Each Vial,23135.28,12724.41,9.05,20012.02,63
HCPCS,J2804,rifAMPin Recon Soln 1 Each Vial,979.22,538.58,0.8,847.03,48
HCPCS,J2805,sincalide Recon Soln 1 Each Vial,504.05,277.23,86.58,917.8,96
HCPCS,J2810,Inj theophylline per 40 MG,,,0.9,1.11,6
HCPCS,J2820,sargramostim (GM-CSF) 250 mcg Recon Soln 1 Each Vial,1591.615,875.39,50.37,1453.78,126
HCPCS,J2840,Inj sebelipase alfa 1 mg,,,463.23,571.89,21
HCPCS,J2850,secretin 16 mcg Recon Soln 1 Each Vial,3584.4,1971.42,36.55,3100.51,63
HCPCS,J2860,"Injection, siltuximab",,,133.92,1093.23,23
HCPCS,J2865,sulfamethoxazole/trimethoprim 16 MG/ML Solution 10 mL Vial,101.51,55.84,0.25,87.81,48
HCPCS,J2916,Na ferric gluconate complex,,,1.71,14.72,8
HCPCS,J2919,methylPREDNISolone sod succ 1000 mg Recon Soln 1 Each Vial,272.61,149.94,0.21,241.23,126
HCPCS,J2919,methylPREDNISolone sod succ 500 mg Recon Soln 1 Each Vial,170.41,93.73,0.21,153.81,126
HCPCS,J2919,methylPREDNISolone sod succ Recon Soln 1 Each Vial,79.01,43.459999999999994,0.21,75.89,126
HCPCS,J2941,Somatropin injection,,,42.0,51.86,21
HCPCS,J2993,Reteplase injection,,,2384.45,2991.71,21
HCPCS,J2995,Lab/Drugs Fee Schedule,,,61.1,75.43,6
HCPCS,J2997,alteplase 0.5 MG/ML Solution 0.01 Each Syringe,18490.76,10169.92,78.54,15994.51,63
HCPCS,J2997,alteplase 0.5 mg/2 mL Solution 0.01 Each Syringe,18490.76,10169.92,78.54,15994.51,63
HCPCS,J2997,alteplase 1 MG/ML Recon Soln 1 Each Vial,36971.51,20334.34,78.54,31980.36,63
HCPCS,J2997,alteplase 1 mg/mL Recon Soln 1 Each Vial,18490.76,10169.92,78.54,31980.36,189
HCPCS,J2997,alteplase 2 MG/2 ML Solution 2 mg Syringe,965.44,531.0,78.54,835.11,63
HCPCS,J2997,alteplase 2 mg/mL Solution 1 Each Vial,1014.92,558.21,78.54,877.91,63
HCPCS,J2998,Inj plasminogen tvmh 1mg,,,27.92,34.47,21
HCPCS,J3000,streptomycin sulfate 1 g Recon Soln 1 Each Vial,465.0,255.75,24.26,402.23,48
HCPCS,J3010,fentaNYL 0.05 MG/ML Solution 2 mL Syringe,101.4,55.77,0.73,87.71,48
HCPCS,J3010,fentaNYL 0.05 MG/ML Solution 2 mL Vial,66.5,36.58,0.73,57.52,48
HCPCS,J3010,fentaNYL 0.05 MG/ML Solution 20 mL Ampule,105.0,57.75,0.73,90.83,48
HCPCS,J3010,fentaNYL 0.05 MG/ML Solution 5 mL Vial,74.46,40.96,0.73,64.41,48
HCPCS,J3010,fentaNYL 0.05 MG/ML Solution 50 mL Vial,333.5,183.43,0.73,288.48,48
HCPCS,J3010,fentaNYL 100 MCG/2ML Solution 2 mL Vial,66.5,36.58,0.73,57.52,48
HCPCS,J3010,fentaNYL 1000 MCG/20ML Solution 20 mL Vial,127.4,70.07,0.73,112.45,96
HCPCS,J3010,fentaNYL 250 MCG/5ML Solution 5 mL Vial,74.46,40.96,0.73,64.41,48
HCPCS,J3010,fentaNYL 2500 MCG/50ML Solution 50 mL Vial,333.5,183.43,0.73,288.48,48
HCPCS,J3010,fentaNYL Citrate (PF) 50 MCG/ML Solution 1 mL Vial,58.73,32.31,0.73,50.8,48
HCPCS,J3030,SUMAtriptan 6 MG/0.5ML Solution 0.5 mL Vial,91.5,50.33,27.45,171.65,48
HCPCS,J3031,"Inj., fremanezumab-vfrm 1 mg",,,3.47,4.29,6
HCPCS,J3032,eptinezumab-jjmr 100 MG/ML Solution 1 mL Vial,10211.01,5616.06,16.59,8832.52,63
HCPCS,J3055,talquetamab-tgvs 3 MG/1.5ML Solution 1.5 mL Vial,3785.02,2081.77,60.08,3274.04,63
HCPCS,J3055,talquetamab-tgvs 40 MG/ML Solution 1 mL Vial,45692.36,25130.8,60.08,39523.89,126
HCPCS,J3060,"Inj, taliglucerace alfa 10 u",,,35.74,277.16,23
HCPCS,J3070,Pentazocine injection,,,22.77,28.11,6
HCPCS,J3090,tedizolid 200 MG Recon Soln 1 Each Vial,1676.8,922.24,1.56,1450.43,63
HCPCS,J3095,Telavancin injection,,,6.35,50.42,23
HCPCS,J3101,tenecteplase 50 mg/10 mL Kit 1 Each Box,34858.49,19172.17,139.46,30152.59,63
HCPCS,J3105,terbutaline 1 MG/ML Solution 1 mL Vial,148.05,81.43,1.84,128.06,48
HCPCS,J3110,Teriparatide injection,,,60.08,74.18,6
HCPCS,J3111,romosozumab 105 MG/1.17ML Solution Prefilled Syringe 1.17 mL Syringe,7113.08,3912.2,9.86,6152.81,63
HCPCS,J3121,Inj testostero enanthate 1mg,,,0.05,0.41,8
HCPCS,J3145,testosterone undecanoate 750 MG/3ML Solution 3 mL Vial,8714.42,4792.94,1.66,7537.97,63
HCPCS,J3230,chlorproMAZINE 25 MG/ML Solution 1 mL Ampule,188.33,103.59,26.17,182.72,48
HCPCS,J3240,Thyrotropin Alfa 0.9 MG Recon Soln 1 Each Vial,8502.95,4676.63,1775.5,14264.37,63
HCPCS,J3241,teprotumumab-trbw 500 MG Recon Soln 1 Each Vial,73556.75,40456.22,298.03,63626.59,63
HCPCS,J3243,tigecycline 50 mg Recon Soln 1 Each Vial,312.0,171.6,0.54,269.88,48
HCPCS,J3244,Inj. tigecycline (accord),,,2.9,3.58,6
HCPCS,J3245,tildrakizumab-asmn 100 MG/ML Solution Prefilled Syringe 1 mL Syringe,75448.05,41496.43,114.35,65262.56,63
HCPCS,J3246,Tirofiban HCl,,,3.11,23.15,8
HCPCS,J3247,secukinumab 125 MG/5ML Solution 5 mL Vial,9071.54,4989.35,15.21,7846.88,63
HCPCS,J3250,Trimethobenzamide hcl inj,,,43.75,360.45,8
HCPCS,J3260,tobramycin (preservative free) 80 mg/mL Solution 1 Each Vial,516.0,283.8,1.69,446.34,48
HCPCS,J3260,tobramycin 1.2 GM/30ML Solution 30 mL Vial,159.43,87.69,1.69,137.91,48
HCPCS,J3260,tobramycin 20 mg/mL Recon Soln 1 Each Vial,495.0,272.25,1.69,428.18,48
HCPCS,J3260,tobramycin 40 mg/mL Solution 30 mL Vial,162.94,89.62,1.69,140.94,48
HCPCS,J3260,tobramycin Recon Soln 1 Each Vial,477.0,262.35,1.69,412.61,48
HCPCS,J3260,tobramycin sulfate 40 mg/mL Solution 2 mL Vial,47.38,26.06,1.69,40.98,48
HCPCS,J3260,tobramycin sulfate 80 MG/2ML Solution 2 mL Vial,45.84,25.22,1.69,39.65,48
HCPCS,J3262,tocilizumab 162 MG/0.9ML Solution Prefilled Syringe 0.9 mL Syringe,6358.97,3497.44,5.13,5500.51,63
HCPCS,J3262,tocilizumab 200 mg/10 mL Solution 10 mL Vial,7185.71,3952.15,5.13,6215.64,63
HCPCS,J3262,tocilizumab 400 mg/20 mL Solution 20 mL Vial,11164.44,6140.45,5.13,9657.24,63
HCPCS,J3262,tocilizumab 80 MG/4ML Solution 4 mL Vial,2883.26,1585.8,5.13,2494.02,63
HCPCS,J3263,toripalimab-tpzi 240 mg/6 mL Solution 6 mL Vial,38118.11,20964.97,33.76,32972.17,63
HCPCS,J3280,Lab/Drugs Fee Schedule,,,3.89,4.8,6
HCPCS,J3285,treprostinil 1 mg/mL Solution 20 mL Vial,6547.16,3600.94,48.04,5663.29,126
HCPCS,J3285,treprostinil 1 mg/mL Solution 3 mL Syringe,1046.39,575.52,48.04,905.13,63
HCPCS,J3285,treprostinil 1 mg/mL Solution 3 mL Vial,1046.39,575.52,48.04,905.13,63
HCPCS,J3285,treprostinil 10 mg/mL Solution 20 mL Vial,50815.47,27948.51,48.04,43955.38,63
HCPCS,J3285,treprostinil 10 mg/mL Solution 3 mL Syringe,10328.89,5680.89,48.04,8934.49,63
HCPCS,J3285,treprostinil 10 mg/mL Solution 3 mL Vial,10328.89,5680.89,48.04,8934.49,63
HCPCS,J3285,treprostinil 2.5 mg/mL Solution 20 mL Vial,12711.39,6991.27,48.04,10995.35,63
HCPCS,J3285,treprostinil 2.5 mg/mL Solution 3 mL Vial,2593.47,1426.41,48.04,2243.35,126
HCPCS,J3285,treprostinil 5 mg/mL Solution 20 mL Vial,25412.78,13977.03,48.04,21982.05,63
HCPCS,J3285,treprostinil 5 mg/mL Solution 3 mL Vial,5171.95,2844.58,48.04,4473.74,126
HCPCS,J3299,Inj xipere 1 mg,,,41.58,324.0,23
HCPCS,J3300,triamcinolone acetonide (PF) 40 MG/ML Suspension 1 mL Vial,5112.6,2811.93,24.32,4422.4,63
HCPCS,J3301,HC TRIAMCINOLONE ACETONIDE INJ NOS 10 MG,70.0,38.5,0.77,60.55,96
HCPCS,J3301,triamcinolone acetonide 10 MG/ML Suspension 5 mL Vial,98.59,54.23,0.77,85.28,48
HCPCS,J3301,triamcinolone acetonide 40 mg/mL Suspension 1 mL Vial,90.52,49.79,0.77,78.3,48
HCPCS,J3302,Triamcinolone diacetate inj,,,0.28,0.34,6
HCPCS,J3303,Triamcinolone hexacetonl inj,,,8.38,10.34,6
HCPCS,J3304,triamcinolone acetonide 32 MG Suspension Reconstituted ER 1 Each Vial,3377.47,1857.61,15.45,2921.51,63
HCPCS,J3315,triptorelin pamoate 11.25 MG Recon Susp 1 Each Vial,11523.33,6337.84,413.24,9967.68,63
HCPCS,J3315,triptorelin pamoate 22.5 MG Recon Susp 1 Each Vial,23036.67,12670.17,413.24,19926.72,63
HCPCS,J3315,triptorelin pamoate 3.75 MG Recon Susp 1 Each Vial,4949.25,2722.09,413.24,4281.1,63
HCPCS,J3316,"Inj., triptorelin xr 3.75 mg",,,3015.49,25466.74,23
HCPCS,J3355,Lab/Drugs Fee Schedule,,,50.82,62.74,6
HCPCS,J3357,ustekinumab 45 MG/0.5ML Solution Prefilled Syringe 0.5 mL Syringe,61228.11,33675.47,133.84,52962.32,63
HCPCS,J3357,ustekinumab 90 mg/mL Solution Prefilled Syringe 1 mL Syringe,122446.13,67345.38,133.84,105915.9,63
HCPCS,J3358,ustekinumab 130 MG/26ML Solution 26 mL Vial,8912.53,4901.9,10.96,7709.34,63
HCPCS,J3360,diazePAM 5 MG/ML Solution 10 mL Vial,415.09,228.3,7.34,359.05,48
HCPCS,J3360,diazePAM 5 MG/ML Solution 2 mL Crtrdg-NDL,356.61,196.14,7.34,308.48,96
HCPCS,J3370,Lab/Drugs Fee Schedule,,,1.59,1.97,6
HCPCS,J3371,Lab/Drugs Fee Schedule,,,5.53,6.82,6
HCPCS,J3372,Lab/Drugs Fee Schedule,,,5.47,6.76,6
HCPCS,J3373,vancomycin (neonatal) Recon Soln 1 Each Vial,82.13,45.18,0.15,71.04,48
HCPCS,J3373,vancomycin 1 GM/200ML Solution 200 mL Plas Cont,155.0,85.25,0.15,134.08,48
HCPCS,J3373,vancomycin 1 g Recon Soln 1 Each Vial,125.82499999999999,69.21,0.15,108.84,96
HCPCS,J3373,vancomycin 10 mg/mL Recon Soln 1 Each Vial,47.5,26.13,0.15,41.09,48
HCPCS,J3373,vancomycin 1000 mg Recon Soln 1 Each Vial,67.0,36.85,0.15,57.96,48
HCPCS,J3373,vancomycin 500 mg Recon Soln 1 Each Vial,51.25,28.189999999999998,0.15,47.58,144
HCPCS,J3373,vancomycin 5000 mg Recon Soln 1 Each Vial,556.56,306.11,0.15,481.42,48
HCPCS,J3373,vancomycin 750-0.9 MG/250ML-% Solution 250 mL Flex Cont,127.25,69.99,0.15,110.07,48
HCPCS,J3373,vancomycin 750-5 MG/250ML-% Solution 250 mL Flex Cont,127.25,69.99,0.15,110.07,48
HCPCS,J3374,"Inj, vancomycin (mylan) 10mg",,,0.6,0.81,2
HCPCS,J3375,Inj vancomycin (xellia) 10mg,,,0.65,0.88,2
HCPCS,J3380,vedolizumab 60 mg/mL Recon Soln 1 Each Vial,39321.62,21626.9,18.6,34013.2,63
HCPCS,J3385,Velaglucerase alfa,,,321.13,2566.22,23
HCPCS,J3391,"Inj, atidarsagene autotemcel",,,4505000.0,4640150.0,15
HCPCS,J3392,"Inj, exagamglogene autotem",,,2002255.2,2471920.0,21
HCPCS,J3393,"Inj, betibeglogene autotemce",,,2548324.8,3146080.0,21
HCPCS,J3394,"Inj, lovotibeglogene autotem",,,2741509.8,3384580.0,21
HCPCS,J3396,verteporfin Recon Soln 1 Each Vial,9247.43,5086.09,9.87,7999.03,63
HCPCS,J3397,"Inj., vestronidase alfa-vjbk",,,271.7,335.43,21
HCPCS,J3398,Inj luxturna 1 billion vec g,,,3002.58,3092.66,15
HCPCS,J3399,Inj onase abepar-xioi treat,,,2455110.61,2528763.92,15
HCPCS,J3401,"Vyjuvek 5x10^9pfu/ml, 0.1 ml",,,873.01,7000.56,23
HCPCS,J3402,Inj. remestemcel-l-rknd/ td,,,205640.0,211809.2,15
HCPCS,J3403,"Revakinagene, per implant",,,257500.0,265225.0,15
HCPCS,J3410,Hydroxyzine hcl injection,,,10.58,114.28,8
HCPCS,J3411,thiamine 100 MG/ML Solution 2 mL Vial,94.65,52.06,1.51,81.87,48
HCPCS,J3415,pyridoXINE 100 MG/ML Solution 1 mL Vial,161.25,88.69,13.55,139.48,48
HCPCS,J3420,cyanocobalamin 1000 MCG/ML Solution 1 mL Vial,44.24,24.34,1.1,38.27,48
HCPCS,J3424,hydroxocobalamin 5 g Recon Soln 1 Each Box,5404.2,2972.31,4.45,4674.63,63
HCPCS,J3425,Hydroxocobalamin im 10mcg,,,0.01,0.07,23
HCPCS,J3430,phytonadione 1 MG/0.5ML Solution 0.5 mL Syringe,180.75,99.42,1.9,156.35,48
HCPCS,J3430,phytonadione 10 MG/ML Solution 1 mL Ampule,308.8,169.84,1.9,267.11,48
HCPCS,J3465,voriconazole Recon Soln 1 Each Vial,247.47500000000002,136.115,0.84,325.93,96
HCPCS,J3470,Hyaluronidase injection,,,25.81,212.96,8
HCPCS,J3471,hyaluronidase 200 UNIT/ML Solution 1.2 mL Vial,667.46,367.11,0.32,577.35,48
HCPCS,J3472,"Ovine, 1000 USP units",,,91.38,112.81,6
HCPCS,J3473,hyaluronidase human 150 units/mL Solution 1 mL Vial,349.8,192.39,0.32,302.58,48
HCPCS,J3475,magnesium sulfate 2 GM/50ML Solution 50 mL Flex Cont,70.225,38.625,0.42,72.88,96
HCPCS,J3475,magnesium sulfate 4.06 mEq/mL Solution 20 mL Vial,88.42,48.64,0.42,76.48,48
HCPCS,J3475,magnesium sulfate 50 % Solution 2 mL Vial,42.03,23.12,0.42,36.36,48
HCPCS,J3475,magnesium sulfate 50 % Solution 20 mL Vial,88.42,48.64,0.42,76.48,48
HCPCS,J3475,magnesium sulfate in D5W 10 MG/ML Solution 100 mL Flex Cont,63.4,34.87,0.42,54.84,48
HCPCS,J3475,magnesium sulfate in water 20 GM/500ML Solution 500 mL Flex Cont,61.0,33.55,0.42,52.77,48
HCPCS,J3475,magnesium sulfate in water 4 GM/100ML Solution 100 mL Flex Cont,79.6,43.78,0.42,68.85,48
HCPCS,J3480,potassium chloride 2 MEQ/ML Solution 250 mL Flex Cont,137.5,75.63,0.09,118.94,48
HCPCS,J3480,potassium chloride 2 MEQ/ML Solution 30 mL Vial,57.51,31.64,0.09,49.75,48
HCPCS,J3480,potassium chloride 20 mEq in 100 mL 20 MEQ/100ML Solution 100 mL Plas Cont,58.7,32.29,0.09,50.78,48
HCPCS,J3480,potassium chloride 20 mEq in 50 mL 20 MEQ/50ML Solution 50 mL Plas Cont,56.6,31.13,0.09,48.96,48
HCPCS,J3485,zidovudine 10 MG/ML Solution 20 mL Vial,190.2,104.61,1.3,164.52,48
HCPCS,J3486,ziprasidone Recon Soln 1 Each Vial,211.74,116.46,6.17,183.16,48
HCPCS,J3489,zoledronic acid 1 mg/20 mL Solution 100 mL Bottle,4591.85,2525.52,4.82,3971.95,48
HCPCS,J3489,zoledronic acid 4 MG/100ML Solution 100 mL Plas Cont,735.0,404.25,4.82,635.78,48
HCPCS,J3489,zoledronic acid 4 MG/5ML Conc 5 mL Vial,987.0,542.85,4.82,853.76,48
HCPCS,J3489,zoledronic acid 5 mg/100 mL Solution 100 mL Bag,450.2,247.61,4.82,389.42,48
HCPCS,J3489,zoledronic acid 5 mg/100 mL Solution 100 mL Bottle,4591.85,2525.52,4.82,3971.95,48
HCPCS,J3520,edetate disodium 150 MG/ML Solution 30 mL Vial,1230.0,676.5,0.28,1063.95,48
HCPCS,J7030,Normal saline solution infus,,,2.15,15.39,8
HCPCS,J7040,Normal saline solution infus,,,1.08,9.32,8
HCPCS,J7042,5% dextrose/normal saline,,,1.02,9.18,8
HCPCS,J7050,Normal saline solution infus,,,0.54,4.79,8
HCPCS,J7060,5% dextrose/water,,,1.55,13.7,8
HCPCS,J7070,D5w infusion,,,3.1,20.52,8
HCPCS,J7100,dextran 40 10% in 0.9% NaCl 10-0.9 % Solution 500 mL Flex Cont,365.13,200.83,44.24,315.84,48
HCPCS,J7100,dextran 40 10% in dextrose 5% 10 % Solution 500 mL Flex Cont,981.0,539.55,44.24,848.57,48
HCPCS,J7120,Ringers lactate infusion,,,2.07,16.61,8
HCPCS,J7121,5% dextrose in lac ringers,,,5.19,6.41,6
HCPCS,J7131,sodium chloride 3 % Solution 500 mL Flex Cont,141.0,77.55,0.08,121.97,48
HCPCS,J7165,"Inj, human-lans, per i.u",,,1.55,1.91,21
HCPCS,J7168,Prothrombin Complex Conc Human 1000 units Kit 1 Each Vial,36.62,20.15,1.9,32.23,63
HCPCS,J7168,prothrombin complex conc human 500 units Kit 1 Each Vial,36.62,20.15,1.9,32.23,63
HCPCS,J7169,andexanet alfa - coagulation factor Xa inactivated-zhzo 200 MG Recon Soln 1 Each Vial,10510.0,5780.5,113.17,9091.15,63
HCPCS,J7170,emicizumab-kxwh 105 MG/0.7ML Solution 0.7 mL Vial,49535.38,27244.46,44.67,43591.13,63
HCPCS,J7171,ADAMTS13 recombinant-krhn 1500 units Kit 1 Each Vial,49.6,27.28,14.88,240.23,63
HCPCS,J7171,ADAMTS13 recombinant-krhn 500 units Kit 1 Each Vial,49.6,27.28,14.88,240.23,63
HCPCS,J7172,"Inj marstacim-hncq, 0.5 mg",,,51.1,342.29,17
HCPCS,J7173,"Inj. concizumab-mtci, 0.5 mg",,,86.41,89.0,15
HCPCS,J7174,Injection fitusiran 0.04 mg,,,133.25,137.25,15
HCPCS,J7175,"Inj, factor x, (human), 1iu",,,8.18,66.89,23
HCPCS,J7177,"Inj., fibryga, 1 mg",,,0.95,8.17,23
HCPCS,J7178,Inj human fibrinogen con nos,,,1.27,10.26,23
HCPCS,J7179,Von Willebrand Factor (Recomb) 1300 units Recon Soln 1 Each Vial,32.72,18.0,1.58,28.79,63
HCPCS,J7179,Von Willebrand Factor (Recomb) 650 units Recon Soln 1 Each Vial,32.72,18.0,1.58,28.79,63
HCPCS,J7180,Factor XIII anti-hem factor,,,8.99,72.77,23
HCPCS,J7181,Factor xiii recomb a-subunit,,,14.74,123.46,23
HCPCS,J7182,Factor viii recomb novoeight,,,1.23,10.26,23
HCPCS,J7183,Wilate injection,,,1.1,8.57,23
HCPCS,J7185,Xyntha inj,,,1.29,10.4,23
HCPCS,J7186,antihemophilic factor/VWF in units of FVIII 10 units/mL Recon Soln 1 Each Vial,30.165,16.595,1.03,26.73,126
HCPCS,J7186,antihemophilic factor/VWF in units of FVIII Recon Soln 1 Each Vial,29.95,16.48,1.03,26.36,63
HCPCS,J7187,antihemophilic factor/VWF in units of FVIII Recon Soln 1 Each Vial,31.44,17.3,1.25,27.67,63
HCPCS,J7187,antihemophilic factor/VWF in units of VWF Recon Soln 1 Each Vial,31.44,17.3,1.25,27.67,63
HCPCS,J7188,antihemophilic factor rpFVIII 500 units Recon Soln 1 Each Vial,40.815,22.455,2.77,39.71,189
HCPCS,J7189,"Coagulation Factor VIIa Recomb 5 MG Recon Soln 5,000 mcg Vial",54820.0,30151.0,2.19,48241.6,63
HCPCS,J7189,"coagulation factor VIIa recombinant 1 mg Recon Soln 1,000 mcg Vial",10984.0,6041.2,2.19,9665.92,63
HCPCS,J7190,Factor viii,,,0.96,7.63,23
HCPCS,J7192,antihemophilic factor 10 units/mL Recon Soln 1 Each Vial,32.64,17.96,1.32,28.72,63
HCPCS,J7193,Factor IX non-recombinant,,,1.15,9.05,23
HCPCS,J7194,Factor ix complex,,,1.42,11.48,23
HCPCS,J7195,coagulation factor IX recombinant 250 units Kit 1 Each Vial,31.79,17.49,1.58,27.98,63
HCPCS,J7197,antithrombin III human 500 units Recon Soln 1 Each Vial,41.89,23.04,3.4,36.23,63
HCPCS,J7198,Anti-inhibitor,,,2.03,16.54,23
HCPCS,J7200,coagulation Factor IX recombinant 1000 units Recon Soln 1 Each Vial,32.22,17.73,1.42,28.35,48
HCPCS,J7200,coagulation Factor IX recombinant 2000 units Recon Soln 1 Each Vial,32.22,17.73,1.42,28.35,48
HCPCS,J7200,coagulation factor IX recombinant 250 units Recon Soln 1 Each Vial,32.22,17.73,1.42,28.35,48
HCPCS,J7201,Factor ix alprolix recomb,,,3.07,24.5,23
HCPCS,J7202,"coagulation factor IX recombinant, albumin fusion protein 250 units Recon Soln 1 Each Box",46.61,25.64,4.47,41.02,63
HCPCS,J7203,Factor ix recomb gly rebinyn,,,3.77,30.92,23
HCPCS,J7204,Inj recombin esperoct per iu,,,1.88,15.26,23
HCPCS,J7205,Factor viii fc fusion recomb,,,2.01,16.34,23
HCPCS,J7207,Factor viii pegylated recomb,,,1.81,14.51,23
HCPCS,J7208,Inj. jivi 1 iu,,,2.11,17.89,23
HCPCS,J7209,Factor viii nuwiq recomb 1iu,,,1.06,7.97,23
HCPCS,J7210,"Inj, afstyla, 1 i.u.",,,1.31,10.67,23
HCPCS,J7211,Antihemophil Factor (rAHF-PFM) 1000 units Recon Soln 1 Each Vial,34.4,18.92,1.27,30.27,63
HCPCS,J7211,antihemophilic factor VIII recombinant 250 units Recon Soln 1 Each Vial,34.4,18.92,1.27,30.27,63
HCPCS,J7211,antihemophilic factor VIII recombinant Kit 1 Each Vial,34.4,18.92,1.27,30.27,63
HCPCS,J7212,Factor viia recomb sevenfact,,,2.02,16.2,8
HCPCS,J7213,"Inj, ixinity, 1 i.u.",,,1.89,12.89,23
HCPCS,J7214,antihemophilic factor Fc-VWF-XTEN-ehtl recombinant 250 units Recon Soln 1 Each Vial,46.33,25.49,3.99,40.77,63
HCPCS,J7294,Seg acet and eth estr yearly,,,2493.95,3078.94,6
HCPCS,J7295,Eth estr and eton monthly,,,160.52,198.17,6
HCPCS,J7296,"HC LEVONORGESTREL-RELEAS INTRAUTER CONTRACEPT SYS (KYLEENA), 19.5 MG",2590.0,1424.5,777.0,2240.35,192
HCPCS,J7296,levonorgestrel 19.5 MG IUD 1 Each Box,2920.11,1606.07,876.03,2525.9,48
HCPCS,J7297,"Liletta, 52 mg",,,914.27,1128.72,6
HCPCS,J7298,"HC LEVONORGESTREL-RELEAS INTRAUTER CONTRACEPT SYS (MIRENA), 52 MG",1820.0,1001.0,546.0,1574.3,288
HCPCS,J7300,HC PARAGARD CONTRACEPTIVE IMPLANTS,1489.0,818.95,446.7,1447.96,144
HCPCS,J7301,"HC LEVONORGESTREL-RELEAS INTRAUTER CONTRACEPT SYS (SKYLA), 13.5 MG",2900.5,1595.28,870.15,2508.93,144
HCPCS,J7306,Levonorgestrel implant sys,,,322.72,398.42,6
HCPCS,J7307,HC ETONOGESTREL IMPLANT SYS,2140.5,1177.28,642.15,1851.53,192
HCPCS,J7307,etonogestrel 68 MG Implant 1 Each Box,6574.0,3615.7,1251.46,5686.51,48
HCPCS,J7308,aminolevulinic acid 20 % Recon Soln 1 Each,1189.66,654.32,339.37,2658.62,63
HCPCS,J7310,Lab/Drugs Fee Schedule,,,3524.36,4351.06,6
HCPCS,J7311,"Inj., Retisert, 0.01 mg",,,286.11,2293.38,23
HCPCS,J7312,dexAMETHasone 0.7 MG Implant 1 Each Box,7429.2,4086.06,176.49,6426.26,63
HCPCS,J7313,Fluocinolone Acetonide 0.59 MG Implant 1 Each Package,79915.0,43953.25,423.87,69126.48,63
HCPCS,J7313,fluocinolone acetonide 0.19 MG Implant 1 Each Box,38099.8,20954.89,423.87,32956.33,63
HCPCS,J7314,fluocinolone Acetonide 0.18 MG Implant 1 Each Box,38360.2,21098.11,451.53,33181.57,63
HCPCS,J7318,sodium hyaluronate 60 MG/3ML Prefilled Syringe 3 mL Syringe,6036.01,3319.81,5.75,5221.15,63
HCPCS,J7320,"Genvisc 850, inj, 1mg",,,5.3,40.64,23
HCPCS,J7321,Sodium Hyaluronate (Viscosup) 25 MG/2.5ML Solution Prefilled Syringe 2.5 mL Syringe,574.3,315.87,62.7,496.77,48
HCPCS,J7321,Sodium Hyaluronate 20 MG/2ML Solution Prefilled Syringe 2 mL Syringe,1041.0,572.55,62.7,900.47,48
HCPCS,J7322,"Hyaluronan, hymo or hymo one",,,14.96,117.72,23
HCPCS,J7323,Sodium Hyaluronate 20 MG/2ML Solution Prefilled Syringe 2 mL Syringe,1962.4,1079.32,103.62,1697.48,63
HCPCS,J7324,hyaluronan 30 MG/2ML Solution Prefilled Syringe 2 mL Syringe,2596.2,1427.91,79.11,2245.71,63
HCPCS,J7325,Hylan G-F 20 16 MG/2ML Solution Prefilled Syringe 2 mL Syringe,2480.32,1364.18,7.87,2145.48,63
HCPCS,J7325,hylan 48 mg/6mL Solution Prefilled Syringe 6 mL Syringe,7410.95,4076.03,7.87,6410.47,63
HCPCS,J7326,cross-linked hyaluronate 30 MG/3ML Prefilled Syringe 3 mL Syringe,6224.99,3423.75,451.94,5384.62,63
HCPCS,J7327,Monovisc inj per dose,,,484.81,3567.92,23
HCPCS,J7328,Gel-syn injection 0.1 mg,,,0.48,4.39,8
HCPCS,J7329,"Inj, trivisc 1 mg",,,4.69,36.79,23
HCPCS,J7330,Cultured chondrocytes implnt,,,62504.36,77165.88,6
HCPCS,J7331,"Synojoynt, inj., 1 mg",,,7.64,37.87,8
HCPCS,J7332,"Inj., Triluron, 1 mg",,,8.67,68.58,23
HCPCS,J7336,Capsaicin 8% patch,,,2.86,22.82,23
HCPCS,J7340,Carbidopa levodopa ent 100ml,,,202.59,1641.26,23
HCPCS,J7342,Ciprofloxacin otic susp 6 mg,,,29.18,36.02,6
HCPCS,J7345,aminolevulinic acid 10 % Gel 2 g Tube,1099.0,604.45,1.48,950.64,63
HCPCS,J7351,"HC INJECTION, BIMATOPROST, INTRACAMERAL IMPLANT, 1 MICROGRAM",1006.0,553.3,180.21,1433.43,63
HCPCS,J7351,bimatoprost 10 MCG Implant 1 Each Syringe,4865.0,2675.75,180.21,4208.23,63
HCPCS,J7352,"Afamelanotide implant, 1 mg",,,2467.04,3045.73,21
HCPCS,J7353,Anacaulase-bcdb 8.8% gel 1 g,,,48.93,60.41,21
HCPCS,J7354,"Cantharidin top, applicator",,,611.11,4519.73,23
HCPCS,J7355,Inj travoprost intra impl,,,169.28,1317.94,23
HCPCS,J7402,mometasone furoate 1350 MCG Implant 1 Each Box,3543.44,1948.9,9.75,3065.08,63
HCPCS,J7500,azaTHIOprine 25 mg half tablet Tab 0.5 tablet Package,8.65,4.76,1.02,14.45,48
HCPCS,J7500,azaTHIOprine 50 MG Tab 100 Each Bottle,9.12,5.02,1.02,14.45,48
HCPCS,J7501,Azathioprine parenteral,,,196.6,261.69,21
HCPCS,J7502,cycloSPORINE 100 mg Cap 1 Each Blister,45.04,24.78,1.89,38.96,48
HCPCS,J7502,cycloSPORINE modified 100 MG/ML Solution 0.25 mL Syringe,10.54,5.8,1.89,13.97,48
HCPCS,J7502,cycloSPORINE modified 100 MG/ML Solution 1 mL Syringe,21.15,11.64,1.89,18.29,48
HCPCS,J7502,cycloSPORINE modified 100 MG/ML Solution 50 mL Bottle,714.4,392.92,1.89,617.96,48
HCPCS,J7502,cycloSPORINE modified 100 mg Cap 30 Each Box,20.19,11.11,1.89,17.46,48
HCPCS,J7503,tacrolimus 0.75 MG Tablet Extended Release 24 Hour 100 Each Bottle,20.08,11.05,1.55,17.37,48
HCPCS,J7503,tacrolimus 1 MG Tablet Extended Release 24 Hour 100 Each Bottle,24.77,13.63,1.55,21.43,48
HCPCS,J7503,tacrolimus 4 MG Tablet Extended Release 24 Hour 30 Each Bottle,71.74,39.46,1.55,62.06,48
HCPCS,J7504,antithymocyte globulin (atg) (horse) 50 MG/ML Solution 5 mL Ampule,21267.5,11697.13,3739.82,33838.49,63
HCPCS,J7505,Lab/Drugs Fee Schedule,,,745.7,920.61,6
HCPCS,J7507,tacrolimus 0.5 MG Cap 100 Each Bottle,9.22,5.08,0.15,7.98,48
HCPCS,J7507,tacrolimus 1 MG Cap 100 Each Bottle,9.17,5.05,0.15,7.93,48
HCPCS,J7507,tacrolimus 5 MG Cap 100 Each Bottle,17.36,9.55,0.15,15.02,48
HCPCS,J7508,Tacrol astagraf ex rel oral,,,0.49,3.98,8
HCPCS,J7509,methylPREDNISolone 4 MG Tab 100 Each Bottle,9.06,4.99,0.22,7.84,48
HCPCS,J7510,Prednisolone oral per 5 mg,,,0.49,1.82,8
HCPCS,J7511,antithymocyte globulin (rabbit) Recon Soln 1 Each Vial,6060.14,3333.08,815.9,6725.63,63
HCPCS,J7512,predniSONE 1 MG Tab 100 Each Bottle,8.33,4.59,0.01,7.21,48
HCPCS,J7512,predniSONE 10 MG Tab 1 Each Blister,8.58,4.72,0.01,7.42,48
HCPCS,J7512,predniSONE 2.5 MG Tab 100 Each Bottle,8.44,4.65,0.01,7.3,48
HCPCS,J7512,predniSONE 20 MG Tab 1 Each Blister,8.65,4.76,0.01,7.48,48
HCPCS,J7512,predniSONE 20 MG Tab 24 tablet Pack,24.24,13.34,0.01,20.97,48
HCPCS,J7512,"predniSONE 5 MG Tab 1,000 Each Bottle",8.5,4.68,0.01,7.35,48
HCPCS,J7512,predniSONE 5 MG Tab 100 Each Box,8.66,4.77,0.01,7.49,48
HCPCS,J7512,predniSONE 5 MG/5ML Solution 500 mL Bottle,937.0,515.35,0.01,810.51,48
HCPCS,J7512,predniSONE 50 MG Tab 1 Each Blister,9.48,5.22,0.01,8.2,48
HCPCS,J7512,predniSONE 50 MG Tab 100 Each Box,9.48,5.22,0.01,8.2,48
HCPCS,J7513,Lab/Drugs Fee Schedule,,,321.89,397.39,6
HCPCS,J7514,Mycophenol (myhibbin) 100 mg,,,2.25,2.78,6
HCPCS,J7515,cycloSPORINE 25 mg Cap 1 Each Blister,19.69,10.83,0.71,17.03,48
HCPCS,J7515,cycloSPORINE modified 25 mg Cap 30 Each Box,10.3,5.67,0.71,8.91,48
HCPCS,J7516,cycloSPORINE 50 MG/ML Solution 5 mL Ampule,433.68,238.53,61.27,490.66,96
HCPCS,J7517,mycophenolate mofetil 200 MG/ML Recon Susp 160 mL Bottle,1364.44,750.45,0.13,1180.24,48
HCPCS,J7517,mycophenolate mofetil 200 MG/ML Recon Susp 2.5 mL Oral Syringe,64.25,35.34,0.13,55.58,48
HCPCS,J7517,mycophenolate mofetil 200 MG/ML Recon Susp 5 mL Oral Syringe,122.51,67.39,0.13,105.97,48
HCPCS,J7517,mycophenolate mofetil 250 MG Cap 100 Each Bottle,8.93,4.92,0.13,7.72,48
HCPCS,J7517,mycophenolate mofetil 500 MG Tab 100 Each Bottle,9.32,5.13,0.13,8.06,48
HCPCS,J7518,mycophenolic acid 180 MG Tablet Delayed Response 120 Each Bottle,8.61,4.74,0.41,7.45,48
HCPCS,J7518,mycophenolic acid 360 MG Tablet Delayed Response 120 Each Bottle,9.22,5.08,0.41,7.98,48
HCPCS,J7519,mycophenolate mofetil Recon Soln 1 Each Vial,450.0,247.5,0.35,389.25,48
HCPCS,J7520,sirolimus 0.5 MG Tab 100 Each Bottle,19.0,10.45,0.91,16.44,48
HCPCS,J7520,sirolimus 1 MG Tab 1 Each Blister,31.41,17.28,0.91,27.17,48
HCPCS,J7520,sirolimus 1 MG/ML Solution 60 mL Bottle,2848.13,1566.48,0.91,2463.63,48
HCPCS,J7520,sirolimus 2 MG Tab 100 Each Bottle,26.25,14.44,0.91,22.71,48
HCPCS,J7521,Tacrolim granules oral susp,,,6.25,8.44,2
HCPCS,J7525,tacrolimus Solution 1 mL Ampule,1392.15,765.69,218.66,1770.05,63
HCPCS,J7525,tacrolimus Solution 100 mL Vial,2607.0,1433.85,218.66,2255.06,63
HCPCS,J7525,tacrolimus Solution 50 mL Vial,1311.0,721.05,218.66,1770.05,63
HCPCS,J7527,everolimus 0.25 MG Tab 60 Each Box,19.5,10.73,1.99,16.87,48
HCPCS,J7527,everolimus 0.5 MG Tab 60 Each Box,28.13,15.48,1.99,24.33,48
HCPCS,J7527,everolimus 1 MG Tab 60 Each Box,86.9,47.8,1.99,75.17,48
HCPCS,J7601,Ensifentrine inh 3 mg,,,50.66,351.81,8
HCPCS,J7605,Arformoterol non-comp unit,,,0.69,5.33,8
HCPCS,J7606,"Formoterol fumarate, inh",,,1.62,13.3,8
HCPCS,J7608,Acetylcysteine non-comp unit,,,7.0,60.01,8
HCPCS,J7611,Albuterol non-comp con,,,0.14,1.08,8
HCPCS,J7612,Levalbuterol non-comp con,,,0.25,2.03,8
HCPCS,J7613,Albuterol non-comp unit,,,0.05,0.54,8
HCPCS,J7614,Levalbuterol non-comp unit,,,0.08,0.61,8
HCPCS,J7615,Levalbuterol comp unit,,,1.67,2.06,6
HCPCS,J7620,Albuterol ipratrop non-comp,,,0.16,1.35,8
HCPCS,J7626,Budesonide non-comp unit,,,1.21,8.64,8
HCPCS,J7627,Budesonide comp unit,,,3.89,4.8,6
HCPCS,J7631,Cromolyn sodium noncomp unit,,,0.18,1.96,8
HCPCS,J7632,Cromolyn sodium comp unit,,,0.28,0.34,6
HCPCS,J7639,Dornase alfa non-comp unit,,,46.02,372.33,8
HCPCS,J7641,Flunisolide comp unit,,,8.61,10.63,6
HCPCS,J7644,Ipratropium bromide non-comp,,,0.32,2.63,8
HCPCS,J7665,Mannitol for inhaler,,,1.02,1.25,6
HCPCS,J7674,methacholine 0.0625 mg/mL Solution 1 Syringe Syringe,69.8,38.39,1.39,60.38,48
HCPCS,J7674,methacholine 0.25 mg/mL Solution 1 Syringe Syringe,69.8,38.39,1.39,60.38,48
HCPCS,J7674,methacholine 1 mg/mL Solution 1 Syringe Syringe,69.8,38.39,1.39,60.38,48
HCPCS,J7674,methacholine 16 mg/mL Solution 1 Syringe Syringe,69.8,38.39,1.39,60.38,48
HCPCS,J7674,methacholine 4 mg/mL Solution 1 Syringe Syringe,69.8,38.39,1.39,60.38,48
HCPCS,J7677,Revefenacin inh non-com 1mcg,,,0.17,1.28,8
HCPCS,J7680,Terbutaline sulf comp con,,,10.84,13.38,6
HCPCS,J7681,Terbutaline sulf comp unit,,,10.84,13.38,6
HCPCS,J7682,Tobramycin non-comp unit,,,13.73,97.61,8
HCPCS,J7683,Triamcinolone comp con,,,3.89,4.8,6
HCPCS,J7685,Tobramycin comp unit,,,49.71,61.37,6
HCPCS,J7686,"Treprostinil, non-comp unit",,,652.66,5401.01,8
HCPCS,J7999,mitoMYcin (preservative-free) 0.4 mg/mL 1 mL Syringe,232.1,127.66,69.63,200.77,48
HCPCS,J7999,moxifloxacin 0.16 % Solution Prefilled Syringe 1 mL Syringe,91.44,50.3,27.43,79.1,48
HCPCS,J7999,succinylcholine 20 mg/mL Solution 10 mL Syringe,148.5,81.68,44.55,128.45,48
HCPCS,J8501,aprepitant 125 MG Cap 1 Each Blister,616.3,338.97,2.46,533.1,48
HCPCS,J8501,aprepitant 40 MG Cap 1 Each Blister,216.08,118.85,2.46,186.91,48
HCPCS,J8501,aprepitant 80 MG Cap 6 Each Box,396.22,217.93,2.46,342.73,48
HCPCS,J8510,busulfan 2 MG Tab 25 Each Bottle,69.24,38.09,20.77,89.26,63
HCPCS,J8515,"Cabergoline, oral 0.25mg",,,15.74,19.43,6
HCPCS,J8522,"Capecitabine, oral, 50 mg",,,0.04,0.34,23
HCPCS,J8530,cycloPHOSphamide 25 MG Cap 100 Each Bottle,15.775,8.68,0.72,13.84,96
HCPCS,J8530,cycloPHOSphamide 50 MG Cap 100 Each Bottle,20.85,11.47,0.72,18.04,48
HCPCS,J8540,dexAMETHasone 0.5 MG Tab 100 Each Box,8.57,4.72,0.05,7.41,48
HCPCS,J8540,dexAMETHasone 0.5 MG/5ML Solution 500 mL Bottle,60.8,33.44,0.05,52.59,48
HCPCS,J8540,dexAMETHasone 1 MG/ML Conc 30 mL Bottle,78.55,43.21,0.05,67.95,48
HCPCS,J8540,dexAMETHasone 2 MG Tab 100 Each Box,8.85,4.87,0.05,7.66,48
HCPCS,J8540,dexAMETHasone 4 MG Tab 100 Each Box,10.01,5.51,0.05,8.66,48
HCPCS,J8541,"Oral, hemady, 0.25 mg",,,0.35,0.43,6
HCPCS,J8560,Etoposide oral 50 MG,,,65.7,511.38,8
HCPCS,J8565,Gefitinib oral,,,249.85,308.46,6
HCPCS,J8600,melphalan 2 MG Tab 50 Each Bottle,36.56,20.11,10.97,31.62,48
HCPCS,J8610,methotrexate 2.5 MG Tab 1 Each Blister,15.31,8.43,0.15,13.24,48
HCPCS,J8611,Oral methotrexate (jylamvo),,,16.29,125.08,23
HCPCS,J8612,Oral methotrexate (xatmep),,,17.78,152.96,23
HCPCS,J8650,Lab/Drugs Fee Schedule,,,13.05,16.11,6
HCPCS,J8655,"Oral netupitant, palonosetro",,,343.32,2764.26,23
HCPCS,J8670,"Rolapitant, oral, 1mg",,,1.4,10.53,23
HCPCS,J8700,temozolomide 100 MG Cap 5 Each Bottle,85.88,47.24,0.23,74.29,48
HCPCS,J8700,temozolomide 20 MG Cap 5 Each Bottle,22.15,12.19,0.23,19.16,48
HCPCS,J8700,temozolomide 5 MG Cap 14 Each Bottle,14.77,8.13,0.23,12.78,48
HCPCS,J8705,Topotecan oral,,,107.27,843.08,8
HCPCS,J8999,PONATinib 15 mg Tab 30 Each Bottle,1816.2,998.91,544.86,1571.01,48
HCPCS,J9000,DOXOrubicin 2 MG/ML Solution 100 mL Vial,656.51,361.09,2.85,567.88,48
HCPCS,J9000,DOXOrubicin 2 mg/mL Injection 1 Each Vial,1266.24,696.44,2.85,1095.3,48
HCPCS,J9000,DOXOrubicin Recon Soln 1 Each Vial,1266.24,696.44,2.85,1095.3,48
HCPCS,J9011,"Datopotamab deruxtecan, 1 mg",,,51.56,53.1,15
HCPCS,J9015,aldesleukin 500000 units/0.1 mL Solution 0.1 mL Syringe,623.0,342.65,186.9,5619.34,63
HCPCS,J9015,aldesleukin Recon Soln 1 Each Vial,22776.03,12526.82,4551.67,19701.27,63
HCPCS,J9017,arsenic trioxide 10 MG/10ML Solution 10 mL Vial,1811.54,996.35,4.01,1566.98,63
HCPCS,J9019,Lab/Drugs Fee Schedule,,,415.31,512.72,6
HCPCS,J9020,Lab/Drugs Fee Schedule,,,43.88,54.18,6
HCPCS,J9021,"Inj, aspara, rylaze, 0.1 mg",,,46.49,373.28,23
HCPCS,J9022,Atezolizumab 840 MG/14ML Solution 14 mL Vial,32307.72,17769.25,75.74,27946.18,63
HCPCS,J9022,atezolizumab 1200 MG/20ML Solution 20 mL Vial,46147.46,25381.11,75.74,39917.55,63
HCPCS,J9023,avelumab 200 MG/10ML Solution 10 mL Vial,9085.66,4997.12,83.24,7859.1,63
HCPCS,J9024,Inj atezolizumb 5mg hya-tqjs,,,31.58,213.57,17
HCPCS,J9025,azaCITIDine 100 MG Recon Susp 1 Each Vial,241.5,132.83,0.25,208.9,48
HCPCS,J9026,tarlatamab-dlle 1 MG Recon Soln 1 Each Vial,8115.0,4463.25,1352.66,10580.56,63
HCPCS,J9026,tarlatamab-dlle 10 MG Recon Soln 1 Each Vial,63010.0,34655.5,1352.66,54503.65,63
HCPCS,J9027,clofarabine 1 MG/ML Solution 20 mL Vial,10911.13,6001.13,4.19,9438.13,63
HCPCS,J9028,"Inj, nogapendekin pmln, 1mcg",,,81.45,635.31,23
HCPCS,J9029,"Instill adstiladrin, tx dose",,,54436.99,428159.59,23
HCPCS,J9030,BCG vaccine 50 MG Recon Susp 1 Each Vial,860.35,473.2,2.57,744.2,48
HCPCS,J9032,"Injection, belinostat, 10mg",,,43.17,351.27,23
HCPCS,J9033,bendamustine 25 MG Recon Soln 1 Each Vial,3368.28,1852.56,1.55,2913.56,63
HCPCS,J9033,bendamustine 5 mg/mL Recon Soln 1 Each Vial,3368.28,1852.56,1.55,2913.56,63
HCPCS,J9033,bendamustine 5 mg/ml Recon Soln 1 Each Vial,12798.74,7039.31,1.55,11070.91,63
HCPCS,J9034,bendamustine 100 MG/4ML Solution 4 mL Vial,11157.1,6136.41,11.55,9650.89,63
HCPCS,J9035,bevacizumab 100 MG/4ML Solution 4 mL Vial,3611.23,1986.18,62.84,3123.71,63
HCPCS,J9035,bevacizumab 400 MG/16ML Solution 16 mL Vial,13727.37,7550.06,62.84,11874.18,63
HCPCS,J9036,"Inj., belrapzo/bendamustine",,,12.28,80.93,23
HCPCS,J9037,Lab/Drugs Fee Schedule,,,35.83,44.23,6
HCPCS,J9038,axatilimab-csfr 50 mg/mL Solution 0.18 mL Vial,20337.5,11185.63,55.65,17591.94,63
HCPCS,J9038,axatilimab-csfr 50 mg/mL Solution 0.44 mL Vial,47370.0,26053.5,55.65,40975.05,63
HCPCS,J9039,blinatumomab 12.5 mcg/mL Recon Soln 1 Each Vial,22797.76,12538.77,130.94,19720.06,63
HCPCS,J9040,bleomycin 1 mg/mL Solution 0.5 mL Syringe,263.64,145.01,17.95,228.05,48
HCPCS,J9040,bleomycin 30 units Recon Soln 1 Each Vial,470.01,258.51,17.95,406.56,48
HCPCS,J9040,bleomycin Recon Soln 1 Each Vial,267.16,146.94,17.95,231.09,48
HCPCS,J9041,bortezomib 2.5 mg/mL Injection 1 Each Vial,359.0,197.45,1.91,310.54,48
HCPCS,J9041,bortezomib Recon Soln 1 Each Vial,359.0,197.45,1.91,310.54,48
HCPCS,J9042,brentuximab 5 mg/mL Recon Soln 1 Each Vial,50035.0,27519.25,213.73,43280.28,126
HCPCS,J9043,Cabazitaxel injection,,,192.41,1532.93,23
HCPCS,J9045,CARBOplatin 150 MG/15ML Solution 15 mL Vial,157.75,86.77,3.12,136.45,48
HCPCS,J9045,CARBOplatin 450 MG/45ML Solution 45 mL Vial,356.56,196.11,3.12,308.42,48
HCPCS,J9045,CARBOplatin 600 MG/60ML Solution 60 mL Vial,453.0,249.15,3.12,391.85,48
HCPCS,J9046,"Inj, bortezomib, dr. reddy's",,,4.21,5.2,21
HCPCS,J9047,carfilzomib 2 mg/mL Recon Soln 1 Each Vial,2677.89,1472.84,44.62,2316.37,63
HCPCS,J9047,carfilzomib 30 MG Recon Soln 1 Each Vial,7983.7,4391.04,44.62,6905.9,63
HCPCS,J9047,carfilzomib 60 MG Recon Soln 1 Each Vial,15229.92,8376.46,44.62,13173.88,63
HCPCS,J9048,"Inj, bortezomib freseniuskab",,,14.17,17.49,21
HCPCS,J9049,"Inj, bortezomib, hospira",,,1.24,10.46,8
HCPCS,J9050,carmustine 3.3 mg/mL Recon Soln 1 Each Vial,2927.5,1610.125,219.22,2941.0,126
HCPCS,J9052,"Inj, carmustine (accord)",,,0.05,267.49,21
HCPCS,J9054,Inj bortezomib boruzu 0.1 mg,,,26.15,26.93,15
HCPCS,J9055,Cetuximab 200 MG/100ML Solution 100 mL Vial,7334.35,4033.9,66.2,6344.21,63
HCPCS,J9055,cetuximab 100 MG/50ML Solution 50 mL Vial,3679.68,2023.83,66.2,3182.92,63
HCPCS,J9056,"Inj, vivimusta, 1 mg",,,24.6,189.41,23
HCPCS,J9057,"Inj., copanlisib, 1 mg",,,76.55,94.51,6
HCPCS,J9060,CISplatin 100 MG/100ML Solution 100 mL Vial,218.0,119.9,2.31,188.57,48
HCPCS,J9060,CISplatin 50 MG Recon Soln 1 Each Vial,2380.0,1309.0,2.31,2058.7,48
HCPCS,J9060,CISplatin 50 MG/50ML Solution 50 mL Vial,147.5,81.13,2.31,127.59,48
HCPCS,J9061,amivantamab-vmjw 350 mg/7mL Solution 7 mL Vial,16388.71,9013.8,18.51,14176.23,63
HCPCS,J9063,"Inj, elahere, 1 mg",,,58.48,469.26,23
HCPCS,J9065,cladribine 10 MG/10ML Solution 10 mL Vial,1675.0,921.25,9.68,1448.88,126
HCPCS,J9070,cycloPHOSphamide 20 mg/ml Recon Soln 1 Each Vial,1751.38,963.26,525.41,1514.94,48
HCPCS,J9071,Inj cyclophosphamd auromedic,,,0.6,5.27,23
HCPCS,J9072,Inj cyclophos frindovyx 5 mg,,,9.02,60.75,23
HCPCS,J9073,cycloPHOSphamide 200 mg/mL Solution 2.5 mL Vial,1751.38,963.26,0.78,1514.94,63
HCPCS,J9073,cycloPHOSphamide 200 mg/mL Solution 5 mL Vial,3321.25,1826.69,0.78,2872.88,126
HCPCS,J9074,"Inj, cyclophosphamd, sandoz",,,3.74,28.42,23
HCPCS,J9075,cycloPHOSphamide 20 mg/mL Recon Soln 1 Each Vial,1346.89,740.79,0.48,1165.06,63
HCPCS,J9075,cycloPHOSphamide 20 mg/ml Recon Soln 1 Each Vial,4427.03,2434.87,0.48,5724.14,126
HCPCS,J9076,"Inj, cyclophos (baxter) 5mg",,,4.99,33.95,23
HCPCS,J9098,Lab/Drugs Fee Schedule,,,351.05,433.39,6
HCPCS,J9100,cytarabine 100 MG/ML Solution 20 mL Vial,128.23,70.53,0.68,110.92,48
HCPCS,J9100,cytarabine 20 MG/ML Solution 5 mL Vial,59.82,32.91,0.68,51.74,48
HCPCS,J9118,Inj. calaspargase pegol-mknl,,,65.71,552.89,23
HCPCS,J9119,"Inj., cemiplimab-rwlc, 1 mg",,,24.22,193.73,23
HCPCS,J9120,DACTINomycin 0.5 mg/mL Recon Soln 1 Each Vial,3343.75,1839.07,278.87,2892.34,63
HCPCS,J9130,dacarbazine 10 mg/mL Recon Soln 1 Each Vial,88.23,48.53,3.58,76.32,48
HCPCS,J9130,dacarbazine 10 mg/ml Recon Soln 1 Each Vial,86.4,47.52,3.58,74.74,48
HCPCS,J9144,daratumumab-hyaluronidase-fihj 1800-30000 mg-UT/15 mL Solution 15 mL Vial,43359.65,23847.81,44.12,37506.1,63
HCPCS,J9145,Daratumumab 400 MG/20ML Solution 20 mL Vial,12667.59,6967.18,56.09,10957.47,63
HCPCS,J9145,daratumumab 100 MG/5ML Solution 5 mL Vial,3515.34,1933.44,56.09,3040.77,63
HCPCS,J9150,DAUNOrubicin hydrochloride 5 MG/ML Solution 4 mL Vial,646.36,355.5,20.2,559.1,63
HCPCS,J9151,Lab/Drugs Fee Schedule,,,44.43,54.86,6
HCPCS,J9153,DAUNOrubicin-cytarabine liposomal 44-100 MG Recon Susp 1 Each Vial,44161.75,24288.97,213.28,38199.91,63
HCPCS,J9155,degarelix acetate 120 MG/VIAL Recon Soln 1 Each Vial,1834.02,1008.72,3.68,1586.43,63
HCPCS,J9155,degarelix acetate 80 MG Recon Soln 1 Each Vial,2325.72,1279.15,3.68,2011.75,63
HCPCS,J9171,DOCEtaxel 160 MG/16ML Solution 16 mL Vial,1423.5700000000002,782.965,0.62,1326.91,96
HCPCS,J9171,DOCEtaxel 160 MG/8ML Conc 8 mL Vial,892.92,491.11,0.62,772.38,48
HCPCS,J9171,DOCEtaxel 80 MG/8ML Solution 8 mL Vial,876.0,481.8,0.62,839.05,96
HCPCS,J9171,DOCEtaxel Solution 2 mL Vial,357.97,196.89,0.62,309.64,48
HCPCS,J9172,"Docetaxel (docivyx), 1 mg",,,44.83,331.29,23
HCPCS,J9173,durvalumab 120 MG/2.4ML Solution 2.4 mL Vial,4572.3,2514.77,72.02,3955.04,63
HCPCS,J9173,durvalumab 500 MG/10ML Solution 10 mL Vial,18124.94,9968.72,72.02,15678.07,63
HCPCS,J9174,"Inj, docetaxel (beizray) 1mg",,,52.47,54.04,15
HCPCS,J9175,Elliotts b solution per ml,,,9.91,12.23,6
HCPCS,J9176,Elotuzumab 25 mg/mL Recon Soln 1 Each Vial,13066.97,7186.84,6.62,11302.93,63
HCPCS,J9176,elotuzumab 25 mg/mL Recon Soln 1 Each Vial,10265.47,5646.01,6.62,8879.63,63
HCPCS,J9177,enfortumab vedotin-ejfv 20 MG Recon Soln 1 Each Vial,12098.7,6654.29,31.47,10465.38,63
HCPCS,J9177,enfortumab vedotin-ejfv 30 MG Recon Soln 1 Each Vial,18138.05,9975.93,31.47,15689.41,63
HCPCS,J9178,epiRUBicin 50 MG/25ML Solution 25 mL Vial,256.07,140.84,1.4,221.5,48
HCPCS,J9179,eriBULin 1 MG/2ML Solution 2 mL Vial,6370.0,3503.5,89.34,5510.05,63
HCPCS,J9181,Etoposide 1 GM/50ML Solution 50 mL Vial,387.2,212.96,0.85,334.93,48
HCPCS,J9181,Etoposide 500 MG/25ML Solution 25 mL Vial,208.6,114.73,0.85,180.44,48
HCPCS,J9181,etoposide 100 MG/5ML Solution 5 mL Vial,78.41,43.13,0.85,67.82,48
HCPCS,J9185,fludarabine phosphate 25 mg/mL Solution 2 mL Vial,1307.84,719.32,68.2,1131.28,126
HCPCS,J9190,fluorouracil 1 GM/20ML Solution 20 mL Vial,62.15,34.19,1.91,53.76,48
HCPCS,J9190,fluorouracil 1.25 mg/0.5 mL Solution 1 Each Syringe,30.35,16.7,1.91,26.25,48
HCPCS,J9190,fluorouracil 2.5 GM/50ML Solution 50 mL Vial,98.86,54.38,1.91,85.51,48
HCPCS,J9190,fluorouracil 5 GM/100ML Solution 100 mL Vial,309.18,170.05,1.91,267.44,48
HCPCS,J9190,fluorouracil 50 mg/mL Solution 10 mL Vial,46.07,25.34,1.91,39.85,48
HCPCS,J9190,fluorouracil 500 MG/10ML Solution 10 mL Vial,46.07,25.34,1.91,39.85,96
HCPCS,J9196,Inj gemcitabine hcl (accord),,,8.02,35.71,8
HCPCS,J9200,floxuridine 0.5 g Recon Soln 1 Each Vial,589.3,324.12,176.79,27847.46,63
HCPCS,J9201,Gemcitabine HCl 2 GM/52.6ML Solution 52.6 mL Vial,458.95,252.43,2.47,396.99,48
HCPCS,J9201,gemcitabine 1 GM/26.3ML Solution 26.3 mL Vial,248.52,136.69,2.47,214.97,48
HCPCS,J9201,gemcitabine 38 mg/mL Solution 5.26 mL Vial,73.86,40.63,2.47,63.89,48
HCPCS,J9202,goserelin 10.8 MG Implant 1 Each Box,12576.09,6916.85,603.65,10878.32,63
HCPCS,J9202,goserelin 3.6 MG Implant 1 Each Syringe,4756.3,2615.97,603.65,4955.51,63
HCPCS,J9203,gemtuzumab ozogamicin 1 mg/mL Recon Soln 1 Each Vial,41199.5,22659.73,200.16,35637.57,63
HCPCS,J9204,Mogamulizumab-kpkc 20 MG/5ML Solution 5 mL Vial,20181.07,11099.59,208.92,17456.63,63
HCPCS,J9205,irinotecan liposome 43 MG/10ML Injection 10 mL Vial,12829.7,7056.34,55.13,11097.69,63
HCPCS,J9206,Irinotecan HCl 300 MG/15ML Solution 15 mL Vial,564.32,310.38,1.69,488.14,48
HCPCS,J9206,Irinotecan HCl 40 MG/2ML Solution 2 mL Vial,97.02,53.37,1.69,83.92,48
HCPCS,J9206,irinotecan 100 MG/5ML Solution 5 mL Vial,174.1,95.76,1.69,150.6,48
HCPCS,J9207,ixabepilone 2 mg/mL Recon Soln 1 Each Vial,16942.305,9318.27,117.14,21446.89,126
HCPCS,J9208,ifosfamide 50 mg/mL Solution 20 mL Vial,202.68,111.48,21.52,175.32,48
HCPCS,J9208,ifosfamide 50 mg/mL Solution 60 mL Vial,535.34,294.44,21.52,463.07,48
HCPCS,J9209,mesna 100 MG/ML Solution 10 mL Vial,147.5,81.13,1.35,127.59,48
HCPCS,J9210,"Inj., emapalumab-lzsg, 1 mg",,,384.85,2576.07,17
HCPCS,J9211,IDArubicin 10 MG/10ML Solution 10 mL Vial,536.57,295.12,40.19,464.13,48
HCPCS,J9211,IDArubicin 5 MG/5ML Solution 5 mL Vial,283.33,155.84,40.19,250.09,48
HCPCS,J9212,Lab/Drugs Fee Schedule,,,5.28,6.52,6
HCPCS,J9213,Interferon alfa-2a inj,,,29.16,36.0,6
HCPCS,J9214,Interferon alfa-2b inj,,,10.84,13.38,6
HCPCS,J9215,Interferon alfa-n3 inj,,,31.03,38.31,6
HCPCS,J9216,Interferon gamma 1-b inj,,,8388.97,10356.75,6
HCPCS,J9217,leuprolide acetate (3 month) 22.5 MG Kit 1 Each Box,26414.41,14527.93,155.23,22848.46,63
HCPCS,J9217,leuprolide acetate (4 month) 30 MG Kit 1 Each Box,35214.32,19367.88,155.23,30460.39,63
HCPCS,J9217,leuprolide acetate 22.5 MG Kit 1 Each Box,6122.82,3367.56,155.23,5296.24,63
HCPCS,J9217,leuprolide acetate 30 MG Kit 1 Each Box,8155.42,4485.49,155.23,7054.44,63
HCPCS,J9217,leuprolide acetate 45 MG Kit 1 Each Box,32244.16,17734.29,155.23,45684.77,126
HCPCS,J9217,leuprolide acetate 7.5 MG Kit 1 Each Box,5588.72,3073.7999999999997,155.23,7806.19,126
HCPCS,J9218,Leuprolide acetate injeciton,,,7.65,9.44,6
HCPCS,J9220,indigotindisulfonate sodium 8 mg/mL Solution 5 mL Ampule,2175.0,1196.25,9.96,1881.38,63
HCPCS,J9223,lurbinectedin 4 mg/8 mL Recon Soln 1 Each Vial,33266.0,18296.3,175.92,28775.09,63
HCPCS,J9225,Vantas implant,,,3915.95,4834.51,6
HCPCS,J9226,Supprelin LA implant,,,38861.78,307532.63,23
HCPCS,J9227,isatuximab-irfc 100 MG/5ML Solution 5 mL Vial,3818.23,2100.03,68.13,3302.77,63
HCPCS,J9227,isatuximab-irfc 500 MG/25ML Solution 25 mL Vial,18143.32,9978.83,68.13,15693.97,63
HCPCS,J9228,Ipilimumab injection,,,154.59,1238.02,23
HCPCS,J9229,inotuzumab ozogamicin 0.25 mg/ml Recon Soln 1 Each Vial,93937.8,51665.79,2282.27,81256.2,63
HCPCS,J9230,Mechlorethamine hcl inj,,,108.87,134.41,6
HCPCS,J9245,melphalan 5 mg/mL Injection 1 Each Vial,2380.0,1309.0,95.9,2058.7,63
HCPCS,J9245,melphalan Recon Soln 1 Each Vial,2380.0,1309.0,95.9,2058.7,63
HCPCS,J9246,melphalan HCl (PG Free) 5 MG/ML Recon Soln 1 Each Vial,7220.5,3971.28,15.45,6245.73,63
HCPCS,J9248,Inj melphalan (hepzato) 1 mg,,,664.39,5317.58,23
HCPCS,J9249,"Inj, melphalan (apotex) 1 mg",,,64.78,66.72,15
HCPCS,J9255,methotrexate (preservative free) 1 GM/40ML Solution 40 mL Vial,204.09,112.25,61.23,176.54,48
HCPCS,J9260,methotrexate (preservative free) 50 MG/2ML Solution 2 mL Vial,49.88,27.44,2.89,43.15,48
HCPCS,J9261,nelarabine 5 MG/ML Solution 50 mL Vial,3661.68,2013.93,64.2,3167.35,63
HCPCS,J9262,"Inj, omacetaxine mep, 0.01mg",,,3.39,4.19,6
HCPCS,J9263,oxaliplatin 100 MG/20ML Solution 20 mL Vial,500.0,275.0,0.06,432.5,96
HCPCS,J9263,oxaliplatin 50 MG/10ML Solution 10 mL Vial,265.0,145.75,0.06,229.23,96
HCPCS,J9263,oxaliplatin 5000 mcg/mL Solution 10 mL Vial,265.0,145.75,0.06,229.23,48
HCPCS,J9264,nab-PACLitaxel 100 MG Recon Susp 1 Each Vial,7400.37,4070.21,10.54,6401.32,126
HCPCS,J9266,pegaspargase 750 UNIT/ML Solution 5 mL Vial,109957.12,60476.42,23242.75,191862.41,63
HCPCS,J9267,PACLitaxel 100 MG/16.7ML Conc 16.7 mL Vial,162.49,89.37,0.1,140.55,48
HCPCS,J9267,PACLitaxel 30 MG/5ML Conc 5 mL Vial,90.77,49.93,0.1,78.52,96
HCPCS,J9267,PACLitaxel 300 MG/50ML Conc 50 mL Vial,637.71,350.75,0.1,551.62,48
HCPCS,J9268,pentostatin 2 mg/mL Recon Soln 1 Each Vial,12710.5,6990.78,2346.15,17171.26,63
HCPCS,J9269,tagraxofusp-erzs 1000 MCG/ML Solution 1 mL Vial,138417.27,76129.5,290.97,119730.94,63
HCPCS,J9271,pembrolizumab 100 MG/4ML Solution 4 mL Vial,24195.65,13307.61,49.46,20929.24,63
HCPCS,J9271,pembrolizumab 200 mg 200 mg Solution 58 mL Bag,51852.78,28519.03,49.46,44852.65,126
HCPCS,J9271,pembrolizumab 400 mg 400 mg Solution 66 mL Bag,119237.3,65580.52,49.46,103140.26,126
HCPCS,J9272,"Inj, dostarlimab-gxly, 10 mg",,,206.11,1645.79,23
HCPCS,J9273,tisotumab vedotin-tftv 40 MG Recon Soln 1 Each Vial,29219.3,16070.62,156.15,25274.69,63
HCPCS,J9274,Tebentafusp-tebn 100 MCG/0.5ML Solution 0.5 mL Vial,83983.0,46190.65,184.4,72645.3,63
HCPCS,J9276,"Inj zanidatamab-hrii, 2 mg",,,25.05,169.29,17
HCPCS,J9280,mitoMYcin 0.2 mg/mL Recon Soln 1 Each Vial,463.29,254.81,20.35,400.75,63
HCPCS,J9280,mitoMYcin 0.4 mg/mL Recon Soln 1 Each Vial,463.29,254.81,20.35,400.75,63
HCPCS,J9280,mitoMYcin 20 MG Recon Soln 1 Each Vial,2868.91,1577.91,20.35,2481.61,63
HCPCS,J9280,mitoMYcin 40 MG Recon Soln 1 Each Vial,5713.0,3142.15,20.35,4941.75,63
HCPCS,J9280,mitoMYcin Recon Soln 1 Each Vial,463.29,254.81,20.35,400.75,63
HCPCS,J9281,mitoMYcin 80 (2 x 40) MG Recon Soln 1 Each Box,100383.0,55210.65,267.34,86831.3,63
HCPCS,J9285,"Inj, olaratumab, 10 mg",,,50.61,62.48,6
HCPCS,J9286,glofitamab-gxbm 10 MG/10ML Solution 10 mL Vial,43169.76,23743.37,2379.1,37341.84,63
HCPCS,J9286,glofitamab-gxbm 2.5 MG/2.5ML Solution 2.5 mL Vial,11334.93,6234.22,2379.1,18701.35,63
HCPCS,J9289,Inj nivolumab 2 mg hyaluron,,,27.36,28.18,15
HCPCS,J9292,"Inj, pemetrexed dipotassium",,,81.4,100.49,21
HCPCS,J9293,mitoXANTRONE 30 MG/15ML Conc 15 mL Vial,1246.55,685.61,23.88,1078.27,63
HCPCS,J9293,mitoXANTRONE HCl 20 MG/10ML Conc 10 mL Vial,1946.0,1070.3,23.88,1683.29,63
HCPCS,J9294,"Inj pemetrexed, hospira 10mg",,,2.21,33.28,23
HCPCS,J9295,"Injection, necitumumab, 1 mg",,,4.91,38.68,23
HCPCS,J9296,Inj pemetrexed (accord) 10mg,,,8.36,65.75,23
HCPCS,J9297,Inj pemetrexed (sandoz) 10mg,,,1.31,8.17,8
HCPCS,J9298,nivolumab-relatlimab-rmbw 240-80 mg/20mL Solution 20 mL Vial,62005.28,34102.91,166.45,53634.57,63
HCPCS,J9299,nivolumab 100 MG/10ML Solution 10 mL Vial,13972.25,7684.74,27.74,12086.0,63
HCPCS,J9299,nivolumab 240 MG/24ML Solution 24 mL Vial,31943.04,17568.68,27.74,27630.73,63
HCPCS,J9299,nivolumab 40 MG/4ML Solution 4 mL Vial,5865.51,3226.04,27.74,5073.67,63
HCPCS,J9299,nivolumab Solution 124 mL Flex Cont,37387.48,20563.12,27.74,32340.17,63
HCPCS,J9299,nivolumab Solution 148 mL Flex Cont,89147.25,49030.99,27.74,77112.37,63
HCPCS,J9301,obinutuzumab 1000 MG/40ML Solution 40 mL Vial,35327.15,19429.94,64.25,30557.98,63
HCPCS,J9302,Ofatumumab injection,,,53.42,65.96,21
HCPCS,J9303,panitumumab 100 MG/5ML Solution 5 mL Vial,8177.43,4497.59,142.28,7073.48,63
HCPCS,J9303,panitumumab 400 MG/20ML Solution 20 mL Vial,29726.06,16349.34,142.28,25713.04,63
HCPCS,J9304,"Inj. pemetrexed, 10 mg",,,45.24,356.0,23
HCPCS,J9305,PEMEtrexed 25 mg/ml Recon Soln 1 Each Vial,2199.35,1209.645,4.36,15055.24,252
HCPCS,J9306,pertuzumab 420 MG/14ML Solution 14 mL Vial,27979.02,15388.47,13.9,24201.85,63
HCPCS,J9307,PRALAtrexate 20 MG/ML Solution 1 mL Vial,30395.14,16717.33,320.92,26291.8,63
HCPCS,J9307,PRALAtrexate 40 MG/2ML Solution 2 mL Vial,60775.28,33426.41,320.92,52570.62,63
HCPCS,J9308,Ramucirumab 500 MG/50ML Solution 50 mL Vial,30177.88,16597.84,62.6,26103.87,63
HCPCS,J9308,ramucirumab 100 MG/10ML Solution 10 mL Vial,6646.12,3655.37,62.6,5748.89,63
HCPCS,J9309,polatuzumab vedotin-piiq 20 mg/mL Recon Soln 1 Each Vial,46745.455,25710.005,114.13,66018.34,126
HCPCS,J9311,"Inj rituximab, hyaluronidase",,,31.4,249.48,23
HCPCS,J9312,riTUXimab 1 mg/0.1 mL Solution 0.5 mL Syringe,250.79,137.94,65.88,512.53,63
HCPCS,J9312,riTUXimab 10 mg/mL Solution 10 mL Vial,4252.84,2339.07,65.88,3678.71,63
HCPCS,J9312,riTUXimab 100 MG/10ML Solution 10 mL Vial,4252.84,2339.07,65.88,3678.71,126
HCPCS,J9312,riTUXimab 500 MG/50ML Solution 50 mL Vial,20219.68,11120.83,65.88,17490.02,63
HCPCS,J9313,"Inj., Lumoxiti, 0.01 mg",,,20.08,24.79,21
HCPCS,J9314,Inj pemetrexed (teva) 10mg,,,6.13,25.58,23
HCPCS,J9316,pertuzumab/trastuzumab/hyaluronidase-zzxf 60-60-2000 MG-MG-U/ML Solution 10 mL Vial,38052.01,20928.61,54.85,32914.99,63
HCPCS,J9316,pertuzumab/trastuzumab/hyaluronidase-zzxf 80-40-2000 MG-MG-U/ML Solution 15 mL Vial,57072.79,31390.04,54.85,49367.96,63
HCPCS,J9317,sacituzumab Govitecan-hziy 10 mg/mL Recon Soln 1 Each Vial,10826.93,5954.82,30.43,9365.29,63
HCPCS,J9318,Inj romidepsin non-lyo 0.1mg,,,24.49,192.51,23
HCPCS,J9319,romiDEPsin 5 mg/mL Recon Soln 1 Each Vial,13774.2,7575.81,26.09,11914.68,63
HCPCS,J9320,streptozocin 100 mg/mL Recon Soln 1 Each Vial,1671.38,919.26,359.82,1445.74,48
HCPCS,J9321,epcoritamab-bysp 4 MG/0.8ML Solution 0.8 mL Vial,6083.94,3346.17,47.39,5262.61,63
HCPCS,J9321,epcoritamab-bysp 4 MG/5ML Solution 5 mL Vial,7162.0,3939.1,47.39,6195.13,63
HCPCS,J9321,epcoritamab-bysp 48 MG/0.8ML Solution 0.8 mL Vial,66259.36,36442.65,47.39,57314.35,63
HCPCS,J9322,Inj pemetrexed (bluepoint),,,10.6,10.92,15
HCPCS,J9323,Inj pemetrexed ditromethamin,,,0.13,69.8,23
HCPCS,J9324,"Inj, pemrydi rtu, 10 mg",,,70.52,540.68,23
HCPCS,J9325,Inj talimogene laherparepvec,,,60.42,496.46,23
HCPCS,J9328,Temozolomide injection,,,8.94,70.13,23
HCPCS,J9329,"Inj, tislelizumab-jsgr",,,57.45,584.72,23
HCPCS,J9330,temsirolimus Solution 1 mL Vial,9026.44,4964.55,25.34,7807.87,63
HCPCS,J9331,sirolimus protein-bound 100 mg Recon Susp 1 Each Vial,32726.97,17999.84,84.57,28308.83,63
HCPCS,J9332,efgartigimod alfa-fcab 400 mg/20 mL Solution 20 mL Vial,26009.6,14305.28,27.86,22498.3,63
HCPCS,J9333,Inj rozanolixizum-noli 1 mg,,,19.59,156.33,23
HCPCS,J9334,efgartigimod alfa-hyaluronidase-qvfc 1008-11200 mg-UT/5.6 mL Solution 5.6 mL Vial,67581.53,37169.85,28.42,58458.02,63
HCPCS,J9340,Lab/Drugs Fee Schedule,,,190.4,235.06,6
HCPCS,J9342,thiotepa 10 mg/ml Recon Soln 1 Each Vial,2420.0,1331.0,10.54,2941.0,126
HCPCS,J9342,thiotepa 100 MG Recon Soln 1 Each Vial,13210.0,7265.5,10.54,15825.18,126
HCPCS,J9345,"Inj, retifanlimab-dlwr, 1 mg",,,25.13,202.37,23
HCPCS,J9347,tremelimumab-actl 25 mg/1.25mL Solution 1.25 mL Vial,14559.59,8007.78,118.86,12594.05,63
HCPCS,J9347,tremelimumab-actl 300 mg/15mL Solution 15 mL Vial,166374.96,91506.23,118.86,143914.34,63
HCPCS,J9348,"Inj. naxitamab-gqgk, 1 mg",,,551.48,4629.89,23
HCPCS,J9349,tafasitamab-cxix 40 mg/mL Recon Soln 1 Each Vial,6306.42,3468.54,12.0,5455.05,63
HCPCS,J9350,Mosunetuzumab-axgb 30 MG/30ML Solution 30 mL Vial,76798.37,42239.11,654.63,66430.59,53
HCPCS,J9350,mosunetuzumab-axgb 1 mg/mL Solution 1 mL Vial,2834.13,1558.78,654.63,2451.52,53
HCPCS,J9351,topoTECAN 4 MG/4ML Solution 4 mL Vial,735.0,404.25,1.53,635.78,48
HCPCS,J9352,trabectedin 0.05 mg/mL Recon Soln 1 Each Vial,15884.16,8736.29,311.46,13739.8,63
HCPCS,J9353,"Inj. margetuximab-cmkb, 5 mg",,,42.41,340.54,23
HCPCS,J9354,Ado-Trastuzumab Emtansine 160 MG Recon Soln 1 Each Vial,26186.94,14402.82,35.18,22651.7,63
HCPCS,J9354,ado-trastuzumab emtansine 100 MG Recon Soln 1 Each Vial,17175.41,9446.48,35.18,14856.73,63
HCPCS,J9354,ado-trastuzumab emtansine 20 mg/mL Recon Soln 1 Each Vial,17175.41,9446.48,35.18,14856.73,63
HCPCS,J9355,trastuzumab 21 mg/mL Recon Soln 1 Each Vial,7037.89,3870.84,66.15,6087.77,63
HCPCS,J9356,"trastuzumab/hyaluronidase-oysk 600-10,000 mg-unit/5 mL Solution 5 mL Vial",20123.53,11067.95,54.14,17406.85,63
HCPCS,J9357,Valrubicin injection,,,1195.61,9293.33,23
HCPCS,J9358,fam-trastuzumab deruxtecan-nxki 20 mg/mL Recon Soln 1 Each Vial,12639.43,6951.69,24.74,10933.11,63
HCPCS,J9359,loncastuximab tesirine-lpyl 10 mg/2 mL Recon Soln 1 Each Vial,113857.24,62621.49,182.13,98486.51,63
HCPCS,J9360,vinBLAStine 1 MG/ML Solution 10 mL Vial,282.67,155.47,4.15,244.51,48
HCPCS,J9370,vinCRIStine 1 MG/ML Solution 1 mL Vial,113.43,62.39,7.16,98.12,48
HCPCS,J9376,"Inj pozelimab-bbfg, 1 mg",,,89.16,110.08,21
HCPCS,J9380,teclistamab-cqyv 10 mg/mL Solution 3 mL Vial,8914.48,4902.97,33.58,7711.03,53
HCPCS,J9380,teclistamab-cqyv 90 mg/mL Solution 1.7 mL Vial,41321.6,22726.88,33.58,35743.18,53
HCPCS,J9381,teplizumab-mzwv 2 MG/2ML Solution 2 mL Vial,59099.91,32504.96,31.97,51121.42,63
HCPCS,J9382,Inj zenocutuzumab-zbco 1 mg,,,32.91,33.9,15
HCPCS,J9390,Vinorelbine Tartrate 50 MG/5ML Solution 5 mL Vial,429.5,236.23,5.58,371.52,48
HCPCS,J9390,vinorelbine 10 MG/ML Solution 1 mL Vial,147.5,81.13,5.58,127.59,48
HCPCS,J9393,"Inj, fulvestrant (teva)",,,18.2,47.6,21
HCPCS,J9394,"Inj, fulvestrant (fresenius)",,,10.53,27.57,23
HCPCS,J9395,fulvestrant 250 MG/5ML Solution Prefilled Syringe 5 mL Syringe,793.75,436.57,5.72,3795.5,189
HCPCS,J9400,"Inj, ziv-aflibercept, 1mg",,,6.85,53.87,23
HCPCS,J9600,porfimer Recon Soln 1 Each Vial,97966.6,53881.63,20802.53,84741.11,63
HCPCS,K0552,Sup/ext non-ins inf pump syr,,,3.38,3.48,15
HCPCS,K0609,Repl electrode for AED,,,1126.25,1160.04,15
HCPCS,K0672,Removable soft interface LE,,,102.18,105.25,15
HCPCS,K0739,Repair/svc DME non-oxygen eq,,,19.58,20.17,15
HCPCS,K1007,Bil hkaf pc s/d micro sensor,,,93216.7,96013.2,15
HCPCS,L0112,Cranial cervical orthosis,,,1686.33,1736.92,15
HCPCS,L0113,Cranial cervical torticollis,,,343.6,353.91,15
HCPCS,L0120,Cerv flex n/adj foam pre ots,,,31.87,32.83,15
HCPCS,L0130,Flex thermoplastic collar mo,,,183.91,189.43,15
HCPCS,L0140,Cervical semi-rigid adjustab,,,72.12,74.28,15
HCPCS,L0150,Cerv semi-rig adj molded chn,,,128.96,132.83,15
HCPCS,L0160,Cerv sr wire occ/man pre ots,,,188.31,193.96,15
HCPCS,L0170,Cervical collar molded to pt,,,968.74,997.8,15
HCPCS,L0172,HC CERV COLLAR SEMI-RIGID THERMOPLAS FOAM 2 PC PREFAB OTS,278.0,152.9,83.4,244.64,50
HCPCS,L0174,Cerv sr 2pc thor ext pre ots,,,335.53,345.6,15
HCPCS,L0180,HC CERV POST COLLAR OCCIP MANDIB SUPPORT ADJ,2416.5,1329.08,543.58,2126.52,50
HCPCS,L0190,HC CERV MULT POST COLLAR OCCIP MAND SUPP ADJ BAR,2817.0,1549.35,641.1,2478.96,50
HCPCS,L0200,HC CERV MULT PST COLLR OCCIP MAND SUP ADJ BAR THOR,2963.5,1629.93,743.62,2607.88,50
HCPCS,L0220,Thor rib belt custom fabrica,,,155.65,160.32,15
HCPCS,L0450,Tlso flex trunk/thor pre ots,,,119.94,123.54,15
HCPCS,L0454,Tlso trnk sj-t9 pre cst,,,417.86,430.4,15
HCPCS,L0455,Tlso flex trnk sj-t9 pre ots,,,222.65,229.33,15
HCPCS,L0456,Tlso flex trnk sj-ss pre cst,,,1198.34,1234.29,15
HCPCS,L0457,Tlso flex trnk sj-ss pre ots,,,638.5,657.66,15
HCPCS,L0458,HC TLSO TRIPLNR CNTRL MOD SEGM SP SYS 2 RIG SYMPH PUB-XIPHD PREFAB CUSTM,1557.5,856.63,467.25,1370.6,50
HCPCS,L0460,HC TLSO TRIPLNR CNTRL MOD SEGM SP SYS 2 RIG SYMPH PUB-STERN PREFAB CUSTM,4450.0,2447.5,1209.49,3916.0,50
HCPCS,L0462,TLSO 3Mod sacro-scap pre,,,1504.38,1549.51,15
HCPCS,L0464,TLSO 4Mod sacro-scap pre,,,1790.97,1844.7,15
HCPCS,L0466,Tlso r fram soft ant pre cst,,,457.12,470.83,15
HCPCS,L0467,Tlso r fram soft pre ots,,,249.71,257.2,15
HCPCS,L0468,Tlso rig fram pelvic pre cst,,,572.88,590.07,15
HCPCS,L0469,Tlso rig fram pelvic pre ots,,,318.17,327.72,15
HCPCS,L0470,TLSO rigid frame pre subclav,,,792.74,816.52,15
HCPCS,L0472,HC TLSO RIGID FRAME HYPEREXT PREFAB,1330.5,731.78,399.15,1170.84,50
HCPCS,L0480,TLSO rigid plastic custom fa,,,1819.89,1874.49,15
HCPCS,L0482,TLSO rigid lined custom fab,,,2032.83,2093.81,15
HCPCS,L0484,HC TLSO RIGID PLASTIC CUSTOM FAB,2426.0,1334.3,727.8,2261.22,50
HCPCS,L0486,HC TLSO RIGID LINED CUST FAB TWO PIECE,4853.0,2669.15,1455.9,4270.64,50
HCPCS,L0488,TLSO rigid lined pre one pie,,,1209.49,1245.77,15
HCPCS,L0490,TLSO rigid plastic pre one,,,340.82,351.04,15
HCPCS,L0491,TLSO 2 piece rigid shell,,,925.33,953.09,15
HCPCS,L0492,TLSO 3 piece rigid shell,,,602.54,620.62,15
HCPCS,L0621,Sio flex pelvic/sacr pre ots,,,63.23,65.13,15
HCPCS,L0622,SIO flex pelvisacral custom,,,322.04,331.7,15
HCPCS,L0623,Sio rig pnl pelv/sac pre ots,,,113.35,116.75,15
HCPCS,L0625,Lo flex l1-below l5 pre ots,,,35.37,36.43,15
HCPCS,L0626,Lo sag rig pnl stays pre cst,,,93.91,96.73,15
HCPCS,L0627,Lo sag ri an/pos pnl pre cst,,,495.23,510.09,15
HCPCS,L0628,Lso flex no ri stays pre ots,,,53.86,55.48,15
HCPCS,L0630,Lso r post pnl sj-t9 pre cst,,,195.15,201.0,15
HCPCS,L0631,Lso sag r an/pos pnl pre cst,,,1236.86,1273.97,15
HCPCS,L0633,Lso sc r pos/lat pnl pre cst,,,345.5,355.87,15
HCPCS,L0635,LSO sagit rigid panel prefab,,,1203.94,1240.06,15
HCPCS,L0636,LSO sagittal rigid panel cus,,,1633.55,1682.56,15
HCPCS,L0637,HC LSO SAG-CORONAL CNTRL RIGID ANT POST PNL PREFAB CUSTOM FIT,5018.5,2760.18,1505.55,4416.28,50
HCPCS,L0638,"HC LUMBAR SACRAL ORTHOSIS, SAGITTAL CORONAL CONTROL, PANEL, CUSTOM",7613.5,4187.43,1589.13,6699.88,50
HCPCS,L0639,Lso s/c shell/panel prefab,,,1560.91,1607.74,15
HCPCS,L0640,LSO s/c shell/panel custom,,,1260.75,1298.57,15
HCPCS,L0641,Lo rig pos pnl l1-l5 pre ots,,,50.05,51.55,15
HCPCS,L0642,Lo sag ri an/pos pnl pre ots,,,263.95,271.87,15
HCPCS,L0643,Lso sag ctr rigi pos pre ots,,,103.99,107.11,15
HCPCS,L0648,Lso sag r an/pos pnl pre ots,,,659.19,678.97,15
HCPCS,L0649,Lso sc r pos/lat pnl pre ots,,,184.14,189.66,15
HCPCS,L0650,HC LSO SAG-CORONAL CNTRL RIGID ANT POST PNL PREFAB OTS,5018.5,2760.18,762.72,4416.28,50
HCPCS,L0651,LSO sag-co shell pnl pre ots,,,762.72,785.6,15
HCPCS,L0700,Ctlso a-p-l control molded,,,2398.6,2470.56,15
HCPCS,L0710,"HC CTLSO, ANTERIOR POSTERIOR LATERAL CONTROL, MOLDED, W INTERFACE MATERIAL",12761.0,7018.55,2636.69,11229.68,50
HCPCS,L0720,Ctlso a-p-l control custom,,,2334.55,2404.59,15
HCPCS,L0810,Halo cervical into jckt vest,,,3220.5,3317.12,15
HCPCS,L0820,Halo cervical into body jack,,,2533.35,2609.35,15
HCPCS,L0830,Halo cerv into milwaukee typ,,,3876.39,3992.68,15
HCPCS,L0859,MRI compatible system,,,1372.45,1413.62,15
HCPCS,L0861,Halo repl liner/interface,,,259.7,267.49,15
HCPCS,L0970,Tlso corset front,,,128.76,132.62,15
HCPCS,L0972,Lso corset front,,,117.2,120.72,15
HCPCS,L0974,Tlso full corset,,,210.55,216.87,15
HCPCS,L0976,Lso full corset,,,180.14,185.54,15
HCPCS,L0978,Axillary crutch extension,,,226.72,233.52,15
HCPCS,L0980,Peroneal straps pair pre ots,,,20.58,21.2,15
HCPCS,L0982,Stocking sup grips 4 pre ots,,,18.85,19.42,15
HCPCS,L0984,Protect body sock ea pre ots,,,81.53,83.98,15
HCPCS,L1000,Ctlso milwauke initial model,,,2443.18,2516.48,15
HCPCS,L1005,Tension based scoliosis orth,,,3856.33,3972.02,15
HCPCS,L1006,Scoliosis orth sag/ cor,,,1283.42,1321.92,15
HCPCS,L1010,Ctlso axilla sling,,,100.82,103.84,15
HCPCS,L1020,Kyphosis pad,,,129.84,133.74,15
HCPCS,L1025,Kyphosis pad floating,,,187.31,192.93,15
HCPCS,L1030,Lumbar bolster pad,,,94.34,97.17,15
HCPCS,L1040,Lumbar or lumbar rib pad,,,106.82,110.02,15
HCPCS,L1050,Sternal pad,,,120.89,124.52,15
HCPCS,L1060,Thoracic pad,,,130.49,134.4,15
HCPCS,L1070,Trapezius sling,,,135.17,139.23,15
HCPCS,L1080,Outrigger,,,63.04,64.93,15
HCPCS,L1085,Outrigger bil w/ vert extens,,,211.05,217.38,15
HCPCS,L1090,Lumbar sling,,,121.24,124.88,15
HCPCS,L1100,Ring flange plastic/leather,,,228.81,235.67,15
HCPCS,L1110,Ring flange plas/leather mol,,,383.64,395.15,15
HCPCS,L1120,Covers for upright each,,,45.82,47.19,15
HCPCS,L1200,Furnsh initial orthosis only,,,2156.12,2220.8,15
HCPCS,L1210,HC LATERAL THORACIC EXTENSION,447.0,245.85,134.1,393.36,50
HCPCS,L1220,Anterior thoracic extension,,,286.92,295.53,15
HCPCS,L1230,Milwaukee type superstructur,,,803.78,827.89,15
HCPCS,L1240,Lumbar derotation pad,,,109.58,112.87,15
HCPCS,L1250,Anterior asis pad,,,95.29,98.15,15
HCPCS,L1260,Anterior thoracic derotation,,,113.64,117.05,15
HCPCS,L1270,Abdominal pad,,,99.86,102.86,15
HCPCS,L1280,Rib gusset (elastic) each,,,105.28,108.44,15
HCPCS,L1290,Lateral trochanteric pad,,,93.62,96.43,15
HCPCS,L1300,Body jacket mold to patient,,,2076.54,2138.84,15
HCPCS,L1310,Post-operative body jacket,,,2162.89,2227.78,15
HCPCS,L1600,Ho flex frejka w/cov pre cst,,,155.26,159.92,15
HCPCS,L1610,Ho frejka cov only pre cst,,,65.94,67.92,15
HCPCS,L1620,Ho flex pavlik harns pre cst,,,189.31,194.99,15
HCPCS,L1630,Abduct control hip semi-flex,,,254.53,262.17,15
HCPCS,L1640,Pelv band/spread bar thigh c,,,570.38,587.49,15
HCPCS,L1650,HO abduction hip adjustable,,,297.13,306.04,15
HCPCS,L1652,Ho bi thighcuffs w sprdr bar,,,429.5,442.39,15
HCPCS,L1653,Ho abduction static ots,,,429.5,442.39,15
HCPCS,L1660,HO abduction static plastic,,,217.73,224.26,15
HCPCS,L1680,Pelvic & hip control thigh c,,,1372.66,1413.84,15
HCPCS,L1681,Ho bilateral hip abduction,,,2257.96,2325.7,15
HCPCS,L1685,Post-op hip abduct custom fa,,,1340.06,1380.26,15
HCPCS,L1686,HC HO POST-OP HIP ABDUCTION,3604.0,1982.2,1081.2,3171.52,50
HCPCS,L1690,Combination bilateral HO,,,2329.91,2399.81,15
HCPCS,L1700,Leg perthes orth toronto typ,,,1874.55,1930.79,15
HCPCS,L1710,Legg perthes orth newington,,,2387.05,2458.66,15
HCPCS,L1720,Legg perthes orthosis trilat,,,1777.39,1830.71,15
HCPCS,L1730,Legg perthes orth scottish r,,,1500.51,1545.53,15
HCPCS,L1755,Legg perthes patten bottom t,,,2157.3,2222.02,15
HCPCS,L1810,Ko elastic with joints,,,124.04,127.76,15
HCPCS,L1812,Ko elastic w/joints pre ots,,,76.45,78.74,15
HCPCS,L1820,"HC KO, ELASTIC W/ CONDYLAR PADS AND JOINT, W/WO PATELLAR CONTROL, PREFAB",250.0,137.5,75.0,220.0,50
HCPCS,L1821,Ko elas w/ condyle pads otf,,,171.23,176.37,15
HCPCS,L1830,Ko immob canvas long pre ots,,,68.89,70.96,15
HCPCS,L1831,Knee orth pos locking joint,,,354.61,365.25,15
HCPCS,L1832,Ko adj jnt pos r sup pre cst,,,829.91,854.81,15
HCPCS,L1833,Ko adj jnt pos r sup pre ots,,,496.23,511.12,15
HCPCS,L1834,HC KO WO JOINT RIGID CUSTOM FAB,1004.0,552.2,301.2,900.77,300
HCPCS,L1836,Ko rigid w/o joints pre ots,,,97.41,100.33,15
HCPCS,L1840,Ko derot ant cruciate custom,,,1133.06,1167.05,15
HCPCS,L1843,Ko single upright pre cst,,,1081.09,1113.52,15
HCPCS,L1844,Ko w/adj jt rot cntrl molded,,,1834.81,1889.85,15
HCPCS,L1845,HC KO DOUBLE UPRIGHT THIGH & CALF PREFAB CUSTOM FIT,1531.0,842.05,459.3,1347.28,50
HCPCS,L1846,Ko w adj flex/ext rotat mold,,,1409.73,1452.02,15
HCPCS,L1847,Ko dbl upright w/air pre cst,,,693.0,713.79,15
HCPCS,L1848,Ko dbl upright w/air pre ots,,,693.0,713.79,15
HCPCS,L1850,HC KO SWEDISH TYPE PREFAB OTS,2721.5,1496.83,224.35,2394.92,50
HCPCS,L1851,Ko single upright prefab ots,,,654.99,674.64,15
HCPCS,L1852,Ko double upright prefab ots,,,624.85,643.6,15
HCPCS,L1860,Ko supracondylar socket mold,,,1502.44,1547.51,15
HCPCS,L1900,Afo sprng wir drsflx calf bd,,,343.76,354.07,15
HCPCS,L1902,Afo ankle gauntlet pre ots,,,89.93,92.63,15
HCPCS,L1904,Afo molded ankle gauntlet,,,543.84,560.16,15
HCPCS,L1906,Afo multilig ank sup pre ots,,,135.49,139.55,15
HCPCS,L1907,Afo supramalleolar custom,,,677.99,698.33,15
HCPCS,L1910,Afo sing bar clasp attach sh,,,337.89,348.03,15
HCPCS,L1920,Afo sing upright w/ adjust s,,,494.96,509.81,15
HCPCS,L1930,HC AFO INCLUDING FIT AND ADJUSTMENT,426.5,234.58,127.95,375.32,50
HCPCS,L1930,"HC LEAF SPRING, ANKLE FOOT ORTHOSIS, PLASTIC AND/OR OTH MAT, PREFAB FIT/ADJ",267.5,147.13,80.25,312.64,50
HCPCS,L1932,Afo rig ant tib tcf/= custom,,,1075.14,1107.39,15
HCPCS,L1933,Afo rig ant tib tcf/= ots,,,1075.14,1107.39,15
HCPCS,L1940,HC AFO CUSTOM STATIC,700.0,385.0,210.0,616.0,400
HCPCS,L1945,Afo molded plas rig ant tib,,,1352.44,1393.01,15
HCPCS,L1950,Afo spiral molded to pt plas,,,926.61,954.41,15
HCPCS,L1951,Afo spiral prefab custom,,,1011.85,1042.21,15
HCPCS,L1952,Afo spiral prefab ots,,,1011.85,1042.21,15
HCPCS,L1960,HC AFO POST SOLID ANKLE PLASTIC CUSTOM FAB,3277.0,1802.35,746.86,2883.76,50
HCPCS,L1970,HC AFO PLASTIC W ANKLE JT CUSTOM FAB,4730.0,2601.5,833.93,4162.4,50
HCPCS,L1971,"Afo w/ankle joint, prefab",,,564.8,581.74,15
HCPCS,L1980,Afo sing solid stirrup calf,,,486.48,501.07,15
HCPCS,L1990,HC AFO DOUBLE SOLID STIRRUP CALF CUSTOM FAB,4781.0,2629.55,563.04,4207.28,50
HCPCS,L2000,Kafo sing fre stirr thi/calf,,,1347.85,1388.29,15
HCPCS,L2005,KAFO sng/dbl mechanical act,,,4937.19,5085.31,15
HCPCS,L2006,Kaf sng/dbl swg/stn mcpr cus,,,38762.63,39925.51,15
HCPCS,L2010,Kafo sng solid stirrup w/o j,,,1051.31,1082.85,15
HCPCS,L2020,HC KAFO DOUBLE SOLID STIRRUP CALF CUSTOM FAB,6847.5,3766.13,1327.77,6025.8,50
HCPCS,L2030,Kafo dbl solid stirrup w/o j,,,1305.09,1344.24,15
HCPCS,L2034,KAFO pla sin up w/wo k/a cus,,,2447.64,2521.07,15
HCPCS,L2035,KAFO plastic pediatric size,,,208.74,215.0,15
HCPCS,L2036,HC KAFO PLASTIC DOUBLE FREE KNEE MOTION CUSTOM FAB,12033.5,6618.43,2233.75,10589.48,50
HCPCS,L2037,HC KAFO PLASTIC SINGLE FREE KNEE MOTION CUSTOM FAB,3049.5,1677.23,914.85,2683.56,250
HCPCS,L2038,Kafo w/o joint multi-axis an,,,1610.72,1659.04,15
HCPCS,L2040,Hkafo torsion bil rot straps,,,243.75,251.06,15
HCPCS,L2050,Hkafo torsion cable hip pelv,,,587.14,604.75,15
HCPCS,L2060,Hkafo torsion ball bearing j,,,734.39,756.42,15
HCPCS,L2070,Hkafo torsion unilat rot str,,,187.01,192.62,15
HCPCS,L2080,Hkafo unilat torsion cable,,,449.64,463.13,15
HCPCS,L2090,Hkafo unilat torsion ball br,,,599.09,617.06,15
HCPCS,L2106,Afo tib fx cast plaster mold,,,949.69,978.18,15
HCPCS,L2108,Afo tib fx cast molded to pt,,,1385.15,1426.7,15
HCPCS,L2112,HC AFO TIBIAL FRACTURE SOFT,575.0,316.25,172.5,626.1,50
HCPCS,L2114,HC AFO TIBIAL FX ORTHOSIS SEMI-RIGID PREFAB,575.0,316.25,172.5,784.2,50
HCPCS,L2116,HC AFO TIBIAL FRACTURE RIGID,575.0,316.25,172.5,956.49,50
HCPCS,L2126,Kafo fem fx cast thermoplas,,,1538.47,1584.62,15
HCPCS,L2128,Kafo fem fx cast molded to p,,,1931.8,1989.75,15
HCPCS,L2132,Kafo femoral fx cast soft,,,1172.57,1207.75,15
HCPCS,L2134,Kafo fem fx cast semi-rigid,,,1388.47,1430.12,15
HCPCS,L2136,HC KAFO FEMORAL FX CAST RIGID,6582.5,3620.38,1519.47,5792.6,50
HCPCS,L2180,HC PLASTIC SHOE INSERT W ANKLE JOINT,1003.0,551.65,159.73,882.64,50
HCPCS,L2182,Drop lock knee,,,137.68,141.81,15
HCPCS,L2184,Limited motion knee joint,,,139.56,143.75,15
HCPCS,L2186,HC ADJ MOTION KNEE JT LERMAN TYPE,864.5,475.48,185.6,760.76,50
HCPCS,L2188,Quadrilateral brim,,,337.4,347.52,15
HCPCS,L2190,Waist belt,,,102.77,105.85,15
HCPCS,L2192,Pelvic band & belt thigh fla,,,401.69,413.74,15
HCPCS,L2200,HC LTD ANKLE MOTION EACH JT,386.0,212.3,60.54,339.68,50
HCPCS,L2210,HC DORSIFLEXION ASSIST EACH JT,303.0,166.65,75.73,266.64,50
HCPCS,L2220,HC DORSI & PLANTAR FLEX ASSIST RESIST EACH JT,385.5,212.03,97.48,339.24,50
HCPCS,L2230,Split flat caliper stirr & p,,,115.26,118.72,15
HCPCS,L2232,"Rocker bottom, contact AFO",,,117.04,120.55,15
HCPCS,L2240,Round caliper and plate atta,,,114.72,118.16,15
HCPCS,L2250,Foot plate molded stirrup at,,,402.45,414.52,15
HCPCS,L2260,Reinforced solid stirrup,,,225.84,232.62,15
HCPCS,L2265,Long tongue stirrup,,,161.97,166.83,15
HCPCS,L2270,Varus/valgus strap padded/li,,,74.27,76.5,15
HCPCS,L2275,HC PLASTIC MOD LOW EXT PAD LINE,575.0,316.25,157.05,506.0,50
HCPCS,L2280,Molded inner boot,,,680.18,700.59,15
HCPCS,L2300,Abduction bar jointed adjust,,,303.33,312.43,15
HCPCS,L2310,Abduction bar-straight,,,138.6,142.76,15
HCPCS,L2320,Non-molded lacer,,,232.43,239.4,15
HCPCS,L2330,Lacer molded to patient mode,,,442.37,455.64,15
HCPCS,L2335,Anterior swing band,,,338.69,348.85,15
HCPCS,L2340,Pre-tibial shell molded to p,,,503.51,518.62,15
HCPCS,L2350,Prosthetic type socket molde,,,1003.85,1033.97,15
HCPCS,L2360,Extended steel shank,,,62.13,63.99,15
HCPCS,L2370,Patten bottom,,,385.6,397.17,15
HCPCS,L2375,Torsion ank & half solid sti,,,148.25,152.7,15
HCPCS,L2380,Torsion straight knee joint,,,155.49,160.15,15
HCPCS,L2385,Straight knee joint heavy du,,,177.04,182.35,15
HCPCS,L2387,Add LE poly knee custom KAFO,,,230.0,236.9,15
HCPCS,L2390,Offset knee joint each,,,123.32,127.02,15
HCPCS,L2395,Offset knee joint heavy duty,,,176.27,181.56,15
HCPCS,L2397,Suspension sleeve lower ext,,,147.06,151.47,15
HCPCS,L2405,HC KNEE JOINT DROP LOCK EA JT,419.0,230.45,105.04,368.72,50
HCPCS,L2415,Knee joint cam lock each joi,,,146.37,150.76,15
HCPCS,L2425,Knee disc/dial lock/adj flex,,,172.72,177.9,15
HCPCS,L2430,Knee jnt ratchet lock ea jnt,,,172.72,177.9,15
HCPCS,L2492,Knee lift loop drop lock rin,,,141.32,145.56,15
HCPCS,L2500,Thi/glut/ischia wgt bearing,,,377.04,388.35,15
HCPCS,L2510,HC THIGH WT BEAR QUAD LAT BRIM MOLDED,2421.0,1331.55,726.3,2130.48,50
HCPCS,L2520,Th/wght bear quad-lat brim c,,,647.63,667.06,15
HCPCS,L2525,Th/wght bear nar m-l brim mo,,,1373.3,1414.5,15
HCPCS,L2526,Th/wght bear nar m-l brim cu,,,771.65,794.8,15
HCPCS,L2530,"HC ADD TO LOWER EXTREMITY, THIGH WEIGHT BEARING, LACER, NON-MOLDED",1124.5,618.48,288.95,989.56,50
HCPCS,L2540,Thigh/wght bear lacer molded,,,546.76,563.16,15
HCPCS,L2550,Thigh/wght bear high roll cu,,,409.96,422.26,15
HCPCS,L2570,Hip clevis type 2 posit jnt,,,536.6,552.7,15
HCPCS,L2580,Pelvic control pelvic sling,,,522.86,538.55,15
HCPCS,L2600,Hip clevis/thrust bearing fr,,,256.98,264.69,15
HCPCS,L2610,Hip clevis/thrust bearing lo,,,283.97,292.49,15
HCPCS,L2620,Pelvic control hip heavy dut,,,301.22,310.26,15
HCPCS,L2622,Hip joint adjustable flexion,,,383.4,394.9,15
HCPCS,L2624,HC HIP ADJ FLEX EXT ABDUCT CONT,1033.5,568.43,310.05,909.48,50
HCPCS,L2627,Plastic mold recipro hip & c,,,2575.08,2652.33,15
HCPCS,L2628,Metal frame recipro hip & ca,,,1887.48,1944.1,15
HCPCS,L2630,Pelvic control band & belt u,,,278.97,287.34,15
HCPCS,L2640,Pelvic control band & belt b,,,378.59,389.95,15
HCPCS,L2650,Pelv & thor control gluteal,,,166.73,171.73,15
HCPCS,L2660,Thoracic control thoracic ba,,,215.88,222.36,15
HCPCS,L2670,Thorac cont paraspinal uprig,,,192.17,197.94,15
HCPCS,L2680,Thorac cont lat support upri,,,176.29,181.58,15
HCPCS,L2750,Plating chrome/nickel pr bar,,,94.16,96.98,15
HCPCS,L2755,Carbon graphite lamination,,,157.43,162.15,15
HCPCS,L2760,Extension per extension per,,,68.45,70.5,15
HCPCS,L2768,Ortho sidebar disconnect,,,156.97,161.68,15
HCPCS,L2780,Non-corrosive finish,,,76.25,78.54,15
HCPCS,L2785,Drop lock retainer each,,,35.7,36.77,15
HCPCS,L2795,Knee control full kneecap,,,98.82,101.78,15
HCPCS,L2800,Knee cap medial or lateral p,,,121.33,124.97,15
HCPCS,L2810,Knee control condylar pad,,,98.41,101.36,15
HCPCS,L2820,Soft interface below knee se,,,97.83,100.76,15
HCPCS,L2830,HC SOFT INTERFACE ABOVE KNEE SECTION,840.0,462.0,105.84,739.2,50
HCPCS,L2840,Tibial length sock fx or equ,,,51.98,53.54,15
HCPCS,L2850,Femoral lgth sock fx or equa,,,72.88,75.07,15
HCPCS,L3000,Ft insert ucb berkeley shell,,,378.49,389.84,15
HCPCS,L3001,Foot insert remov molded spe,,,159.37,164.15,15
HCPCS,L3002,Foot insert plastazote or eq,,,194.59,200.43,15
HCPCS,L3003,Foot insert silicone gel eac,,,209.91,216.21,15
HCPCS,L3010,Foot longitudinal arch suppo,,,209.91,216.21,15
HCPCS,L3020,Foot longitud/metatarsal sup,,,239.05,246.22,15
HCPCS,L3030,Foot arch support remov prem,,,91.93,94.69,15
HCPCS,L3031,Foot lamin/prepreg composite,,,147.56,151.99,15
HCPCS,L3040,Ft arch suprt premold longit,,,56.71,58.41,15
HCPCS,L3050,Foot arch supp premold metat,,,56.71,58.41,15
HCPCS,L3060,Foot arch supp longitud/meta,,,88.87,91.54,15
HCPCS,L3070,Arch suprt att to sho longit,,,38.31,39.46,15
HCPCS,L3080,Arch supp att to shoe metata,,,38.31,39.46,15
HCPCS,L3090,Arch supp att to shoe long/m,,,49.04,50.51,15
HCPCS,L3100,Hallus-valgus nt dyn pre ots,,,52.12,53.68,15
HCPCS,L3140,Abduction rotation bar shoe,,,107.26,110.48,15
HCPCS,L3150,Abduct rotation bar w/o shoe,,,98.09,101.03,15
HCPCS,L3170,Foot plas heel stabi pre ots,,,61.29,63.13,15
HCPCS,L3224,Woman's shoe oxford brace,,,81.41,83.85,15
HCPCS,L3225,Man's shoe oxford brace,,,88.92,91.59,15
HCPCS,L3250,HC ORTHOPED FTWEAR CUSTOM MOLD SHOE REM PROSTH EA,1292.0,710.6,387.6,1136.96,35
HCPCS,L3300,Sho lift taper to metatarsal,,,62.84,64.73,15
HCPCS,L3310,Shoe lift elev heel/sole neo,,,98.09,101.03,15
HCPCS,L3330,Lifts elevation metal extens,,,681.87,702.33,15
HCPCS,L3332,Shoe lifts tapered to one-ha,,,88.87,91.54,15
HCPCS,L3334,Shoe lifts elevation heel /i,,,45.95,47.33,15
HCPCS,L3340,Shoe wedge sach,,,102.69,105.77,15
HCPCS,L3350,Shoe heel wedge,,,27.56,28.39,15
HCPCS,L3360,Shoe sole wedge outside sole,,,42.9,44.19,15
HCPCS,L3370,Shoe sole wedge between sole,,,59.76,61.55,15
HCPCS,L3380,Shoe clubfoot wedge,,,59.76,61.55,15
HCPCS,L3390,Shoe outflare wedge,,,59.76,61.55,15
HCPCS,L3400,Shoe metatarsal bar wedge ro,,,49.04,50.51,15
HCPCS,L3410,Shoe metatarsal bar between,,,111.85,115.21,15
HCPCS,L3420,Full sole/heel wedge btween,,,65.89,67.87,15
HCPCS,L3430,Sho heel count plast reinfor,,,193.08,198.87,15
HCPCS,L3440,Heel leather reinforced,,,91.93,94.69,15
HCPCS,L3450,Shoe heel sach cushion type,,,127.15,130.96,15
HCPCS,L3455,Shoe heel new leather standa,,,49.04,50.51,15
HCPCS,L3460,Shoe heel new rubber standar,,,41.39,42.63,15
HCPCS,L3465,Shoe heel thomas with wedge,,,70.53,72.65,15
HCPCS,L3470,Shoe heel thomas extend to b,,,75.07,77.32,15
HCPCS,L3480,Shoe heel pad & depress for,,,75.07,77.32,15
HCPCS,L3500,Ortho shoe add leather insol,,,35.23,36.29,15
HCPCS,L3510,Orthopedic shoe add rub insl,,,35.23,36.29,15
HCPCS,L3520,O shoe add felt w leath insl,,,38.31,39.46,15
HCPCS,L3530,Ortho shoe add half sole,,,38.31,39.46,15
HCPCS,L3540,Ortho shoe add full sole,,,61.29,63.13,15
HCPCS,L3550,O shoe add standard toe tap,,,10.77,11.09,15
HCPCS,L3560,O shoe add horseshoe toe tap,,,27.56,28.39,15
HCPCS,L3570,O shoe add instep extension,,,102.69,105.77,15
HCPCS,L3580,O shoe add instep velcro clo,,,78.14,80.48,15
HCPCS,L3590,O shoe convert to sof counte,,,64.37,66.3,15
HCPCS,L3595,Ortho shoe add march bar,,,50.53,52.05,15
HCPCS,L3600,Trans shoe calip plate exist,,,91.93,94.69,15
HCPCS,L3610,Trans shoe caliper plate new,,,121.06,124.69,15
HCPCS,L3620,Trans shoe solid stirrup exi,,,91.93,94.69,15
HCPCS,L3630,Trans shoe solid stirrup new,,,121.06,124.69,15
HCPCS,L3640,Shoe dennis browne splint bo,,,52.12,53.68,15
HCPCS,L3650,So 8 abd restraint pre ots,,,79.02,81.39,15
HCPCS,L3660,So 8 ab rstr can/web pre ots,,,113.31,116.71,15
HCPCS,L3670,HC SO ACROMIO-CLAVICULAR PREFAB OTS,305.0,167.75,91.5,268.4,50
HCPCS,L3671,HC SO CAP DESIGN WO JT CUSTOM FAB,1187.5,653.13,356.25,1045.0,250
HCPCS,L3674,SO airplane w/wo joint CF,,,1296.14,1335.02,15
HCPCS,L3675,So vest canvas/web pre ots,,,192.46,198.23,15
HCPCS,L3702,HC EO WO JT CUSTOM FAB,375.5,206.53,112.65,330.44,350
HCPCS,L3710,Eo elas w/metal jnts pre ots,,,156.57,161.27,15
HCPCS,L3720,Forearm/arm cuffs free motio,,,749.24,771.72,15
HCPCS,L3730,Forearm/arm cuffs ext/flex a,,,993.78,1023.59,15
HCPCS,L3740,Cuffs adj lock w/ active con,,,1178.21,1213.56,15
HCPCS,L3760,"HC BLEDSOE, EO, W/ ADJ POSITION LOCK JT(S), PREFAB, CUSTOM FIT SPECIFIC PAT",628.5,345.68,188.55,564.84,250
HCPCS,L3761,"Eo, adj lock joint prefab ot",,,548.39,564.84,15
HCPCS,L3762,Eo rigid w/o joints pre ots,,,117.89,121.43,15
HCPCS,L3763,HC EWHO RIGID WO JT CUSTOM FAB,886.5,487.58,265.95,845.2,350
HCPCS,L3764,HC EWHO W JT CUSTOM FAB,983.0,540.65,294.9,884.52,300
HCPCS,L3765,HC EWHFO RIGID WO JT CUSTOM FAB,1608.5,884.68,482.55,1448.21,250
HCPCS,L3766,EWHFO w/joint(s) CF,,,1488.9,1533.57,15
HCPCS,L3806,HC WHFO W JOINT(S) CUSTOM FAB,960.5,528.28,288.15,845.24,250
HCPCS,L3807,HC WHFO WO JOINTS PREFAB CUSTOM FIT,325.5,179.03,97.65,286.44,250
HCPCS,L3808,"HC WHFO RIGID W/O JOINTS, MAY INCLD SOFT INTERFACE MATERIAL; STRAPS, CUSTOM",575.0,316.25,172.5,506.0,350
HCPCS,L3809,Whfo w/o joints pre ots,,,274.19,282.42,15
HCPCS,L3900,Hinge extension/flex wrist/f,,,1776.32,1829.61,15
HCPCS,L3901,Hinge ext/flex wrist finger,,,2327.97,2397.81,15
HCPCS,L3904,Whfo electric custom fitted,,,3701.21,3812.25,15
HCPCS,L3905,HC WHO W NONTORSION JT CUSTOM FAB,593.5,326.43,178.05,1120.03,300
HCPCS,L3906,HC WHO WO JT CUSTOM FAB,441.0,242.55,132.3,572.35,300
HCPCS,L3908,Who cock-up nonmolde pre ots,,,80.39,82.8,15
HCPCS,L3912,Hfo flexion glove pre ots,,,115.53,119.0,15
HCPCS,L3913,HC HFO WO JT CUSTOM FAB,352.5,193.88,105.75,310.2,350
HCPCS,L3915,Who nontorsion jnts pre cst,,,582.88,600.37,15
HCPCS,L3916,Who nontorsion jnts pre ots,,,582.88,600.37,15
HCPCS,L3917,Metacarp fx orthosis pre cst,,,115.79,119.26,15
HCPCS,L3918,Metacarp fx orthosis pre ots,,,115.79,119.26,15
HCPCS,L3919,HC HO WO JT CUSTOM FAB,353.5,194.43,106.05,311.08,350
HCPCS,L3921,HC HFO W JT CUSTOM FAB,417.5,229.63,125.25,367.4,300
HCPCS,L3923,Hfo without joints pre cst,,,105.92,109.1,15
HCPCS,L3924,Hfo without joints pre ots,,,105.92,109.1,15
HCPCS,L3925,Fo pip dip jnt/sprng pre ots,,,72.03,74.19,15
HCPCS,L3927,Fo pip dip no jt spr pre ots,,,38.38,39.53,15
HCPCS,L3929,Hfo nontorsion jnts pre cst,,,100.16,103.16,15
HCPCS,L3930,Hfo nontorsion jnts pre ots,,,100.16,103.16,15
HCPCS,L3931,HC WHFO NONTORSION JOINT PREFAB,272.0,149.6,81.6,239.36,350
HCPCS,L3933,HC FO WO JT CUSTOM FAB,277.5,152.63,83.25,244.2,350
HCPCS,L3935,FO nontorsion joint CF,,,242.23,249.5,15
HCPCS,L3960,Sewho airplan desig abdu pos,,,874.56,900.8,15
HCPCS,L3961,SEWHO cap design w/o jnts CF,,,1842.32,1897.59,15
HCPCS,L3962,Sewho erbs palsey design abd,,,790.98,814.71,15
HCPCS,L3967,SEWHO airplane w/o jnts CF,,,2175.13,2240.38,15
HCPCS,L3971,SEWHO cap design w/jnt(s) CF,,,2064.71,2126.65,15
HCPCS,L3973,SEWHO airplane w/jnt(s) CF,,,2175.13,2240.38,15
HCPCS,L3975,SEWHFO cap design w/o jnt CF,,,1842.32,1897.59,15
HCPCS,L3976,SEWHFO airplane w/o jnts CF,,,1842.32,1897.59,15
HCPCS,L3977,SEWHFO cap desgn w/jnt(s) CF,,,2064.71,2126.65,15
HCPCS,L3978,SEWHFO airplane w/jnt(s) CF,,,2175.13,2240.38,15
HCPCS,L3980,Up ext fx orthos humeral nos,,,424.21,436.94,15
HCPCS,L3981,Ue fx orth shoul cap forearm,,,1103.73,1136.84,15
HCPCS,L3982,Upper ext fx orthosis rad/ul,,,430.74,443.66,15
HCPCS,L3984,Upper ext fx orthosis wrist,,,379.44,390.82,15
HCPCS,L3995,Sock fracture or equal each,,,45.02,46.37,15
HCPCS,L4000,Repl girdle milwaukee orth,,,1592.13,1639.89,15
HCPCS,L4010,Replace trilateral socket br,,,967.72,996.75,15
HCPCS,L4020,Replace quadlat socket brim,,,1162.49,1197.36,15
HCPCS,L4030,Replace socket brim cust fit,,,738.73,760.89,15
HCPCS,L4040,Replace molded thigh lacer,,,500.28,515.29,15
HCPCS,L4045,Replace non-molded thigh lac,,,369.55,380.64,15
HCPCS,L4050,Replace molded calf lacer,,,495.46,510.32,15
HCPCS,L4055,Replace non-molded calf lace,,,301.17,310.21,15
HCPCS,L4060,Replace high roll cuff,,,391.49,403.23,15
HCPCS,L4070,Replace prox & dist upright,,,317.05,326.56,15
HCPCS,L4080,Repl met band kafo-afo prox,,,119.7,123.29,15
HCPCS,L4090,Repl met band kafo-afo calf/,,,101.84,104.9,15
HCPCS,L4100,Repl leath cuff kafo prox th,,,122.36,126.03,15
HCPCS,L4110,Repl leath cuff kafo-afo cal,,,95.54,98.41,15
HCPCS,L4130,Replace pretibial shell,,,577.5,594.83,15
HCPCS,L4205,Ortho dvc repair per 15 min,,,29.13,30.0,15
HCPCS,L4350,Ankle control ortho pre ots,,,116.57,120.07,15
HCPCS,L4360,HC PNEUMATIC WALKING BOOT W WO JOINTS PREFAB CUSTOM FIT,351.5,193.33,105.45,321.3,50
HCPCS,L4361,Pneuma/vac walk boot pre ots,,,311.94,321.3,15
HCPCS,L4370,Pneum full leg splnt pre ots,,,283.58,292.09,15
HCPCS,L4386,HC NON-PNEUMATIC WALKING BOOT W WO JOINTS PREFAB CUSTOM FIT,370.0,203.5,111.0,325.6,50
HCPCS,L4387,Non-pneum walk boot pre ots,,,191.04,196.77,15
HCPCS,L4392,Replace AFO soft interface,,,28.34,29.19,15
HCPCS,L4394,Replace foot drop spint,,,20.68,21.3,15
HCPCS,L4396,HC STATIC DYNAMIC AFO ADJ PREFAB CUSTOM FIT,337.5,185.63,101.25,297.0,50
HCPCS,L4396,HC STATIC DYNAMIC AFO ADJ PREFAB CUSTOM FIT DEMI,348.0,191.4,104.4,306.24,50
HCPCS,L4396,HC STATIC DYNAMIC AFO ADJ PREFAB CUSTOM FIT SPENCO,294.5,161.98,88.35,259.16,50
HCPCS,L4397,HC STATIC OR DYNAMIC AFO ADJ PREFAB OTS,337.5,185.63,101.25,297.0,200
HCPCS,L4398,SPLINT ANKLE SEATTLE LG 18-20,523.25,287.79,93.06,460.46,50
HCPCS,L4631,"Afo, walk boot type, cus fab",,,1776.15,1829.43,15
HCPCS,L5000,Sho insert w arch toe filler,,,691.87,712.63,15
HCPCS,L5010,Mold socket ank hgt w/ toe f,,,1933.16,1991.15,15
HCPCS,L5020,Tibial tubercle hgt w/ toe f,,,3028.63,3119.49,15
HCPCS,L5050,Ank symes mold sckt sach ft,,,3307.84,3407.08,15
HCPCS,L5060,Symes met fr leath socket ar,,,4077.61,4199.94,15
HCPCS,L5100,Molded socket shin sach foot,,,3293.69,3392.5,15
HCPCS,L5105,Plast socket jts/thgh lacer,,,4648.11,4787.55,15
HCPCS,L5150,Mold sckt ext knee shin sach,,,5167.59,5322.62,15
HCPCS,L5160,Mold socket bent knee shin s,,,5673.77,5843.98,15
HCPCS,L5200,Kne sing axis fric shin sach,,,4388.25,4519.9,15
HCPCS,L5210,No knee/ankle joints w/ ft b,,,3484.26,3588.79,15
HCPCS,L5220,No knee joint with artic ali,,,3838.15,3953.29,15
HCPCS,L5230,Fem focal defic constant fri,,,5756.63,5929.33,15
HCPCS,L5250,Hip canad sing axi cons fric,,,6749.81,6952.3,15
HCPCS,L5270,Tilt table locking hip sing,,,7520.6,7746.22,15
HCPCS,L5280,Hemipelvect canad sing axis,,,7310.32,7529.63,15
HCPCS,L5301,BK mold socket SACH ft endo,,,3234.32,3331.35,15
HCPCS,L5312,"Knee disart, SACH ft, endo",,,5095.91,5248.79,15
HCPCS,L5321,AK open end SACH,,,4312.87,4442.26,15
HCPCS,L5331,Hip disart canadian SACH ft,,,6316.78,6506.28,15
HCPCS,L5341,Hemipelvectomy canadian SACH,,,6714.65,6916.09,15
HCPCS,L5400,Postop dress & 1 cast chg bk,,,1926.05,1983.83,15
HCPCS,L5410,Postop dsg bk ea add cast ch,,,532.11,548.07,15
HCPCS,L5420,Postop dsg & 1 cast chg ak/d,,,2432.52,2505.5,15
HCPCS,L5430,Postop dsg ak ea add cast ch,,,660.3,680.11,15
HCPCS,L5450,HC BK RIDGE REMOVABLE SPLINT,2942.5,1618.38,570.93,2589.4,50
HCPCS,L5460,Postop app non-wgt bear dsg,,,748.84,771.31,15
HCPCS,L5500,Init bk ptb plaster direct,,,1780.23,1833.64,15
HCPCS,L5505,Init ak ischal plstr direct,,,2504.29,2579.42,15
HCPCS,L5510,Prep BK ptb plaster molded,,,2125.9,2189.68,15
HCPCS,L5520,Perp BK ptb thermopls direct,,,1905.61,1962.78,15
HCPCS,L5530,Prep BK ptb thermopls molded,,,2505.05,2580.2,15
HCPCS,L5535,Prep BK ptb open end socket,,,2335.24,2405.3,15
HCPCS,L5540,HC PREP BK PTB LAMINATED SOCKET,7728.0,4250.4,2318.4,6800.64,50
HCPCS,L5560,Prep AK ischial plast molded,,,2818.25,2902.8,15
HCPCS,L5570,Prep AK ischial direct form,,,2735.22,2817.28,15
HCPCS,L5580,Prep AK ischial thermo mold,,,3394.81,3496.65,15
HCPCS,L5585,Prep AK ischial open end,,,3975.58,4094.85,15
HCPCS,L5590,Prep AK ischial laminated,,,3539.42,3645.6,15
HCPCS,L5595,Hip disartic sach thermopls,,,5531.2,5697.14,15
HCPCS,L5600,Hip disart sach laminat mold,,,6295.32,6484.18,15
HCPCS,L5610,Above knee hydracadence,,,3036.2,3127.29,15
HCPCS,L5611,Ak 4 bar link w/fric swing,,,1933.8,1991.81,15
HCPCS,L5613,Ak 4 bar ling w/hydraul swig,,,2941.43,3029.67,15
HCPCS,L5614,4-bar link above knee w/swng,,,2037.14,2098.25,15
HCPCS,L5615,Ak 4 bar link hydl swg/stanc,,,6792.14,6995.9,15
HCPCS,L5616,Ak univ multiplex sys frict,,,1773.59,1826.8,15
HCPCS,L5617,AK/BK self-aligning unit ea,,,675.45,695.71,15
HCPCS,L5618,Test socket symes,,,403.36,415.46,15
HCPCS,L5620,Test socket below knee,,,357.88,368.62,15
HCPCS,L5622,Test socket knee disarticula,,,482.15,496.61,15
HCPCS,L5624,Test socket above knee,,,481.97,496.43,15
HCPCS,L5626,Test socket hip disarticulat,,,763.01,785.9,15
HCPCS,L5628,Test socket hemipelvectomy,,,772.66,795.84,15
HCPCS,L5629,Below knee acrylic socket,,,381.43,392.87,15
HCPCS,L5630,Syme typ expandabl wall sckt,,,662.75,682.63,15
HCPCS,L5631,Ak/knee disartic acrylic soc,,,527.36,543.18,15
HCPCS,L5632,Symes type ptb brim design s,,,325.04,334.79,15
HCPCS,L5634,Symes type poster opening so,,,406.49,418.68,15
HCPCS,L5636,Symes type medial opening so,,,310.7,320.02,15
HCPCS,L5637,Below knee total contact,,,462.31,476.18,15
HCPCS,L5638,Below knee leather socket,,,778.81,802.17,15
HCPCS,L5639,Below knee wood socket,,,1345.68,1386.05,15
HCPCS,L5640,Knee disarticulat leather so,,,884.52,911.06,15
HCPCS,L5642,Above knee leather socket,,,819.92,844.52,15
HCPCS,L5643,Hip flex inner socket ext fr,,,2418.36,2490.91,15
HCPCS,L5644,Above knee wood socket,,,708.91,730.18,15
HCPCS,L5645,Bk flex inner socket ext fra,,,1176.04,1211.32,15
HCPCS,L5646,Below knee cushion socket,,,745.29,767.65,15
HCPCS,L5647,Below knee suction socket,,,954.75,983.39,15
HCPCS,L5648,Above knee cushion socket,,,880.62,907.04,15
HCPCS,L5649,Isch containmt/narrow m-l so,,,2958.96,3047.73,15
HCPCS,L5650,Tot contact ak/knee disart s,,,585.94,603.52,15
HCPCS,L5651,Ak flex inner socket ext fra,,,1716.73,1768.23,15
HCPCS,L5652,Suction susp ak/knee disart,,,523.28,538.98,15
HCPCS,L5653,Knee disart expand wall sock,,,816.48,840.97,15
HCPCS,L5654,Socket insert symes,,,473.3,487.5,15
HCPCS,L5655,Socket insert below knee,,,341.73,351.98,15
HCPCS,L5656,Socket insert knee articulat,,,519.16,534.73,15
HCPCS,L5658,Socket insert above knee,,,547.98,564.42,15
HCPCS,L5661,Multi-durometer symes,,,786.24,809.83,15
HCPCS,L5665,Multi-durometer below knee,,,698.99,719.96,15
HCPCS,L5666,Below knee cuff suspension,,,92.55,95.33,15
HCPCS,L5668,Bk molded distal cushion,,,137.86,142.0,15
HCPCS,L5670,Bk molded supracondylar susp,,,325.69,335.46,15
HCPCS,L5671,BK/AK locking mechanism,,,597.02,614.93,15
HCPCS,L5672,Bk removable medial brim sus,,,430.98,443.91,15
HCPCS,L5673,Socket insert w lock mech,,,948.84,977.31,15
HCPCS,L5676,Bk knee joints single axis p,,,434.94,447.99,15
HCPCS,L5677,Bk knee joints polycentric p,,,666.1,686.08,15
HCPCS,L5678,Bk joint covers pair,,,47.66,49.09,15
HCPCS,L5679,HC BELOW KNEE ADD SOCKET INSERT,5158.5,2837.18,790.68,4539.48,50
HCPCS,L5680,Bk thigh lacer non-molded,,,365.32,376.28,15
HCPCS,L5681,Intl custm cong/latyp insert,,,1587.98,1635.62,15
HCPCS,L5682,Bk thigh lacer glut/ischia m,,,750.62,773.14,15
HCPCS,L5683,Initial custom socket insert,,,1587.98,1635.62,15
HCPCS,L5684,Bk fork strap,,,57.77,59.5,15
HCPCS,L5685,HC BELOW KNEE SUS SEAL SLEEVE,308.5,169.68,92.55,271.48,50
HCPCS,L5686,Bk back check,,,69.48,71.56,15
HCPCS,L5688,Bk waist belt webbing,,,73.8,76.01,15
HCPCS,L5690,Bk waist belt padded and lin,,,150.64,155.16,15
HCPCS,L5692,Ak pelvic control belt light,,,159.48,164.26,15
HCPCS,L5694,Ak pelvic control belt pad/l,,,217.74,224.27,15
HCPCS,L5695,Ak sleeve susp neoprene/equa,,,195.73,201.6,15
HCPCS,L5696,Ak/knee disartic pelvic join,,,236.44,243.53,15
HCPCS,L5697,Ak/knee disartic pelvic band,,,112.28,115.65,15
HCPCS,L5698,Ak/knee disartic silesian ba,,,144.04,148.36,15
HCPCS,L5699,Shoulder harness,,,246.18,253.57,15
HCPCS,L5700,Replace socket below knee,,,3702.93,3814.02,15
HCPCS,L5701,Replace socket above knee,,,4593.82,4731.63,15
HCPCS,L5702,Replace socket hip,,,5789.81,5963.5,15
HCPCS,L5703,Symes ankle w/o (SACH) foot,,,3045.61,3136.98,15
HCPCS,L5704,Custom shape cover BK,,,755.01,777.66,15
HCPCS,L5705,Custom shape cover AK,,,1384.22,1425.75,15
HCPCS,L5706,Custom shape cvr knee disart,,,1350.12,1390.62,15
HCPCS,L5707,Custom shape cvr hip disart,,,1813.93,1868.35,15
HCPCS,L5710,Kne-shin exo sng axi mnl loc,,,431.68,444.63,15
HCPCS,L5711,Knee-shin exo mnl lock ultra,,,724.48,746.21,15
HCPCS,L5712,Knee-shin exo frict swg & st,,,517.18,532.7,15
HCPCS,L5714,Knee-shin exo variable frict,,,526.23,542.02,15
HCPCS,L5716,Knee-shin exo mech stance ph,,,1040.55,1071.77,15
HCPCS,L5718,Knee-shin exo frct swg & sta,,,1112.67,1146.05,15
HCPCS,L5722,Knee-shin pneum swg frct exo,,,1353.09,1393.68,15
HCPCS,L5724,Knee-shin exo fluid swing ph,,,2085.56,2148.13,15
HCPCS,L5726,Knee-shin ext jnts fld swg e,,,2482.94,2557.43,15
HCPCS,L5728,Knee-shin fluid swg & stance,,,2909.74,2997.03,15
HCPCS,L5780,Knee-shin pneum/hydra pneum,,,1602.03,1650.09,15
HCPCS,L5781,Lower limb pros vacuum pump,,,4830.29,4975.2,15
HCPCS,L5782,HD low limb pros vacuum pump,,,5092.22,5244.99,15
HCPCS,L5783,Add low ext mec limb vol lam,,,3088.3,3180.95,15
HCPCS,L5785,Exoskeletal bk ultralt mater,,,623.59,642.3,15
HCPCS,L5790,Exoskeletal ak ultra-light m,,,899.99,926.99,15
HCPCS,L5795,Exoskel hip ultra-light mate,,,1288.69,1327.35,15
HCPCS,L5810,Endoskel knee-shin mnl lock,,,686.6,707.2,15
HCPCS,L5811,Endo knee-shin mnl lck ultra,,,947.52,975.95,15
HCPCS,L5812,Endo knee-shin frct swg & st,,,713.05,734.44,15
HCPCS,L5814,Endo knee-shin hydral swg ph,,,4483.45,4617.95,15
HCPCS,L5816,Endo knee-shin polyc mch sta,,,1020.74,1051.36,15
HCPCS,L5818,Endo knee-shin frct swg & st,,,1152.62,1187.2,15
HCPCS,L5822,Endo knee-shin pneum swg frc,,,2114.46,2177.89,15
HCPCS,L5824,Endo knee-shin fluid swing p,,,1998.78,2058.74,15
HCPCS,L5826,Miniature knee joint,,,3770.02,3883.12,15
HCPCS,L5827,Endo knee shin single axis,,,7019.27,7229.85,15
HCPCS,L5828,Endo knee-shin fluid swg/sta,,,3557.34,3664.06,15
HCPCS,L5830,Endo knee-shin pneum/swg pha,,,2398.6,2470.56,15
HCPCS,L5840,Multi-axial knee/shin system,,,4707.8,4849.03,15
HCPCS,L5841,Addition endoskletl knee-shi,,,2759.19,2841.97,15
HCPCS,L5845,Knee-shin sys stance flexion,,,2163.77,2228.68,15
HCPCS,L5848,Knee-shin sys hydraul stance,,,1298.16,1337.1,15
HCPCS,L5850,Endo ak/hip knee extens assi,,,153.54,158.15,15
HCPCS,L5855,Mech hip extension assist,,,370.68,381.8,15
HCPCS,L5856,Elec knee-shin swing/stance,,,28980.18,29849.59,15
HCPCS,L5857,Elec knee-shin swing only,,,10283.25,10591.75,15
HCPCS,L5858,Stance phase only,,,22436.32,23109.41,15
HCPCS,L5859,Knee-shin pro flex/ext cont,,,17515.82,18041.29,15
HCPCS,L5910,HC ADD ENDOSKEL SYS BELOW KNEE ALIGNABLE SYS,657.0,361.35,197.1,578.16,50
HCPCS,L5920,Endo ak/hip alignable system,,,636.84,655.95,15
HCPCS,L5925,Above knee manual lock,,,403.29,415.39,15
HCPCS,L5926,Endoskel posit rotat unit,,,776.22,799.51,15
HCPCS,L5930,High activity knee frame,,,4063.39,4185.29,15
HCPCS,L5940,Endo bk ultra-light material,,,602.05,620.11,15
HCPCS,L5950,Endo ak ultra-light material,,,933.8,961.81,15
HCPCS,L5960,Endo hip ultra-light materia,,,1396.26,1438.15,15
HCPCS,L5961,"Endo poly hip, pneu/hyd/rot",,,5762.36,5935.23,15
HCPCS,L5962,Below knee flex cover system,,,705.49,726.65,15
HCPCS,L5964,Above knee flex cover system,,,1353.27,1393.87,15
HCPCS,L5966,Hip flexible cover system,,,1743.25,1795.55,15
HCPCS,L5968,Multiaxial ankle w dorsiflex,,,4386.88,4518.49,15
HCPCS,L5970,Foot external keel sach foot,,,262.23,270.1,15
HCPCS,L5971,"SACH foot, replacement",,,262.23,270.1,15
HCPCS,L5972,Flexible keel foot,,,477.68,492.01,15
HCPCS,L5973,Ank-foot sys dors-plant flex,,,21313.25,21952.65,15
HCPCS,L5974,Foot single axis ankle/foot,,,279.69,288.08,15
HCPCS,L5975,Combo ankle/foot prosthesis,,,559.67,576.46,15
HCPCS,L5976,Energy storing foot,,,709.45,730.73,15
HCPCS,L5978,Ft prosth multiaxial ankl/ft,,,375.92,387.2,15
HCPCS,L5979,Multi-axial ankle/ft prosth,,,3009.91,3100.21,15
HCPCS,L5980,Flex foot system,,,4585.87,4723.45,15
HCPCS,L5981,Flex-walk sys low ext prosth,,,4119.22,4242.8,15
HCPCS,L5982,Exoskeletal axial rotation u,,,773.83,797.04,15
HCPCS,L5984,Endoskeletal axial rotation,,,776.22,799.51,15
HCPCS,L5985,Lwr ext dynamic prosth pylon,,,340.91,351.14,15
HCPCS,L5986,Multi-axial rotation unit,,,936.35,964.44,15
HCPCS,L5987,Shank ft w vert load pylon,,,8684.41,8944.94,15
HCPCS,L5988,Vertical shock reducing pylo,,,2411.64,2483.99,15
HCPCS,L5990,User adjustable heel height,,,2190.07,2255.77,15
HCPCS,L5991,IMPL BIOHELIX 21X80 -12,64575.0,35516.25,11524.55,56826.0,50
HCPCS,L5999,HC LOWER EXTREMITY PROSTHESIS NOS,1596.0,877.8,478.8,1404.48,35
HCPCS,L6000,Part hand thumb rem,,,2126.34,2190.13,15
HCPCS,L6010,Part hand little/ring,,,2366.26,2437.25,15
HCPCS,L6020,Part hand no fingers,,,2206.16,2272.34,15
HCPCS,L6026,Part hand myo exclu term dev,,,5251.23,5408.77,15
HCPCS,L6050,Wrst MLd sck flx hng tri pad,,,3000.82,3090.84,15
HCPCS,L6055,Wrst mold sock w/exp interfa,,,3827.72,3942.55,15
HCPCS,L6100,Elb mold sock flex hinge pad,,,3036.73,3127.83,15
HCPCS,L6110,Elbow mold sock suspension t,,,3212.66,3309.04,15
HCPCS,L6120,Elbow mold doub splt soc ste,,,3633.53,3742.54,15
HCPCS,L6130,Elbow stump activated lock h,,,3833.45,3948.45,15
HCPCS,L6200,Elbow mold outsid lock hinge,,,3948.9,4067.37,15
HCPCS,L6205,Elbow molded w/ expand inter,,,5447.43,5610.85,15
HCPCS,L6250,Elbow inter loc elbow forarm,,,3885.03,4001.58,15
HCPCS,L6300,Shlder disart int lock elbow,,,5358.53,5519.29,15
HCPCS,L6310,Shoulder passive restor comp,,,4856.35,5002.04,15
HCPCS,L6320,Shoulder passive restor cap,,,2530.97,2606.9,15
HCPCS,L6350,Thoracic intern lock elbow,,,5871.29,6047.43,15
HCPCS,L6360,Thoracic passive restor comp,,,5097.31,5250.23,15
HCPCS,L6370,Thoracic passive restor cap,,,2956.1,3044.78,15
HCPCS,L6380,Postop dsg cast chg wrst/elb,,,1709.72,1761.01,15
HCPCS,L6382,Postop dsg cast chg elb dis/,,,2035.34,2096.4,15
HCPCS,L6384,Postop dsg cast chg shlder/t,,,2574.83,2652.07,15
HCPCS,L6386,Postop ea cast chg & realign,,,564.42,581.35,15
HCPCS,L6388,Postop applicat rigid dsg on,,,621.56,640.21,15
HCPCS,L6400,Below elbow prosth tiss shap,,,3284.97,3383.52,15
HCPCS,L6450,Elb disart prosth tiss shap,,,4293.29,4422.09,15
HCPCS,L6500,Above elbow prosth tiss shap,,,4215.93,4342.41,15
HCPCS,L6550,Shldr disar prosth tiss shap,,,5460.5,5624.32,15
HCPCS,L6570,Scap thorac prosth tiss shap,,,6095.93,6278.81,15
HCPCS,L6580,Wrist/elbow bowden cable mol,,,2437.29,2510.41,15
HCPCS,L6582,Wrist/elbow bowden cbl dir f,,,2047.0,2108.41,15
HCPCS,L6584,Elbow fair lead cable molded,,,3031.05,3121.98,15
HCPCS,L6586,Elbow fair lead cable dir fo,,,2700.85,2781.88,15
HCPCS,L6588,Shdr fair lead cable molded,,,4301.46,4430.5,15
HCPCS,L6590,Shdr fair lead cable direct,,,3748.87,3861.34,15
HCPCS,L6600,Polycentric hinge pair,,,273.82,282.03,15
HCPCS,L6605,Single pivot hinge pair,,,281.84,290.3,15
HCPCS,L6610,Flexible metal hinge pair,,,266.44,274.43,15
HCPCS,L6611,"Additional switch, ext power",,,497.03,511.94,15
HCPCS,L6615,Disconnect locking wrist uni,,,258.63,266.39,15
HCPCS,L6616,Disconnect insert locking wr,,,77.85,80.19,15
HCPCS,L6620,Flexion/extension wrist unit,,,452.13,465.69,15
HCPCS,L6621,Flex/ext wrist w/wo friction,,,2761.27,2844.11,15
HCPCS,L6623,Spring-ass rot wrst w/ latch,,,861.3,887.14,15
HCPCS,L6624,Flex/ext/rotation wrist unit,,,4546.46,4682.85,15
HCPCS,L6625,Rotation wrst w/ cable lock,,,638.35,657.5,15
HCPCS,L6628,Quick disconn hook adapter o,,,687.12,707.73,15
HCPCS,L6629,Lamination collar w/ couplin,,,234.13,241.15,15
HCPCS,L6630,Stainless steel any wrist,,,344.9,355.25,15
HCPCS,L6632,Latex suspension sleeve each,,,77.98,80.32,15
HCPCS,L6635,Lift assist for elbow,,,249.27,256.75,15
HCPCS,L6637,Nudge control elbow lock,,,488.04,502.68,15
HCPCS,L6638,Elec lock on manual pw elbow,,,3018.93,3109.5,15
HCPCS,L6640,Shoulder abduction joint pai,,,406.45,418.64,15
HCPCS,L6641,Excursion amplifier pulley t,,,236.68,243.78,15
HCPCS,L6642,Excursion amplifier lever ty,,,347.98,358.42,15
HCPCS,L6645,Shoulder flexion-abduction j,,,439.56,452.75,15
HCPCS,L6646,Multipo locking shoulder jnt,,,3807.55,3921.78,15
HCPCS,L6647,Shoulder lock actuator,,,626.85,645.66,15
HCPCS,L6648,Ext pwrd shlder lock/unlock,,,3926.95,4044.76,15
HCPCS,L6650,Shoulder universal joint,,,476.75,491.05,15
HCPCS,L6655,Standard control cable extra,,,92.49,95.26,15
HCPCS,L6660,Heavy duty control cable,,,123.76,127.47,15
HCPCS,L6665,Teflon or equal cable lining,,,55.27,56.93,15
HCPCS,L6670,Hook to hand cable adapter,,,57.56,59.29,15
HCPCS,L6672,Harness chest/shlder saddle,,,264.15,272.07,15
HCPCS,L6675,Harness figure of 8 sing con,,,144.14,148.46,15
HCPCS,L6676,Harness figure of 8 dual con,,,150.8,155.32,15
HCPCS,L6677,UE triple control harness,,,358.1,368.84,15
HCPCS,L6680,Test sock wrist disart/bel e,,,371.28,382.42,15
HCPCS,L6682,Test sock elbw disart/above,,,410.5,422.82,15
HCPCS,L6684,Test socket shldr disart/tho,,,557.82,574.55,15
HCPCS,L6686,Suction socket,,,827.74,852.57,15
HCPCS,L6687,Frame typ socket bel elbow/w,,,692.31,713.08,15
HCPCS,L6688,Frame typ sock above elb/dis,,,766.21,789.2,15
HCPCS,L6689,Frame typ socket shoulder di,,,913.18,940.58,15
HCPCS,L6690,Frame typ sock interscap-tho,,,1075.13,1107.38,15
HCPCS,L6691,Removable insert each,,,424.39,437.12,15
HCPCS,L6692,"HC SILICONE GEL INSERT OR EQUAL, W/WO LOCKING MECHANISM, EA",2958.0,1626.9,772.09,2603.04,50
HCPCS,L6693,Lockingelbow forearm cntrbal,,,3427.3,3530.12,15
HCPCS,L6694,Elbow socket ins use w/lock,,,948.84,977.31,15
HCPCS,L6695,Elbow socket ins use w/o lck,,,790.68,814.4,15
HCPCS,L6696,Cus elbo skt in for con/atyp,,,1587.98,1635.62,15
HCPCS,L6697,Cus elbo skt in not con/atyp,,,1587.98,1635.62,15
HCPCS,L6698,Add up-ex prosthes lock mech,,,597.02,614.93,15
HCPCS,L6700,Ue add ext power myoel,,,28931.56,29799.51,15
HCPCS,L6703,"Term dev, passive hand mitt",,,422.25,434.92,15
HCPCS,L6704,"Term dev, sport/rec/work att",,,815.05,839.5,15
HCPCS,L6706,Term dev mech hook vol open,,,505.79,520.96,15
HCPCS,L6707,Term dev mech hook vol close,,,1789.26,1842.94,15
HCPCS,L6708,Term dev mech hand vol open,,,1182.76,1218.24,15
HCPCS,L6709,Term dev mech hand vol close,,,1678.64,1729.0,15
HCPCS,L6711,"Ped term dev, hook, vol open",,,811.62,835.97,15
HCPCS,L6712,"Ped term dev, hook, vol clos",,,1494.39,1539.22,15
HCPCS,L6713,"Ped term dev, hand, vol open",,,1886.02,1942.6,15
HCPCS,L6714,"Ped term dev, hand, vol clos",,,1597.45,1645.37,15
HCPCS,L6715,"Term device, multi art digit",,,3811.37,3925.71,15
HCPCS,L6721,"Hook/hand, hvy dty, vol open",,,2839.36,2924.54,15
HCPCS,L6722,"Hook/hand, hvy dty, vol clos",,,2447.69,2521.12,15
HCPCS,L6805,Term dev modifier wrist unit,,,463.0,476.89,15
HCPCS,L6810,Term dev precision pinch dev,,,246.14,253.52,15
HCPCS,L6880,Elec hand ind art digits,,,28843.34,29708.64,15
HCPCS,L6881,Term dev auto grasp feature,,,4935.41,5083.47,15
HCPCS,L6882,Microprocessor control uplmb,,,3743.74,3856.05,15
HCPCS,L6883,Replc sockt below e/w disa,,,2398.11,2470.05,15
HCPCS,L6884,Replc sockt above elbow disa,,,3281.15,3379.58,15
HCPCS,L6885,Replc sockt shldr dis/interc,,,5097.31,5250.23,15
HCPCS,L6890,Prefab glove for term device,,,241.11,248.34,15
HCPCS,L6895,Custom glove for term device,,,806.21,830.4,15
HCPCS,L6900,Hand restorat thumb/1 finger,,,2341.16,2411.39,15
HCPCS,L6905,Hand restoration multiple fi,,,2317.09,2386.6,15
HCPCS,L6910,Hand restoration no fingers,,,2277.86,2346.2,15
HCPCS,L6915,Hand restoration replacmnt g,,,978.71,1008.07,15
HCPCS,L6920,Wrist disarticul switch ctrl,,,10112.75,10416.13,15
HCPCS,L6925,Wrist disart myoelectronic c,,,10803.79,11127.9,15
HCPCS,L6930,Below elbow switch control,,,9740.0,10032.2,15
HCPCS,L6935,Below elbow myoelectronic ct,,,10753.02,11075.61,15
HCPCS,L6940,Elbow disarticulation switch,,,12577.53,12954.86,15
HCPCS,L6945,Elbow disart myoelectronic c,,,14031.86,14452.82,15
HCPCS,L6950,Above elbow switch control,,,12554.2,12930.83,15
HCPCS,L6955,Above elbow myoelectronic ct,,,14558.92,14995.69,15
HCPCS,L6960,Shldr disartic switch contro,,,15315.43,15774.89,15
HCPCS,L6965,Shldr disartic myoelectronic,,,18143.5,18687.81,15
HCPCS,L6970,Interscapular-thor switch ct,,,19420.61,20003.23,15
HCPCS,L6975,Interscap-thor myoelectronic,,,21406.09,22048.27,15
HCPCS,L7007,Adult electric hand,,,4409.36,4541.64,15
HCPCS,L7008,Pediatric electric hand,,,6837.6,7042.73,15
HCPCS,L7009,Adult electric hook,,,4511.3,4646.64,15
HCPCS,L7040,Prehensile actuator,,,3671.91,3782.07,15
HCPCS,L7045,Pediatric electric hook,,,1939.99,1998.19,15
HCPCS,L7170,Electronic elbow hosmer swit,,,7261.64,7479.49,15
HCPCS,L7180,Electronic elbow sequential,,,46980.38,48389.79,15
HCPCS,L7181,Electronic elbo simultaneous,,,48370.76,49821.88,15
HCPCS,L7185,Electron elbow adolescent sw,,,7634.35,7863.38,15
HCPCS,L7186,Electron elbow child switch,,,12834.42,13219.45,15
HCPCS,L7190,Elbow adolescent myoelectron,,,10130.05,10433.95,15
HCPCS,L7191,Elbow child myoelectronic ct,,,13499.77,13904.76,15
HCPCS,L7259,Electronic wrist rotator any,,,4947.46,5095.88,15
HCPCS,L7360,Six volt bat otto bock/eq ea,,,319.37,328.95,15
HCPCS,L7362,Battery chrgr six volt otto,,,348.89,359.36,15
HCPCS,L7364,Twelve volt battery utah/equ,,,617.34,635.86,15
HCPCS,L7366,Battery chrgr 12 volt utah/e,,,849.0,874.47,15
HCPCS,L7367,Replacemnt lithium ionbatter,,,470.02,484.12,15
HCPCS,L7368,Lithium ion battery charger,,,609.27,627.55,15
HCPCS,L7400,"Add UE prost be/wd, ultlite",,,369.99,381.09,15
HCPCS,L7401,Add UE prost a/e ultlite mat,,,414.17,426.6,15
HCPCS,L7402,Add UE prost s/d ultlite mat,,,447.32,460.74,15
HCPCS,L7403,Add UE prost b/e acrylic,,,444.59,457.93,15
HCPCS,L7404,Add UE prost a/e acrylic,,,671.03,691.16,15
HCPCS,L7405,Add UE prost s/d acrylic,,,877.53,903.86,15
HCPCS,L7406,Add upp ext mec limb vol lam,,,3088.3,3180.95,15
HCPCS,L7499,HC DISTAL DEVICE,1300.0,715.0,390.0,1144.0,35
HCPCS,L7510,"HC ADHEAR, REPAIR/REPLACE MINOR PARTS",857.5,471.63,257.25,754.6,35
HCPCS,L7510,HC CI DISPOSABLE BATTERY HOLDER MED EL REPAIR/REPLACE,1334.0,733.7,400.2,1173.92,35
HCPCS,L7510,HC CI DISPOSABLE BATTERY HOLDER/C AND AB REPAIR/REPLACE,575.0,316.25,172.5,506.0,35
HCPCS,L7510,HC CI RECHARGEABLE BATTERY FRAME REPAIR/REPLACE,1048.0,576.4,314.4,922.24,35
HCPCS,L7510,HC CI REMOTE ASSISTANT/COCHLEAR AND MED EL REPAIR/REPLACE,1524.5,838.48,457.35,1341.56,35
HCPCS,L7510,HC CI REMOTE CONTROL SIMPLE/COCHLEAR REPAIR/REPLACE,575.0,316.25,172.5,506.0,35
HCPCS,L7510,HC CI SOUND PROCESSOR REPAIR 6 MO WARRANTY,2860.5,1573.28,858.15,2517.24,35
HCPCS,L7510,HC MED EL SONNET FM BATTERY COVER REPAIR/REPLACE,1143.5,628.93,343.05,1006.28,35
HCPCS,L7510,HC OSSEO ATTRACT MAGNET REPAIR/REPLACE,575.0,316.25,172.5,506.0,35
HCPCS,L7510,HC OSSEO BATTERY DOORS REPAIR/REPLACE,370.0,203.5,111.0,325.6,35
HCPCS,L7510,HC OSSEO COCHLEAR REPAIR 6 MO WARRANTY,2543.0,1398.65,762.9,2237.84,35
HCPCS,L7510,HC OSSEO OTICON REPAIR 12 MO WARRANTY,2543.0,1398.65,762.9,2237.84,35
HCPCS,L7510,HC OSSEO SOPHONO REPAIR,1524.5,838.48,457.35,1341.56,35
HCPCS,L7520,Repair prosthesis per 15 min,,,39.6,40.79,15
HCPCS,L7700,Pros soc insert gasket/seal,,,180.61,186.03,15
HCPCS,L8000,Mastectomy bra,,,51.11,52.64,15
HCPCS,L8001,Breast prosthesis bra & form,,,151.46,156.0,15
HCPCS,L8002,Brst prsth bra & bilat form,,,199.17,205.15,15
HCPCS,L8015,Ext breastprosthesis garment,,,72.36,74.53,15
HCPCS,L8020,Mastectomy form,,,272.94,281.13,15
HCPCS,L8030,Breast prosthes w/o adhesive,,,421.95,434.61,15
HCPCS,L8031,Breast prosthesis w adhesive,,,421.95,434.61,15
HCPCS,L8032,Reusable nipple prosthesis,,,47.28,48.7,15
HCPCS,L8035,Custom breast prosthesis,,,4422.75,4555.43,15
HCPCS,L8040,Nasal prosthesis,,,2992.89,3082.68,15
HCPCS,L8041,Midfacial prosthesis,,,3607.06,3715.27,15
HCPCS,L8042,Orbital prosthesis,,,4052.87,4174.46,15
HCPCS,L8043,Upper facial prosthesis,,,4539.23,4675.41,15
HCPCS,L8044,Hemi-facial prosthesis,,,5025.57,5176.34,15
HCPCS,L8045,Auricular prosthesis,,,3935.35,4053.41,15
HCPCS,L8046,Partial facial prosthesis,,,3242.33,3339.6,15
HCPCS,L8047,Nasal septal prosthesis,,,1661.69,1711.54,15
HCPCS,L8300,Truss single w/ standard pad,,,101.25,104.29,15
HCPCS,L8310,Truss double w/ standard pad,,,179.36,184.74,15
HCPCS,L8320,Truss addition to std pad wa,,,74.41,76.64,15
HCPCS,L8330,Truss add to std pad scrotal,,,59.25,61.03,15
HCPCS,L8400,Sheath below knee,,,18.89,19.46,15
HCPCS,L8410,Sheath above knee,,,24.86,25.61,15
HCPCS,L8415,Sheath upper limb,,,25.73,26.5,15
HCPCS,L8417,Pros sheath/sock w gel cushn,,,90.8,93.52,15
HCPCS,L8420,Prosthetic sock multi ply BK,,,25.18,25.94,15
HCPCS,L8430,Prosthetic sock multi ply AK,,,28.52,29.38,15
HCPCS,L8435,Pros sock multi ply upper lm,,,27.1,27.91,15
HCPCS,L8440,Shrinker below knee,,,56.27,57.96,15
HCPCS,L8460,Shrinker above knee,,,79.99,82.39,15
HCPCS,L8465,Shrinker upper limb,,,73.93,76.15,15
HCPCS,L8470,Pros sock single ply BK,,,8.01,8.25,15
HCPCS,L8480,Pros sock single ply AK,,,11.05,11.38,15
HCPCS,L8485,Pros sock single ply upper l,,,14.87,15.32,15
HCPCS,L8500,HC TRUTONE PLUS ARTIFICIAL LARYNX,3809.0,2094.95,794.43,3351.92,50
HCPCS,L8501,HC TRACHEOSTOMY SPEAKING VALVE,575.0,316.25,144.99,506.0,50
HCPCS,L8507,HC TRACH-ESOPH VOICE PROSTH PATIENT INSERT,575.0,316.25,50.54,506.0,50
HCPCS,L8509,HC INDWELLING PROVOX 2 VOICE PROSTHESIS,1595.0,877.25,131.84,1403.6,50
HCPCS,L8509,HC INHEALTH ADVANTAGE PROSTHESIS,2494.0,1371.7,131.84,2194.72,50
HCPCS,L8509,HC INHEALTH CLASSIC PROSTHESIS,1237.5,680.63,131.84,1089.0,50
HCPCS,L8509,HC INHEALTH DUAL VALVE PROSTHESIS,2969.0,1632.95,131.84,2612.72,50
HCPCS,L8509,HC INHEALTH SPECIAL OPTION,1491.0,820.05,131.84,1312.08,50
HCPCS,L8509,HC PROVOX ACTIVALVE PROSTHESIS,4921.0,2706.55,131.84,4330.48,50
HCPCS,L8509,HC VEGA PROSTHESIS,1347.5,741.13,131.84,1185.8,50
HCPCS,L8509,HC VEGA XTRASEAL PROSTHESIS,1548.0,851.4,131.84,1362.24,50
HCPCS,L8510,Voice amplifier,,,305.07,314.22,15
HCPCS,L8511,Indwelling trach insert,,,87.79,90.42,15
HCPCS,L8512,Gel cap for trach voice pros,,,2.63,2.71,15
HCPCS,L8513,Trach pros cleaning device,,,6.28,6.47,15
HCPCS,L8514,Repl trach puncture dilator,,,113.85,117.27,15
HCPCS,L8515,Gel cap app device for trach,,,76.22,78.51,15
HCPCS,L8600,IMPL MAM GEL HP 700ML,3487.5,1918.13,999.31,3069.0,50
HCPCS,L8600,IMPL MAM GEL MOD CLASSIC 190,3487.5,1918.13,999.31,3069.0,50
HCPCS,L8600,IMPL MAM GEL MOD CLASSIC 235,3487.5,1918.13,999.31,3069.0,50
HCPCS,L8600,IMPL MAM GEL MOD CLASSIC 405,3487.5,1918.13,999.31,3069.0,50
HCPCS,L8600,IMPL MAM GEL MOD+ 350ML,3487.5,1918.13,999.31,3069.0,50
HCPCS,L8600,IMPL MAM GEL MOD+ 375ML,3487.5,1918.13,999.31,3069.0,50
HCPCS,L8600,IMPL MAM GEL MOD+ 400ML,3487.5,1918.13,999.31,3069.0,50
HCPCS,L8600,IMPL MAM GEL MOD+ 425ML,3487.5,1918.13,999.31,3069.0,50
HCPCS,L8600,IMPL MAM GEL MOD+ 800ML,3487.5,1918.13,999.31,3069.0,50
HCPCS,L8603,Collagen imp urinary 2.5 ml,,,525.58,541.35,15
HCPCS,L8605,Inj bulking agent anal canal,,,864.65,890.59,15
HCPCS,L8606,"HC BULKAMID, INJ BULKING AGENT, IMPL, URINARY TRACT, 1 ML SYR",4974.5,2735.98,247.92,4377.56,50
HCPCS,L8606,HC COAPTITE 1 ML,575.0,316.25,172.5,506.0,50
HCPCS,L8606,HC MACROPLASTIQ IMPLANT INJ 1 ML,575.0,316.25,172.5,506.0,50
HCPCS,L8607,IMPL PROLARYN PLUS INJ,3307.5,1819.13,51.77,2910.6,50
HCPCS,L8609,Artificial cornea,,,7865.54,8101.51,15
HCPCS,L8610,IMPL SILIC ORBITAL 20MM,362.25,199.24,108.68,845.23,50
HCPCS,L8610,IMPL SILIC ORBITAL 22MM,362.25,199.24,108.68,845.23,50
HCPCS,L8612,Aqueous shunt prosthesis,,,955.47,984.13,15
HCPCS,L8613,HNDL BUCKET ROBINSON 0.6X4.50,1195.83,657.71,358.75,1052.33,50
HCPCS,L8613,IMPL BOJRAB ALTO PARTIAL,1963.85,1080.12,410.25,1728.19,50
HCPCS,L8613,IMPL BOJRAB ALTO TOTAL,1963.85,1080.12,410.25,1728.19,50
HCPCS,L8613,IMPL ECLIPSE FLAT 0.5X4.5,1401.62,770.9,410.25,1233.43,50
HCPCS,L8613,IMPL ECLIPSE FLAT 0.5X4.75,1401.62,770.9,410.25,1233.43,50
HCPCS,L8613,OSSICULAR TI KRAUS K-HELIX,2258.87,1242.38,410.25,1987.81,50
HCPCS,L8613,PRSTH TI BUCKET .4X4.5MM,956.66,526.17,287.0,841.86,50
HCPCS,L8614,Cochlear device,,,23637.07,24346.18,15
HCPCS,L8615,Coch implant headset replace,,,544.46,560.79,15
HCPCS,L8616,HC CI T MIC REPLACEMENT,1334.0,733.7,126.8,1153.91,53
HCPCS,L8617,HC CI COIL AB AND MED EL REPLACEMENT,2543.0,1398.65,110.76,2199.7,53
HCPCS,L8617,HC CI COIL COCHLEAR REPLACEMENT,743.5,408.93,110.76,643.13,53
HCPCS,L8618,"HC TRANSMIT CABLE FOR COCH IMP/AUD OSSEOINTEG DEV, REPLACEMENT",575.0,316.25,31.66,497.38,53
HCPCS,L8619,HC CI SOUND PROCESSOR UPGRADE REPLACEMENT,28333.5,15583.43,8500.05,24508.48,53
HCPCS,L8621,Repl zinc air battery,,,0.75,0.77,15
HCPCS,L8622,Repl alkaline battery,,,0.39,0.4,15
HCPCS,L8623,"Lith ion batt CID,non-earlvl",,,78.09,80.43,15
HCPCS,L8624,"HC RECHARGEABLE BATTERY AB, REPLACEMENT, EA",1334.0,733.7,194.68,1153.91,53
HCPCS,L8624,"HC RECHARGEABLE BATTERY/COCHLEAR AND MED EL, REPLACEMENT, EA",667.0,366.85,194.68,576.96,53
HCPCS,L8625,"HC BATTERY CHARGER AB AND COCHLEAR REPLACEMENT OR AOI DEVICE, EACH",667.0,366.85,200.1,586.96,50
HCPCS,L8625,"HC BATTERY CHARGER MED EL REPLACEMENT OR AOI DEVICE, EACH",667.0,366.85,200.1,586.96,50
HCPCS,L8627,CID ext speech process repl,,,8612.66,8871.04,15
HCPCS,L8628,HC CI NEPTUNE CONNECTOR REPLACEMENT,4450.0,2447.5,1335.0,3916.0,50
HCPCS,L8629,"HC COCHLEAR IMPLANT (CI) ACCESSORY COIL/CABLE, REPLACEMENT",1131.0,622.05,216.16,995.28,50
HCPCS,L8630,Metacarpophalangeal implant,,,539.16,555.33,15
HCPCS,L8631,MCP joint repl 2 pc or more,,,2655.63,2735.3,15
HCPCS,L8641,Metatarsal joint implant,,,420.15,432.75,15
HCPCS,L8642,Hallux implant,,,375.67,386.94,15
HCPCS,L8658,Interphalangeal joint spacer,,,366.32,377.31,15
HCPCS,L8659,Interphalangeal joint repl,,,2329.55,2399.44,15
HCPCS,L8670,"Vascular graft, synthetic",,,668.13,688.17,15
HCPCS,L8678,Ext sply implt neurostim,,,12.39,12.76,15
HCPCS,L8679,Imp neurosti pls gn any type,,,10344.16,10654.48,15
HCPCS,L8681,Pt prgrm for implt neurostim,,,1376.84,1418.15,15
HCPCS,L8682,Implt neurostim radiofq rec,,,7390.68,7612.4,15
HCPCS,L8683,Radiofq trsmtr for implt neu,,,6505.5,6700.67,15
HCPCS,L8684,Radiof trsmtr implt scrl neu,,,1020.79,1051.41,15
HCPCS,L8689,External recharg sys intern,,,2082.38,2144.85,15
HCPCS,L8690,"Aud osseo dev, int/ext comp",,,5742.88,5915.17,15
HCPCS,L8691,"HC OSSEO BAHA SOUND PROCESSOR, REPLACEMENT, EA",11528.0,6340.4,2079.0,10144.64,50
HCPCS,L8691,HC OSSEO BAHA SUPER POWER SOUND PROCESSOR REPLACEMENT,7645.5,4205.03,2079.0,6728.04,50
HCPCS,L8691,"HC OSSEO OTICON SOUND PROCESSOR, REPLACEMENT, EA",13644.0,7504.2,2079.0,12006.72,50
HCPCS,L8691,"HC OSSEO SOPHONO SOUND PROCESSOR, REPLACEMENT, EA",11400.0,6270.0,2079.0,10032.0,50
HCPCS,L8692,"HC ADHEAR SYSTEM DUAL FUNCTION, SOUND PROCESSOR, USED W/O OSSEOINTEGRATION",6246.5,3435.58,1873.95,5496.92,35
HCPCS,L8692,HC OSSEO BAHA SOUND PROCESSOR W/ SOFTBAND,11674.0,6420.7,3502.2,10098.01,38
HCPCS,L8692,HC OSSEO OTICON PROCESSOR W/ SOFTBAND,13810.0,7595.5,4143.0,11945.65,38
HCPCS,L8693,"Aud osseo dev, abutment",,,1830.52,1885.44,15
HCPCS,L8694,HC OSSEO BAHA SUPER POWER TRANSDUCER REPLACEMENT,7645.5,4205.03,1140.07,6728.04,50
HCPCS,L8694,HC OSSEO BAHA TRANSDUCER REPLACEMENT,11528.0,6340.4,1140.07,10144.64,50
HCPCS,L8694,HC OSSEO OTICON TRANSDUCER REPLACEMENT,13644.0,7504.2,1140.07,12006.72,50
HCPCS,L8694,HC OSSEO SOPHONO TRANSDUCER REPLACEMENT,11400.0,6270.0,1140.07,10032.0,50
HCPCS,L8695,External recharg sys extern,,,20.13,20.73,15
HCPCS,L8696,Ext antenna phren nerve stim,,,261.63,269.48,15
HCPCS,L8699,COMPONENT FEMORAL L8.5CM LEFT KNEE ELLIPTICAL OSS,26070.66,14338.87,7821.2,22942.18,35
HCPCS,L8699,CONNECTOR SPINAL L20MM SACRAL PELVIC TITANIUM OPEN POLYAXIAL,2883.38,1585.86,865.01,2537.37,35
HCPCS,L8699,END CAP ORTHOPEDIC L+0MM DIA6MM FOR HUMERAL NAILING SYSTEM T,575.0,316.25,172.5,506.0,35
HCPCS,L8699,IMPL TESTICULAR MED,11993.5,6596.43,3598.05,10554.28,35
HCPCS,L8699,LATERAL CONNECTOR OPEN L30,2025.0,1113.75,607.5,1782.0,35
HCPCS,L8699,MODULAR CORTICAL BONE SCREW Ã5.5 L30,1237.5,680.63,371.25,1089.0,35
HCPCS,L8699,MODULAR CORTICAL BONE SCREW Ã5.5 L40,1237.5,680.63,371.25,1089.0,35
HCPCS,L8699,MODULAR CORTICAL BONE SCREW Ã5.5 L45,1237.5,680.63,371.25,1089.0,35
HCPCS,L8699,MODULAR CORTICAL BONE SCREW Ã6.5 L35,1237.5,680.63,371.25,1089.0,35
HCPCS,L8699,MODULAR CORTICAL BONE SCREW Ã6.5 L40,1237.5,680.63,371.25,1089.0,35
HCPCS,L8699,MODULAR CORTICAL BONE SCREW Ã6.5 L45,1237.5,680.63,371.25,1089.0,35
HCPCS,L8699,MODULAR CORTICAL BONE SCREW Ã6.5 L50,1237.5,680.63,371.25,1089.0,35
HCPCS,L8699,MODULAR CORTICAL BONE SCREW Ã7.5 L35,1237.5,680.63,371.25,1089.0,35
HCPCS,L8699,MODULAR POLYAXIAL HEAD,1237.5,680.63,371.25,1089.0,35
HCPCS,L8699,MULTIAXIAL CROSS CONNECTOR PREBENT L31 TO 33,2250.0,1237.5,675.0,1980.0,35
HCPCS,L8699,MULTIAXIAL CROSS CONNECTOR PREBENT L33 TO 36,2250.0,1237.5,675.0,1980.0,35
HCPCS,L8699,MULTIAXIAL CROSS CONNECTOR PREBENT L43 TO 55,2250.0,1237.5,675.0,1980.0,35
HCPCS,L8699,PLATE BONE 1 HOLE STERILE 130DEG TITANIUM FEMORAL NECK SYSTE,2846.34,1565.49,853.9,2504.78,35
HCPCS,L8699,PLATE BONE 2 HOLE STERILE 130DEG TITANIUM FEMORAL NECK SYSTE,1657.94,911.87,497.38,1458.99,35
HCPCS,L8699,POLYAXIAL SCREW Ã5.5 L45,2475.0,1361.25,742.5,2178.0,35
HCPCS,L8699,POLYAXIAL SCREW Ã6.5 L40,2475.0,1361.25,742.5,2178.0,35
HCPCS,L8699,POLYAXIAL SCREW Ã6.5 L45,2475.0,1361.25,742.5,2178.0,35
HCPCS,L8699,POLYAXIAL SCREW Ã6.5 L50,2475.0,1361.25,742.5,2178.0,35
HCPCS,L8699,POLYAXIAL SCREW Ã7.5 L40,2475.0,1361.25,742.5,2178.0,35
HCPCS,L8699,POLYAXIAL SCREW Ã7.5 L50,2475.0,1361.25,742.5,2178.0,35
HCPCS,L8699,POLYAXIAL SCREW Ã8.5 L70,2475.0,1361.25,742.5,2178.0,35
HCPCS,L8699,POLYAXIAL SCREW Ã8.5 L80,2475.0,1361.25,742.5,2178.0,35
HCPCS,L8699,PREBENT ROD Ã5.5 TITANIUM L50,900.0,495.0,270.0,792.0,35
HCPCS,L8699,PREBENT ROD Ã5.5 TITANIUM L60,900.0,495.0,270.0,792.0,35
HCPCS,L8699,PREBENT ROD Ã5.5 TITANIUM L80,900.0,495.0,270.0,792.0,35
HCPCS,L8699,R3 0 DEG XLPE ACET LNR 36MM X 50MM,2610.0,1435.5,783.0,2296.8,35
HCPCS,L8699,SCREW BONE 5X38MM STERILE T25 STARDRIVE RECESS LOCKING SELF,757.8,416.79,227.34,666.86,35
HCPCS,L8699,SCREW BONE 5X48MM STERILE T25 STARDRIVE RECESS LOCKING SELF,757.8,416.79,227.34,666.86,35
HCPCS,L8699,SCREW BONE 6.4X85MM STERILE ANTIROTATION TITANIUM FEMORAL NE,948.78,521.83,284.63,834.93,35
HCPCS,L8699,SCREW SPINAL POSTERIOR THORACOLUMBOSACRAL PEDICLE 8MM X 70MM,4500.0,2475.0,1350.0,3960.0,35
HCPCS,L8699,SCREW SPINAL POSTERIOR THORACOLUMBOSACRAL PEDICLE 8MM X 80MM,4500.0,2475.0,1350.0,3960.0,35
HCPCS,L8699,STEM FEMORAL 15X150MM INTRAMEDULLARY BOWED CEMENTED OSS,7208.14,3964.48,2162.44,6343.16,35
HCPCS,L8699,STRAIGHT ROD HEXA Ã5.5 TITANIUM L140,900.0,495.0,270.0,792.0,35
HCPCS,L8699,STRAIGHT ROD HEXA Ã5.5 TITANIUM L500,900.0,495.0,270.0,792.0,35
HCPCS,L8701,Ewh s/d uprt micro sensor,,,34284.44,35312.97,15
HCPCS,L8702,Ewhf s/d uprt micro sensor,,,67452.66,69476.24,15
HCPCS,L9900,HC OSSEO SOFTBAND,246.5,135.58,73.95,213.22,38
HCPCS,L9900,HC OSSEO SOFTBAND BILATERAL,389.5,214.23,116.85,336.92,38
HCPCS,L9900,HC OSSEO SOFTBAND MONAURAL,281.0,154.55,84.3,243.07,38
HCPCS,M0201,Pne flu hepb cov home admin,,,37.45,38.57,15
HCPCS,M0224,"HC IV INFUSION, PEMIVIBART, INCL POST ADMIN MONITORING",1131.5,622.33,339.45,978.75,150
HCPCS,M0235,"Intrav inf, mon anti, fir do",,,457.8,471.53,15
HCPCS,M0236,"Intrav inf, mon anti, sec do",,,457.8,471.53,15
HCPCS,M0237,"Intrav inf, toci, first dose",,,457.8,471.53,15
HCPCS,M0238,"Intrav inf, toci, second dos",,,457.8,471.53,15
HCPCS,M0249,Adm Tocilizu COVID-19 1st,,,457.8,471.53,15
HCPCS,M0250,Adm Tocilizu COVID-19 2nd,,,457.8,471.53,15
HCPCS,P2028,Cephalin floculation test,,,4.82,24.75,23
HCPCS,P2029,Congo red blood test,,,4.82,24.75,23
HCPCS,P2031,Hair analysis,,,4.82,24.75,23
HCPCS,P2033,Blood thymol turbidity,,,4.82,24.75,23
HCPCS,P2038,Blood mucoprotein,,,4.82,24.75,23
HCPCS,P3000,Screen pap by tech w md supv,,,16.82,86.55,23
HCPCS,P3001,Screening pap smear by phys,,,22.4,27.65,20
HCPCS,P7001,Culture bacterial urine,,,17.78,86.92,8
HCPCS,P9010,HC WHOLE BLOOD,680.0,374.0,204.0,588.2,53
HCPCS,P9010,HC WHOLE BLOOD LEUKO POOR,764.0,420.2,225.12,660.86,53
HCPCS,P9011,HC BLOOD SPLIT UNIT,374.0,205.7,112.2,573.0,53
HCPCS,P9012,HC CRYOPRECIPITATE EACH UNIT,218.0,119.9,63.57,573.0,53
HCPCS,P9016,HC DIRECTED DONATION + RBC LEUKO RED,689.0,378.95,182.0,595.99,53
HCPCS,P9016,HC RBC LEUKO POOR,653.0,359.15,182.0,573.0,53
HCPCS,P9017,HC FF PLASMA ADULT,245.0,134.75,73.5,573.0,53
HCPCS,P9017,"HC LIQUID PLASMA, IRRADIATED",377.0,207.35,84.29,573.0,53
HCPCS,P9019,"Platelets, each unit",,,75.96,78.24,15
HCPCS,P9020,Plaelet rich plasma unit,,,557.32,574.04,15
HCPCS,P9021,HC RED BLOOD CELLS UNIT,684.0,376.2,144.32,591.66,53
HCPCS,P9022,"HC LRBC. I, W, RED BLOOD CELLS, WASHED, EACH UNIT",815.0,448.25,244.5,704.98,53
HCPCS,P9022,HC WASHED RED BLOOD CELLS UNIT,924.0,508.2,277.2,799.26,53
HCPCS,P9023,HC OCTAPLAS (POOLED HUMAN PLASMA),180.0,99.0,54.0,573.0,53
HCPCS,P9025,Plasma cryo redu path each,,,135.15,139.2,15
HCPCS,P9026,Cryo fib comp path redu each,,,313.77,323.18,15
HCPCS,P9027,Rbc o2 co2 reduced,,,487.1,501.71,15
HCPCS,P9031,Platelets leukocytes reduced,,,125.77,129.54,15
HCPCS,P9032,"Platelets, irradiated",,,135.78,139.85,15
HCPCS,P9033,Platelets leukoreduced irrad,,,205.39,211.55,15
HCPCS,P9034,HC PLATELETS PHERESIS,1249.0,686.95,337.0,1080.39,53
HCPCS,P9035,"HC COLD STORED, PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EA UNIT",1147.0,630.85,337.0,992.16,53
HCPCS,P9035,HC PLATELET PHERES LEUKOREDUCED,2318.0,1274.9,337.0,2005.07,53
HCPCS,P9036,Platelet pheresis irradiated,,,587.65,605.28,15
HCPCS,P9037,"HC COLD STORED, PLATELETS, PHERESIS, LEUKOCYTES REDUCED, IRRADIATED,EA UNIT",1436.0,789.8,337.0,1242.14,53
HCPCS,P9037,"HC PLT 7D, PLATELETS, PHERESIS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1707.0,938.85,337.0,1476.56,53
HCPCS,P9037,HC PLT SDP LEUKO RED IRRAD,2664.0,1465.2,337.0,2304.36,53
HCPCS,P9037,HC PLT SDP VARCON LEUKO RED IRRAD,3327.0,1829.85,337.0,2877.86,53
HCPCS,P9038,RBC irradiated,,,149.22,153.7,15
HCPCS,P9039,HC RBC DEGLYCEROLIZED,1471.0,809.05,337.0,1272.42,53
HCPCS,P9040,HC RBC LEUKOREDUCED IRRADIATED,791.0,435.05,237.3,684.22,53
HCPCS,P9041,"Albumin (human),5%, 50ml",,,9.12,71.69,8
HCPCS,P9043,"Plasma protein fract,5%,50ml",,,8.07,8.31,15
HCPCS,P9044,HC CRYOPRECIPITATE REDUCED PLASMA,284.0,156.2,85.2,573.0,53
HCPCS,P9045,albumin human 5 % Solution 250 mL Flex Cont,246.0,135.3,45.57,358.29,53
HCPCS,P9045,albumin human 5 % Solution 250 mL Vial,411.0,226.05,45.57,358.29,53
HCPCS,P9045,albumin human 5 % Solution 50 mL Vial,183.0,100.65,45.57,358.29,53
HCPCS,P9046,"Albumin (human), 25%, 20 ml",,,18.23,143.3,23
HCPCS,P9047,albumin human 25 % Solution 100 mL Vial,735.0,404.25,45.57,635.78,38
HCPCS,P9047,albumin human 25 % Solution 50 mL Vial,375.0,206.25,45.57,358.29,38
HCPCS,P9048,"Plasmaprotein fract,5%,250ml",,,73.72,75.93,15
HCPCS,P9050,HC GRANULOCYTES PHERESIS UNIT,5071.0,2789.05,337.0,4386.42,38
HCPCS,P9051,HC RBC LEUKO RED CMV-NEG,716.0,393.8,172.2,619.34,53
HCPCS,P9051,HC WB LEUKO RED CMV-NEG,1257.0,691.35,172.2,1087.31,53
HCPCS,P9052,HC PLATELETS HLA-M L-R UNIT,2637.0,1450.35,337.0,2281.01,53
HCPCS,P9053,HC PLT APH LEUKO RED CMV-NEG IRRAD,1508.0,829.4,337.0,1304.42,53
HCPCS,P9053,HC PLT SDP LEUKO RED CMV-NEG IRRAD,1710.0,940.5,337.0,1479.15,53
HCPCS,P9053,HC PLT SDP VARCON LEUKO RED CMV-NEG IRRAD,1710.0,940.5,337.0,1479.15,53
HCPCS,P9054,HC BLOOD L-R FROZ DEGLY WASH,909.0,499.95,242.44,786.29,53
HCPCS,P9055,HC PLT SDP LEUKO RED CMV-NEG,1618.0,889.9,227.25,1399.57,53
HCPCS,P9055,HC PLT SDP VARCON LEUKO RED CMV-NEG,1467.0,806.85,227.25,1268.96,53
HCPCS,P9056,HC BLOOD L-R IRRADIATED,591.0,325.05,84.17,573.0,53
HCPCS,P9057,HC RBC FRZ DEG WSH L-R IRRAD,1236.0,679.8,337.0,1069.14,53
HCPCS,P9058,HC RBC L-R CMV-NEG IRRAD,823.0,452.65,222.86,711.9,53
HCPCS,P9059,HC PLASMA FRZ BETWEEN 8-24 HR,270.0,148.5,71.09,573.0,53
HCPCS,P9060,Fr frz plasma donor retested,,,48.93,50.4,15
HCPCS,P9070,Pathogen reduced plasma pool,,,56.11,57.79,15
HCPCS,P9071,Pathogen reduced plasma sing,,,292.53,301.31,15
HCPCS,P9073,"HC PLATELETS, PHERESIS, PATHOGEN-REDUCED, EACH UNIT",2500.0,1375.0,337.0,2162.5,53
HCPCS,P9099,Blood component/product noc,,,48.93,50.4,15
HCPCS,P9100,Pathogen test for platelets,,,55.87,68.98,20
HCPCS,P9604,One-way allow prorated trip,,,49.9,49.9,2
HCPCS,P9612,HC CATH FOR URINE SPECIMEN COLLECT,47.0,25.85,8.33,42.85,2544
HCPCS,P9615,Urine specimen collect mult,,,8.33,42.85,23
HCPCS,Q0035,Cardiokymography,,,39.89,41.08,15
HCPCS,Q0091,"HC SCREENING PAP SMEAR, OBTAIN, PREP AND CONVEY CERV/VAG SMEAR TO LAB",91.0,50.05,24.89,78.72,477
HCPCS,Q0091,Obtaining screen pap smear,,,24.26,29.95,6
HCPCS,Q0092,Set up port xray equipment,,,24.56,42.98,16
HCPCS,Q0111,"HC WET MOUNTS, INCL PREP VAGINAL, CERVICAL OR SKIN SPECIMENS",76.0,41.8,16.82,86.55,106
HCPCS,Q0112,Potassium hydroxide preps,,,5.67,29.15,23
HCPCS,Q0113,Pinworm examinations,,,4.15,21.35,23
HCPCS,Q0114,HC FERN TEST,35.0,19.25,9.47,48.7,53
HCPCS,Q0115,Post-coital mucous exam,,,24.3,125.0,23
HCPCS,Q0138,ferumoxytol 510 MG/17ML Solution 17 mL Vial,5232.45,2877.855,0.32,5588.38,126
HCPCS,Q0139,"Ferumoxytol, esrd use",,,0.32,2.09,23
HCPCS,Q0144,"Azithromycin dihydrate, oral",,,10.84,13.38,6
HCPCS,Q0155,Dronabinol (syndros) 0.1 mg,,,3.34,4.12,6
HCPCS,Q0161,chlorproMAZINE 25 MG Tab 100 Each Bottle,9.56,5.26,2.87,8.27,48
HCPCS,Q0162,ondansetron ODT 4 MG TABLET DISPERSIBLE 1 Each Blister,9.07,4.99,0.01,7.85,48
HCPCS,Q0162,ondansetron ODT 4 MG TABLET DISPERSIBLE 30 Each Box,9.07,4.99,0.01,7.85,48
HCPCS,Q0162,ondansetron ODT 8 MG TABLET DISPERSIBLE 1 Each Blister,10.39,5.72,0.01,8.99,48
HCPCS,Q0163,Diphenhydramine HCI 50mg,,,1.12,1.38,6
HCPCS,Q0164,prochlorperazine 10 MG Tab 1 Each Blister,10.6,5.83,0.68,9.17,48
HCPCS,Q0164,prochlorperazine 5 MG Tab 100 Each Bottle,9.15,5.04,0.68,7.91,48
HCPCS,Q0166,granisetron 1 MG Tab 2 Each Box,33.0,18.15,9.9,54.7,48
HCPCS,Q0167,droNABinol 2.5 MG Cap 100 Each Box,26.84,14.77,1.58,23.22,48
HCPCS,Q0169,promethazine 12.5 mg half tablet Tab 1 Each Package,8.23,4.53,0.24,7.12,48
HCPCS,Q0169,promethazine 25 MG Tab 100 Each Bottle,8.28,4.56,0.24,7.16,48
HCPCS,Q0173,Trimethobenzamide HCI 250mg,,,0.56,0.69,6
HCPCS,Q0174,Lab/Drugs Fee Schedule,,,0.56,0.69,6
HCPCS,Q0175,perphenazine 4 MG Tab 100 Each Bottle,8.86,4.88,0.56,7.66,48
HCPCS,Q0177,Hydroxyzine pamoate 25mg,,,1.67,2.06,6
HCPCS,Q0180,Dolasetron mesylate oral,,,123.44,152.4,6
HCPCS,Q0220,Lab/Drugs Fee Schedule,,,0.01,0.01,6
HCPCS,Q0221,Lab/Drugs Fee Schedule,,,0.01,0.01,6
HCPCS,Q0222,Lab/Drugs Fee Schedule,,,2163.67,2671.2,6
HCPCS,Q0224,"Inj, pemivibart, 4500 mg",,,5652.59,48863.25,23
HCPCS,Q0240,Lab/Drugs Fee Schedule,,,0.01,0.01,6
HCPCS,Q0243,Lab/Drugs Fee Schedule,,,0.01,0.01,6
HCPCS,Q0244,Lab/Drugs Fee Schedule,,,0.01,0.01,6
HCPCS,Q0245,Lab/Drugs Fee Schedule,,,0.01,0.01,6
HCPCS,Q0247,Lab/Drugs Fee Schedule,,,2163.67,2671.2,6
HCPCS,Q0249,Tocilizumab for COVID-19,,,6.5,51.1,23
HCPCS,Q0477,"HC HEARTMATE II POWER MODULE PATIENT CABLE FOR VAD, REPLC ONLY",4742.0,2608.1,936.62,4172.96,50
HCPCS,Q0478,HC HEARTWARE CONTROLLER AC ADAPTER 1430US,4974.5,2735.98,221.84,4377.56,150
HCPCS,Q0478,HC HEARTWARE DC ADAPTER 1435,7587.0,4172.85,221.84,6676.56,50
HCPCS,Q0479,HC HEARTMATE POWER MODULE,27149.5,14932.23,8144.85,23891.56,50
HCPCS,Q0479,"HC POWER MODULE FOR USE W/ ELECTRIC OR ELECT/PNEUMATIC VAD, HEARTMATE (MPU)",27200.0,14960.0,8160.0,23936.0,50
HCPCS,Q0480,"Driver pneumatic vad, rep",,,108727.22,111989.04,15
HCPCS,Q0481,HC HEARTMATE 3 LVAD CONTROLLER INCL EMERGENCY BACK-UP BATTERY,18665.5,10266.03,5599.65,18068.17,50
HCPCS,Q0481,HC HEARTMATE II CONTROLLER STERILE,18665.5,10266.03,5599.65,18068.17,50
HCPCS,Q0481,"HC HEARTMATE II SYSTEM CONTROLLER, REPLACEMENT ONLY",18665.5,10266.03,5599.65,18068.17,50
HCPCS,Q0481,HC HEARTWARE CONTROLLER 1420,19975.0,10986.25,5992.5,18068.17,150
HCPCS,Q0481,HC HEARTWARE CONTROLLER AC ADAPTER 1403US,4974.5,2735.98,1492.35,18068.17,200
HCPCS,Q0482,"Microprcsr cu combo vad, rep",,,5494.45,5659.28,15
HCPCS,Q0483,"Monitor elec vad, rep",,,22634.63,23313.67,15
HCPCS,Q0484,Monitor elec or comb vad rep,,,4395.57,4527.44,15
HCPCS,Q0485,HC HEARTMATE 3 LVAD DISPLAY MODULE TO POWER MODULE CABLE,252.0,138.6,75.6,437.14,50
HCPCS,Q0486,Mon cable elec/pneum vad rep,,,353.22,363.82,15
HCPCS,Q0487,"Leads any type vad, rep only",,,412.07,424.43,15
HCPCS,Q0489,"Pwr pck base combo vad, rep",,,19623.0,20211.69,15
HCPCS,Q0490,"Emr pwr source elec vad, rep",,,848.8,874.26,15
HCPCS,Q0491,Emr pwr source combo vad rep,,,1334.41,1374.44,15
HCPCS,Q0492,"Emr pwr cbl elec vad, rep",,,107.52,110.75,15
HCPCS,Q0493,"Emr pwr cbl combo vad, rep",,,306.1,315.28,15
HCPCS,Q0494,"Emr hd pmp elec/combo, rep",,,259.01,266.78,15
HCPCS,Q0495,HC HEARTMATE BATTERY CHARGER,22213.5,12217.43,5042.62,19547.88,50
HCPCS,Q0495,HC HEARTWARE BATTERY CHARGER,20701.5,11385.83,5042.62,18217.32,50
HCPCS,Q0496,"HC HEARTMATE II POWER MODULE BACKUP BATTERY FOR VAD, REPLC (EXC LI-ION)",575.0,316.25,172.5,1864.19,50
HCPCS,Q0497,HC HEARTMATE 14 VOLT BATTERY CLIP SET,4971.5,2734.33,565.14,4374.92,50
HCPCS,Q0497,HC HEARTMATE 14 VOLT LITHIUM-ION BATTERY CLIP,4450.0,2447.5,565.14,3916.0,50
HCPCS,Q0498,HC HEARTMATE BATTERY HOLSTER,2342.5,1288.38,620.08,2061.4,50
HCPCS,Q0498,HC HEARTMATE HOLSTER VEST (ALL SIZES),1596.0,877.8,478.8,1404.48,50
HCPCS,Q0498,HC HEARTWARE PATIENT PACK,2695.5,1482.53,620.08,2372.04,50
HCPCS,Q0498,HC HEARTWARE SHOULDER PACK,2668.5,1467.68,620.08,2348.28,50
HCPCS,Q0498,HC HEARTWARE WAIST PACK,2520.0,1386.0,620.08,2217.6,50
HCPCS,Q0499,HC HEARTMATE CONSOLIDATED BAG,1444.5,794.48,201.48,1271.16,50
HCPCS,Q0500,"Filters elec/combo vad, rep",,,36.84,37.95,15
HCPCS,Q0501,"HC HEARTMATE SHOWER BAG, ELEC/COMBO VAD, REPLACEMENT ONLY",2668.5,1467.68,616.51,2348.28,50
HCPCS,Q0501,"HC HEARTWARE SHOWER BAG, ELEC/COMBO VAD, REPLACEMENT ONLY",1212.0,666.6,363.6,1066.56,50
HCPCS,Q0502,"Mobility cart pneum vad, rep",,,784.95,808.5,15
HCPCS,Q0503,Battery pneum vad replacemnt,,,1569.8,1616.89,15
HCPCS,Q0504,"Pwr adpt pneum vad, rep veh",,,828.39,853.24,15
HCPCS,Q0506,HC HEARTMATE 11 VOLT LITHIUM-ION BACKUP BATTERY FOR SYSTEM CONTROLLER,2965.0,1630.75,889.5,2609.2,50
HCPCS,Q0506,HC HEARTMATE 14 VOLT LITHIUM-ION BATTERY SET,9415.5,5178.53,1031.09,8285.64,50
HCPCS,Q0506,HC HEARTWARE BATTERY,3335.5,1834.53,1000.65,2935.24,50
HCPCS,Q0508,HC HEARTMATE 14 VOLT POWER MODULE PT CABLE,4742.0,2608.1,1422.6,4172.96,35
HCPCS,Q0508,HC HEARTMATE 3 LVAD MODULAR CABLE,18170.5,9993.78,5451.15,15990.04,35
HCPCS,Q0508,HC HEARTMATE 3 LVAD MODULAR CABLE CAP (PKG 3),2817.0,1549.35,845.1,2478.96,35
HCPCS,Q0508,HC HEARTMATE AUTOMOBILE DC POWER CABLE,1000.0,550.0,300.0,880.0,35
HCPCS,Q0508,HC HEARTMATE POWER MODULE/BATTERY CHARGER AC POWER CORD,241.5,132.83,72.45,212.52,35
HCPCS,Q0508,"HC HEARTMATE SHOWER BAG, MISC SUP/ACCESS USE W/ IMPL VAD",2668.5,1467.68,800.55,2348.28,35
HCPCS,Q0508,HC HEARTMATE TRAVEL CASE,711.5,391.33,213.45,626.12,35
HCPCS,Q0508,HC HEARTMATE WEARABLE ACCESSORIES KIT,755.5,415.53,226.65,664.84,35
HCPCS,Q0508,HC HEARTWARE AC ADAPTER 1425,4552.0,2503.6,1365.6,4005.76,35
HCPCS,Q0508,HC HEARTWARE AC ADAPTER W/POWER CORD,4971.5,2734.33,1491.45,4374.92,35
HCPCS,Q0508,HC HEARTWARE CONTROLLER ALARM ADAPTER 1450,1224.0,673.2,367.2,1077.12,105
HCPCS,Q0508,HC HEARTWARE DATA CABLE,2668.5,1467.68,800.55,2348.28,35
HCPCS,Q0508,"HC HEARTWARE SHOWER BAG, MISC SUP/ACCESS USE W/ IMPL VAD",1212.0,666.6,363.6,1066.56,35
HCPCS,Q0508,HC HEARTWARE USB KEY,316.0,173.8,94.8,278.08,35
HCPCS,Q0509,HC HEARTMATE SHOWER BAG MISC SUP/ACCESS USE W/ IMPL VAD NOT PD BY T18 PT A,2668.5,1467.68,800.55,2348.28,35
HCPCS,Q0509,HC HEARTWARE SHOWER BAG MISC SUP/ACCESS USE W/ IMPL VAD NOT PD BY T18 PT A,1212.0,666.6,363.6,1066.56,35
HCPCS,Q0515,Sermorelin acetate injection,,,1.11,1.37,6
HCPCS,Q2004,Bladder calculi irrig sol,,,11.94,14.74,6
HCPCS,Q2009,fosphenytoin 500 MG PE/10ML Solution 10 mL Vial,670.02,368.52,7.17,579.57,48
HCPCS,Q2017,Lab/Drugs Fee Schedule,,,2571.63,3174.85,6
HCPCS,Q2026,Radiesse injection,,,286.28,353.43,21
HCPCS,Q2028,"Inj, sculptra, 0.5mg",,,0.86,1.06,21
HCPCS,Q2035,"Afluria vacc, 3 yrs & >, im",,,21.28,26.27,6
HCPCS,Q2037,"Fluvirin vacc, 3 yrs & >, im",,,10.28,12.69,6
HCPCS,Q2038,"Fluzone vacc, 3 yrs & >, im",,,42.61,52.6,6
HCPCS,Q2041,axicabtagene ciloleucel Suspension 1 Each Package,2310000.0,1270500.0,420299.42,3598266.24,63
HCPCS,Q2042,tisagenlecleucel-T Suspension 1 Each Flex Cont,2719137.5,1495525.63,485644.63,3903690.92,63
HCPCS,Q2043,Sipuleucel-T auto CD54+,,,47683.64,377635.3,23
HCPCS,Q2049,Imported Lipodox inj,,,454.08,560.59,21
HCPCS,Q2050,DOXOrubicin liposome 2 MG/ML Suspension 10 mL Vial,2576.75,1417.2150000000001,108.47,2602.35,126
HCPCS,Q2050,DOXOrubicin liposome 2 MG/ML Suspension 25 mL Vial,5671.94,3119.57,108.47,6576.6,189
HCPCS,Q2053,brexucabtagene autoleucel 200000000 CELLS Suspension 1 Each Flex Cont,2120000.0,1166000.0,419041.03,3305610.0,63
HCPCS,Q2054,lisocabtagene maraleucel CD8 Suspension 1 Each Vial,2236135.0,1229874.25,443454.86,3656040.71,63
HCPCS,Q2055,idecabtagene vicleucel 460000000 CELLS Suspension 1 Each Bag,2286275.0,1257451.25,453609.05,3653508.04,63
HCPCS,Q2056,ciltacabtagene autoleucel 100000000 CELLS Suspension 1 Each Bag,2394750.0,1317112.5,473361.93,3735307.1,63
HCPCS,Q2057,Afamitresgene autoleucel,,,770620.0,5201685.0,17
HCPCS,Q2058,Obecbtge autol up to 400 mil,,,278250.0,286597.5,15
HCPCS,Q3027,Inj beta interferon im 1 mcg,,,47.75,60.66,21
HCPCS,Q3028,Inj beta interferon sq 1 mcg,,,40.23,49.67,6
HCPCS,Q4001,Cast sup body cast plaster,,,61.14,62.97,15
HCPCS,Q4002,Cast sup body cast fiberglas,,,231.02,237.95,15
HCPCS,Q4003,Cast sup shoulder cast plstr,,,43.9,45.22,15
HCPCS,Q4004,Cast sup shoulder cast fbrgl,,,151.99,156.55,15
HCPCS,Q4005,Cast sup long arm adult plst,,,16.19,16.68,15
HCPCS,Q4006,Cast sup long arm adult fbrg,,,36.47,37.56,15
HCPCS,Q4007,Cast sup long arm ped plster,,,8.09,8.33,15
HCPCS,Q4008,Cast sup long arm ped fbrgls,,,18.23,18.78,15
HCPCS,Q4009,Cast sup sht arm adult plstr,,,10.81,11.13,15
HCPCS,Q4010,Cast sup sht arm adult fbrgl,,,24.31,25.04,15
HCPCS,Q4011,Cast sup sht arm ped plaster,,,5.39,5.55,15
HCPCS,Q4012,Cast sup sht arm ped fbrglas,,,12.19,12.56,15
HCPCS,Q4013,Cast sup gauntlet plaster,,,19.68,20.27,15
HCPCS,Q4014,Cast sup gauntlet fiberglass,,,33.18,34.18,15
HCPCS,Q4015,Cast sup gauntlet ped plster,,,9.85,10.15,15
HCPCS,Q4016,Cast sup gauntlet ped fbrgls,,,16.58,17.08,15
HCPCS,Q4017,Cast sup lng arm splint plst,,,11.37,11.71,15
HCPCS,Q4018,Cast sup lng arm splint fbrg,,,18.12,18.66,15
HCPCS,Q4019,Cast sup lng arm splnt ped p,,,5.69,5.86,15
HCPCS,Q4020,Cast sup lng arm splnt ped f,,,9.1,9.37,15
HCPCS,Q4021,Cast sup sht arm splint plst,,,8.42,8.67,15
HCPCS,Q4022,Cast sup sht arm splint fbrg,,,15.2,15.66,15
HCPCS,Q4023,Cast sup sht arm splnt ped p,,,4.23,4.36,15
HCPCS,Q4024,Cast sup sht arm splnt ped f,,,7.61,7.84,15
HCPCS,Q4025,Cast sup hip spica plaster,,,47.18,48.6,15
HCPCS,Q4026,Cast sup hip spica fiberglas,,,147.37,151.79,15
HCPCS,Q4027,Cast sup hip spica ped plstr,,,23.61,24.32,15
HCPCS,Q4028,Cast sup hip spica ped fbrgl,,,73.73,75.94,15
HCPCS,Q4029,Cast sup long leg plaster,,,36.1,37.18,15
HCPCS,Q4030,Cast sup long leg fiberglass,,,95.02,97.87,15
HCPCS,Q4031,Cast sup lng leg ped plaster,,,18.03,18.57,15
HCPCS,Q4032,Cast sup lng leg ped fbrgls,,,47.51,48.94,15
HCPCS,Q4033,Cast sup lng leg cylinder pl,,,33.68,34.69,15
HCPCS,Q4034,Cast sup lng leg cylinder fb,,,83.72,86.23,15
HCPCS,Q4035,Cast sup lngleg cylndr ped p,,,16.83,17.33,15
HCPCS,Q4036,Cast sup lngleg cylndr ped f,,,41.89,43.15,15
HCPCS,Q4037,Cast sup shrt leg plaster,,,20.51,21.13,15
HCPCS,Q4038,Cast sup shrt leg fiberglass,,,51.45,52.99,15
HCPCS,Q4039,Cast sup shrt leg ped plster,,,10.29,10.6,15
HCPCS,Q4040,Cast sup shrt leg ped fbrgls,,,25.72,26.49,15
HCPCS,Q4041,Cast sup lng leg splnt plstr,,,24.98,25.73,15
HCPCS,Q4042,Cast sup lng leg splnt fbrgl,,,42.64,43.92,15
HCPCS,Q4043,Cast sup lng leg splnt ped p,,,12.49,12.86,15
HCPCS,Q4044,Cast sup lng leg splnt ped f,,,21.35,21.99,15
HCPCS,Q4045,Cast sup sht leg splnt plstr,,,14.5,14.94,15
HCPCS,Q4046,Cast sup sht leg splnt fbrgl,,,23.32,24.02,15
HCPCS,Q4047,Cast sup sht leg splnt ped p,,,7.22,7.44,15
HCPCS,Q4048,Cast sup sht leg splnt ped f,,,11.67,12.02,15
HCPCS,Q4049,"Finger splint, static",,,2.63,2.71,15
HCPCS,Q4074,iloprost 10 mcg/mL Solution 1 mL Glass Cont,364.83,200.66,109.45,1072.71,48
HCPCS,Q4074,iloprost 20 mcg/mL Solution 1 mL Glass Cont,364.83,200.66,109.45,1072.71,48
HCPCS,Q4081,"Epoetin alfa, 100 units ESRD",,,0.56,5.2,8
HCPCS,Q4100,GRAFT DURA GUARD 10X16CM,3519.59,1935.78,1055.88,3097.24,35
HCPCS,Q4100,GRAFT DURA GUARD 6X8,2449.62,1347.3,734.89,2155.67,35
HCPCS,Q4100,GRAFT DURAGEN 3X3,3106.94,1708.82,932.08,2734.11,35
HCPCS,Q4101,Apligraf,,,26.17,204.53,8
HCPCS,Q4101,HC APLIGRAF PER SQCM,110.0,60.5,33.0,96.8,70
HCPCS,Q4102,"HC OASIS WOUND MATRIX, PER SQUARE CENTIMETER (3 X 3.5CM)",55.5,30.53,16.65,48.84,35
HCPCS,Q4102,"HC OASIS WOUND MATRIX, PER SQUARE CENTIMETER (5 X 7 CM)",42.5,23.38,12.75,37.4,35
HCPCS,Q4102,Oasis wound matrix,,,10.36,78.98,8
HCPCS,Q4103,Oasis burn matrix,,,10.72,83.57,8
HCPCS,Q4104,CLIP ANEU L PERM CRVD 7MM,2165.31,1190.93,44.99,1872.99,48
HCPCS,Q4104,TISSUE DERM REGEN MATRIX 2X2,8856.1,4870.86,44.99,7660.53,48
HCPCS,Q4105,Integra drt or omnigraft,,,26.0,176.11,8
HCPCS,Q4106,Lab/Drugs Fee Schedule,,,43.74,54.0,6
HCPCS,Q4107,Graftjacket,,,117.17,144.66,6
HCPCS,Q4107,HC SKIN SUB GRAFT JACKET PER SQ CM,301.0,165.55,90.3,264.88,35
HCPCS,Q4108,Integra matrix,,,38.5,331.56,8
HCPCS,Q4110,Primatrix,,,56.16,441.52,8
HCPCS,Q4111,Gammagraft,,,6.29,48.06,8
HCPCS,Q4113,Graftjacket xpress,,,1715.06,2117.35,6
HCPCS,Q4114,Integra flowable wound matri,,,1374.29,10410.12,8
HCPCS,Q4115,Alloskin,,,13.01,97.74,8
HCPCS,Q4117,HC HYALOMATRIX PER SQCM (10X10CM PER SQCM),67.5,37.13,20.25,59.4,35
HCPCS,Q4117,HC HYALOMATRIX PER SQCM (5X5CM PER SQCM),79.5,43.73,23.85,69.96,35
HCPCS,Q4117,"HC HYALOMATRIX, PER SQ CM (2.5X2CM)",202.0,111.1,60.6,177.76,35
HCPCS,Q4117,Hyalomatrix,,,25.7,31.73,6
HCPCS,Q4118,Matristem micromatrix,,,2.18,17.28,8
HCPCS,Q4121,Theraskin,,,41.6,329.74,8
HCPCS,Q4122,"Dermacell, awm, porous sq cm",,,103.91,128.29,6
HCPCS,Q4123,Alloskin,,,68.5,482.96,8
HCPCS,Q4124,Oasis tri-layer wound matrix,,,8.78,16.74,8
HCPCS,Q4126,Memoderm/derma/tranz/integup,,,51.12,403.72,8
HCPCS,Q4127,Talymed,,,58.81,462.31,8
HCPCS,Q4128,Flexhd/allopatchhd/sq cm,,,26.27,207.23,8
HCPCS,Q4132,"Grafix core, grafixpl core",,,117.5,601.97,8
HCPCS,Q4132,"HC GRAFIX CORE, PER SQ CM, 1.5 X 2 CM",1859.0,1022.45,557.7,1635.92,35
HCPCS,Q4132,"HC GRAFIX CORE, PER SQ CM, 16 MM DISC",1525.5,839.03,457.65,1342.44,35
HCPCS,Q4132,"HC GRAFIX CORE, PER SQ CM, 2 X 3 CM",1162.0,639.1,348.6,1022.56,35
HCPCS,Q4133,Grafix stravix prime pl sqcm,,,119.13,919.22,8
HCPCS,Q4133,"HC GRAFIX PL PRIME, PER SQUARE CENTIMETER, 3X3CM",506.0,278.3,151.8,445.28,70
HCPCS,Q4133,"HC GRAFIX PRIME, PER SQ CM, 1.5 X 2 CM",1859.0,1022.45,557.7,1635.92,70
HCPCS,Q4133,"HC GRAFIX PRIME, PER SQ CM, 16 MM DISC",1536.0,844.8,460.8,1351.68,70
HCPCS,Q4133,"HC GRAFIX PRIME, PER SQ CM, 2 X 3 CM",1162.0,639.1,348.6,1022.56,105
HCPCS,Q4133,"HC GRAFIX PRIME, PER SQ CM, 3 X 4 CM",950.0,522.5,285.0,836.0,105
HCPCS,Q4137,Amnioexcel biodexcel 1sq cm,,,100.18,679.86,8
HCPCS,Q4138,"Biodfence dryflex, 1cm",,,80.33,677.7,8
HCPCS,Q4140,Biodfence 1cm,,,147.52,1112.67,8
HCPCS,Q4141,"Alloskin ac, 1 cm",,,32.61,437.06,8
HCPCS,Q4143,"Repriza, 1cm",,,29.16,228.96,8
HCPCS,Q4145,"Epifix, inj, 1mg",,,97.4,131.49,2
HCPCS,Q4147,Architect ecm px fx 1 sq cm,,,1353.39,1670.86,6
HCPCS,Q4148,Neox neox rt or clarix cord,,,109.48,850.91,8
HCPCS,Q4149,"Excellagen, 0.1 cc",,,149.4,184.44,6
HCPCS,Q4150,Allowrap ds or dry 1 sq cm,,,74.44,572.81,8
HCPCS,Q4151,"Amnioband, guardian 1 sq cm",,,123.15,926.03,8
HCPCS,Q4152,Dermapure 1 square cm,,,44.69,306.52,8
HCPCS,Q4153,"Dermavest, plurivest sq cm",,,199.8,733.05,8
HCPCS,Q4154,Biovance 1 square cm,,,123.95,964.31,8
HCPCS,Q4155,Neoxflo or clarixflo 1 mg,,,24.66,184.34,8
HCPCS,Q4156,Neox 100 or clarix 100,,,54.99,447.86,8
HCPCS,Q4157,Revitalon 1 square cm,,,174.2,215.07,6
HCPCS,Q4158,"Kerecis omega3, per sq cm",,,64.79,447.66,8
HCPCS,Q4159,Affinity1 square cm,,,226.12,1587.4,8
HCPCS,Q4160,Nushield 1 square cm,,,80.65,3577.5,8
HCPCS,Q4161,Bio-connekt per square cm,,,2500.3,11163.29,8
HCPCS,Q4162,"Wndex flw, bioskn flw, 0.5cc",,,2203.74,2720.67,6
HCPCS,Q4163,"Woundex, bioskin, per sq cm",,,156.42,1229.72,8
HCPCS,Q4164,"Helicoll, per square cm",,,1296.55,11076.28,8
HCPCS,Q4165,"Keramatrix, kerasorb sq cm",,,38.3,47.29,6
HCPCS,Q4166,"Cytal, per square centimeter",,,17.65,140.74,8
HCPCS,Q4167,"Truskin, per sq centimeter",,,103.91,128.28,6
HCPCS,Q4169,"Artacent wound, per sq cm",,,2949.17,14988.85,8
HCPCS,Q4170,"Cygnus, per sq cm",,,207.75,815.28,8
HCPCS,Q4171,"Interfyl, 1 mg",,,10.22,71.62,8
HCPCS,Q4173,Palingen or palingen xplus,,,978.41,2406.71,8
HCPCS,Q4174,Palingen or promatrx,,,1237.67,1527.99,6
HCPCS,Q4175,Miroderm,,,59.27,457.11,8
HCPCS,Q4176,"Neopatch or therion, 1 sq cm",,,152.49,188.26,6
HCPCS,Q4177,"Floweramnioflo, 0.1 cc",,,154.55,190.8,6
HCPCS,Q4178,"Floweramniopatch, per sq cm",,,74.85,628.49,8
HCPCS,Q4180,"Revita, per sq cm",,,1432.31,7357.97,8
HCPCS,Q4181,"Amnio wound, per square cm",,,139.99,172.82,6
HCPCS,Q4183,"Surgigraft, 1 sq cm",,,138.17,170.58,6
HCPCS,Q4184,Cellesta or duo per sq cm,,,400.2,661.8,8
HCPCS,Q4186,Epifix 1 sq cm,,,135.95,1014.73,8
HCPCS,Q4186,HC EPIFIX PER SQ CM (18MM DISC),958.5,527.18,287.55,843.48,70
HCPCS,Q4186,HC EPIFIX PER SQ CM (3.5X3.5 CM MESH),587.0,322.85,176.1,516.56,70
HCPCS,Q4186,HC EPIFIX PER SQCM (4X4),1330.0,731.5,399.0,1170.4,35
HCPCS,Q4187,Epicord 1 sq cm,,,208.4,1632.62,8
HCPCS,Q4187,HC EPICORD PER SQ CM (2X3 CM),2314.5,1272.98,694.35,2036.76,70
HCPCS,Q4188,Amnioarmor 1 sq cm,,,297.63,3291.23,8
HCPCS,Q4190,Artacent ac 1 sq cm,,,202.37,873.59,8
HCPCS,Q4191,Restorigin 1 sq cm,,,872.6,4930.4,8
HCPCS,Q4193,Coll-e-derm 1 sq cm,,,2009.99,11563.97,8
HCPCS,Q4194,Novachor 1 sq cm,,,737.47,4845.02,8
HCPCS,Q4195,Puraply 1 sq cm,,,88.25,728.46,8
HCPCS,Q4196,HC PURAPLY AM 2 X 2 CM PER SQCM,1139.5,626.73,341.85,1002.76,35
HCPCS,Q4196,HC PURAPLY AM DISC 1.6 CM PER SQCM,1045.5,575.03,313.65,920.04,35
HCPCS,Q4196,"HC PURAPLY AM, PER SQ CM (6X9CM)",811.5,446.33,243.45,714.12,35
HCPCS,Q4196,Puraply am 1 sq cm,,,90.75,665.15,8
HCPCS,Q4197,Puraply xt 1 sq cm,,,62.37,479.52,8
HCPCS,Q4199,"Cygnus matrix, per sq cm",,,312.35,879.26,8
HCPCS,Q4201,Matrion 1 sq cm,,,73.01,534.8,8
HCPCS,Q4203,"Derma-gide, 1 sq cm",,,257.73,5881.75,8
HCPCS,Q4204,Xwrap 1 sq cm,,,2937.59,25479.7,8
HCPCS,Q4205,Membrane graft or wrap sq cm,,,532.8,1229.19,8
HCPCS,Q4213,"Ascent, 0.5 mg",,,59.23,73.12,6
HCPCS,Q4217,Woundfix biowound plus xplus,,,318.42,2146.5,8
HCPCS,Q4219,Surgigraft dual per sq cm,,,677.43,836.33,6
HCPCS,Q4221,Amniowrap2 per sq cm,,,1649.14,13236.75,8
HCPCS,Q4222,"Progenamatrix, per sq cm",,,100.42,860.96,8
HCPCS,Q4225,"Amnio or derma tl, per sq cm",,,1253.17,9252.43,8
HCPCS,Q4227,Amniocore per sq cm,,,1079.62,1492.7,8
HCPCS,Q4229,Cogenex amnio memb per sq cm,,,447.35,2229.59,8
HCPCS,Q4231,Lab/Drugs Fee Schedule,,,869.86,1073.9,6
HCPCS,Q4232,"Corplex, per sq cm",,,227.66,878.24,8
HCPCS,Q4234,"Xcellerate, per sq cm",,,219.07,1315.1,8
HCPCS,Q4235,Amniorepair or altiply sq cm,,,81.69,543.24,8
HCPCS,Q4237,"Cryo-cord, per sq cm",,,428.81,529.39,6
HCPCS,Q4238,"Derm-maxx, per sq cm",,,1337.69,11644.02,8
HCPCS,Q4239,Amnio-maxx or lite per sq cm,,,2168.58,13759.88,8
HCPCS,Q4246,"Coretext or protext, per cc",,,2764.69,3413.2,6
HCPCS,Q4247,"Amniotext patch, per sq cm",,,1955.13,2413.74,6
HCPCS,Q4248,Dermacyte amn mem allo sq cm,,,2315.95,19065.38,8
HCPCS,Q4249,"Amniply, per sq cm",,,2320.07,12079.46,8
HCPCS,Q4250,Amnioamp-mp per sq cm,,,2451.63,19586.21,8
HCPCS,Q4251,"Vim, per square centimeter",,,154.55,190.8,6
HCPCS,Q4252,"Vendaje, per square centimet",,,66.09,357.75,8
HCPCS,Q4253,Zenith amniotic membrane psc,,,102.55,561.47,8
HCPCS,Q4256,"Mlg complet, per sq cm",,,835.27,5489.17,8
HCPCS,Q4257,"Relese, per sq cm",,,418.75,4405.46,8
HCPCS,Q4258,"Enverse, per sq cm",,,63.05,556.27,8
HCPCS,Q4259,Celera per sq cm,,,1099.64,6354.86,8
HCPCS,Q4261,"Tag, per square centimeter",,,621.81,767.67,6
HCPCS,Q4262,"Dual layer impax, per sq cm",,,259.74,424.24,8
HCPCS,Q4263,"Surgraft tl, per sq cm",,,786.2,11562.75,8
HCPCS,Q4264,"Cocoon membrane, per sq cm",,,1864.45,3434.25,8
HCPCS,Q4265,Neostim tl per sq cm,,,1815.68,11502.2,8
HCPCS,Q4266,Neostim per sq cm,,,763.23,3783.85,8
HCPCS,Q4267,Neostim dl per sq cm,,,318.81,1957.64,8
HCPCS,Q4268,Surgraft ft per sq cm,,,1128.38,3055.79,8
HCPCS,Q4269,Surgraft xt per sq cm,,,773.65,5151.6,8
HCPCS,Q4270,Complete sl per sq cm,,,16854.0,22752.9,2
HCPCS,Q4271,Complete ft per sq cm,,,1323.63,8170.74,8
HCPCS,Q4272,"Esano a, per sq cm",,,300.6,371.11,6
HCPCS,Q4274,"Esano ac, per sq cm",,,1830.08,12368.16,8
HCPCS,Q4275,"Esano aca, per sq cm",,,2208.85,18059.49,8
HCPCS,Q4276,"Orion, per sq cm",,,415.39,1763.51,8
HCPCS,Q4278,"Epieffect, per sq cm",,,262.79,1789.49,8
HCPCS,Q4279,"Vendaje ac, per sq cm",,,2047.76,16098.75,8
HCPCS,Q4280,Xcell amnio matrix per sq cm,,,1769.06,19526.74,8
HCPCS,Q4281,Barrera slor dl per sq cm,,,762.53,3672.34,8
HCPCS,Q4282,Cygnus dual per sq cm,,,417.95,2273.13,8
HCPCS,Q4283,"Biovance tri or 3l, sq cm",,,567.0,3086.91,8
HCPCS,Q4285,Nudyn dl or dl mesh pr sq cm,,,165.07,203.79,6
HCPCS,Q4286,"Nudyn sl or slw, per sq cm",,,217.57,268.6,6
HCPCS,Q4289,"Revoshield+ amnio, per sq cm",,,1596.56,9909.74,8
HCPCS,Q4290,Membrane wrap hydr per sq cm,,,1905.6,12586.79,8
HCPCS,Q4291,"Lamellas xt, per sq cm",,,2993.9,3696.18,6
HCPCS,Q4292,"Lamellas, per sq cm",,,1262.8,1559.01,6
HCPCS,Q4293,"Acesso dl, per sq cm",,,1282.58,10696.73,8
HCPCS,Q4294,"Amnio quad-core, per sq cm",,,954.0,3180.7,8
HCPCS,Q4295,"Amnio tri-core, per sq cm",,,1163.95,2799.01,8
HCPCS,Q4296,"Rebound matrix, per sq cm",,,2320.21,9822.2,8
HCPCS,Q4297,"Emerge matrix, per sq cm",,,1535.32,11457.11,8
HCPCS,Q4298,"Amniocore pro, per sq cm",,,857.45,2302.75,8
HCPCS,Q4299,"Amniocore pro+, per sq cm",,,1110.95,2640.46,8
HCPCS,Q4300,"Acesso tl, per sq cm",,,1815.68,14274.23,8
HCPCS,Q4301,"Activate matrix, per sq cm",,,1661.34,12192.8,8
HCPCS,Q4302,"Complete aca, per sq cm",,,1724.67,8583.3,8
HCPCS,Q4303,"Complete aa, per sq cm",,,2930.22,22734.0,8
HCPCS,Q4304,"Grafix plus, per sq cm",,,789.9,4142.34,8
HCPCS,Q4309,"Via matrix, per sq cm",,,1803.96,8832.71,8
HCPCS,Q4310,"Procenta, per 100 mg",,,1850.27,8892.18,8
HCPCS,Q4313,"Dermabind fm, per sq cm",,,2976.24,23764.66,8
HCPCS,Q4316,"Amchoplast, per sq cm",,,22079.85,29807.8,2
HCPCS,Q4319,"Sanograft, per sq cm",,,644.93,4293.0,8
HCPCS,Q4320,"Pellograft, per sq cm",,,773.07,954.41,6
HCPCS,Q4321,"Renograft, per sq cm",,,3816.0,5151.6,2
HCPCS,Q4322,"Caregraft, per sq cm",,,2026.9,12091.21,8
HCPCS,Q4323,"Alloply, per sq cm",,,1683.23,10628.15,8
HCPCS,Q4324,"Amniotx, per sq cm",,,1665.36,2056.0,6
HCPCS,Q4325,"Acapatch, per sq cm",,,2430.41,13809.56,8
HCPCS,Q4326,"Woundplus, per sq cm",,,1612.83,7309.91,8
HCPCS,Q4328,"Most, per sq cm",,,3000.05,24794.84,8
HCPCS,Q4331,"Axolotl graft, per sq cm",,,1744.04,11053.46,8
HCPCS,Q4332,"Axolotl dualgraft, per sq cm",,,1744.63,11363.42,8
HCPCS,Q4333,"Ardeograft, per sq cm",,,735.33,907.81,6
HCPCS,Q4339,"Artacent vericlen, per sq cm",,,2441.77,13873.55,8
HCPCS,Q4341,"Simplimax, per sq cm",,,3031.37,20731.14,8
HCPCS,Q4342,"Theramend, per sq cm",,,3639.29,14357.99,8
HCPCS,Q4343,Dermacyte ac matrx per sq cm,,,2392.33,19926.68,8
HCPCS,Q4344,"Tri membrane wrap, per sq cm",,,2626.63,18153.99,8
HCPCS,Q4346,Shelter dm matrix per sq cm,,,3609.23,4455.83,6
HCPCS,Q4348,Sentry sl matrix per sq cm,,,2010.85,2482.53,6
HCPCS,Q4349,Mantle dl matrix per sq cm,,,3609.23,4455.83,6
HCPCS,Q4350,Palisade dm matrix per sq cm,,,3609.23,4455.83,6
HCPCS,Q4351,"Enclose tl matrix, per sq cm",,,3867.02,4774.1,6
HCPCS,Q4352,"Overlay sl matrix, per sq cm",,,2010.85,2482.53,6
HCPCS,Q4353,Xceed tl matrix per sq cm,,,3046.7,3761.35,6
HCPCS,Q4357,"Xwrap plus, per sq cm",,,23850.0,32197.5,2
HCPCS,Q4361,"Epixpress, per sq cm",,,7950.0,10732.5,2
HCPCS,Q4367,"Amniocore sl, per sq cm",,,17.2,23.22,2
HCPCS,Q5099,"Inj ustekinumab-stba, 1 mg",,,12.64,13.02,15
HCPCS,Q5100,"Inj ustekinumab-kfce, 1 mg",,,24.98,25.73,15
HCPCS,Q5101,filgrastim-sndz 300 mcg/0.5 mL Solution Prefilled Syringe 0.5 mL Syringe,1496.54,823.1,0.31,1294.51,63
HCPCS,Q5101,filgrastim-sndz 480 mcg/0.8 mL Solution Prefilled Syringe 0.8 mL Syringe,2385.49,1312.02,0.31,2063.45,63
HCPCS,Q5103,inFLIXimab-dyyb 100 mg Recon Soln 1 Each Vial,5124.91,2818.71,9.92,4433.05,63
HCPCS,Q5104,inFLIXimab-abda 100 MG Recon Soln 1 Each Vial,4083.31,2245.83,22.55,3532.06,63
HCPCS,Q5105,Inj retacrit esrd on dialysi,,,0.65,5.13,23
HCPCS,Q5106,epoetin alfa-epbx 10000 UNIT/ML Solution 1 mL Vial,610.62,335.85,6.42,528.19,63
HCPCS,Q5106,epoetin alfa-epbx 2000 UNIT/ML Solution 1 mL Vial,163.39,89.87,6.42,141.33,63
HCPCS,Q5106,epoetin alfa-epbx 20000 UNIT/ML Solution 1 mL Vial,1206.24,663.44,6.42,1043.4,63
HCPCS,Q5106,epoetin alfa-epbx 4000 UNIT/ML Solution 1 mL Vial,279.72,153.85,6.42,241.96,63
HCPCS,Q5106,epoetin alfa-epbx 40000 UNIT/ML Solution 1 mL Vial,2397.48,1318.62,6.42,2073.82,63
HCPCS,Q5107,bevacizumab-awwb 100 MG/4ML Solution 4 mL Vial,3164.79,1740.64,24.67,2737.54,63
HCPCS,Q5107,bevacizumab-awwb 400 MG/16ML Solution 16 mL Vial,12020.85,6611.47,24.67,10398.04,63
HCPCS,Q5108,Pegfilgrastim-jmdb 6 MG/0.6ML Solution Prefilled Syringe 0.6 mL Syringe,8777.5,4827.63,99.13,7592.54,63
HCPCS,Q5110,filgrastim-aafi 300 mcg/0.5 ml Solution Prefilled Syringe 0.5 mL Syringe,1197.6,658.68,0.25,1035.92,63
HCPCS,Q5110,filgrastim-aafi 480 mcg/0.8 mL Solution Prefilled Syringe 0.8 mL Syringe,1907.16,1048.94,0.25,1649.69,63
HCPCS,Q5111,Pegfilgrastim-cbqv 6 MG/0.6ML Solution Prefilled Syringe 0.6 mL Syringe,17545.0,9649.75,106.33,15176.43,63
HCPCS,Q5111,pegfilgrastim-cbqv 6 MG/0.6ML Solution Prefilled Syringe 0.6 mL Syringe,17545.0,9649.75,106.33,15176.43,63
HCPCS,Q5112,trastuzumab-dttb 21 mg/mL Recon Soln 1 Each Vial,10977.42,6037.584999999999,19.0,13813.07,126
HCPCS,Q5113,trastuzumab-pkrb 21 mg/mL Recon Soln 1 Each Vial,11621.175,6391.650000000001,61.8,14623.78,126
HCPCS,Q5114,trastuzumab-dkst 21 mg/mL Recon Soln 1 Each Vial,11307.72,6219.25,40.29,9781.18,63
HCPCS,Q5114,trastuzumab-dkst 21 mg/ml Recon Soln 1 Each Vial,4257.3,2341.52,40.29,3682.56,63
HCPCS,Q5115,riTUXimab-abbs 100 MG/10ML Solution 10 mL Vial,3829.98,2106.49,27.33,3312.93,63
HCPCS,Q5115,riTUXimab-abbs 500 MG/50ML Solution 50 mL Vial,18199.33,10009.64,27.33,15742.42,63
HCPCS,Q5116,trastuzumab-qyyp 21 mg/mL Recon Soln 1 Each Vial,10038.295,5521.07,16.29,12630.42,126
HCPCS,Q5117,trastuzumab-anns 21 mg/mL Recon Soln 1 Each Vial,6145.32,3379.93,29.78,5315.7,63
HCPCS,Q5117,trastuzumab-anns 21 mg/ml Recon Soln 1 Each Vial,16395.17,9017.35,29.78,14181.82,63
HCPCS,Q5118,bevacizumab-bvzr 100 mg/4mL Solution 4 mL Vial,2785.3,1531.92,19.75,2409.28,63
HCPCS,Q5118,bevacizumab-bvzr 400 mg/16mL Solution 16 mL Vial,11066.2,6086.41,19.75,9572.26,63
HCPCS,Q5119,riTUXimab-pvvr 1 mg/0.1 mL Solution 0.5 mL Syringe,198.45,109.15,20.26,178.88,63
HCPCS,Q5119,riTUXimab-pvvr 100 MG/10ML Solution 10 mL Vial,3250.6,1787.83,20.26,2811.77,63
HCPCS,Q5119,riTUXimab-pvvr 500 MG/50ML Solution 50 mL Vial,15431.2,8487.16,20.26,13347.99,63
HCPCS,Q5120,pegfilgrastim-bmez 6 MG/0.6ML Solution Prefilled Syringe 0.6 mL Syringe,16497.23,9073.48,21.21,14270.1,63
HCPCS,Q5121,inFLIXimab-axxq 100 MG Recon Soln 1 Each Vial,2715.0,1493.25,17.03,2348.48,63
HCPCS,Q5122,pegfilgrastim-apgf 6 MG/0.6ML Solution Prefilled Syringe 0.6 mL Syringe,16495.0,9072.25,100.47,14268.18,63
HCPCS,Q5123,riTUXimab-arrx 100 mg/10 mL Solution 10 mL Vial,3250.6,1787.83,26.51,2811.77,63
HCPCS,Q5123,riTUXimab-arrx 500 mg/50 mL Solution 50 mL Vial,15431.2,8487.16,26.51,13347.99,63
HCPCS,Q5124,"Inj. byooviz, 0.1 mg",,,61.8,419.51,23
HCPCS,Q5125,filgrastim-ayow 300 mcg/0.5mL Solution Prefilled Syringe 0.5 mL Syringe,873.6,480.48,0.38,755.66,63
HCPCS,Q5125,filgrastim-ayow 480 mcg/0.8mL Solution Prefilled Syringe 0.8 mL Syringe,1388.76,763.82,0.38,1201.28,63
HCPCS,Q5126,bevacizumab-maly 100 MG/4ML Solution 4 mL Vial,3258.7,1792.29,37.82,2818.78,63
HCPCS,Q5126,bevacizumab-maly 400 MG/16ML Solution 16 mL Vial,12379.92,6808.96,37.82,10708.63,63
HCPCS,Q5127,Pegfilgrastim-fpgk 6 MG/0.6ML Solution Prefilled Syringe 0.6 mL Syringe,18071.05,9939.08,184.91,15631.46,63
HCPCS,Q5128,ranibizumab-eqrn 0.3 MG/0.05ML Solution 0.05 mL Vial,4421.4,2431.77,86.16,3824.51,63
HCPCS,Q5128,ranibizumab-eqrn 0.5 MG/0.05ML Solution 0.05 mL Vial,7359.0,4047.45,86.16,6365.54,63
HCPCS,Q5129,bevacizumab-adcd 100 MG/4ML Solution 4 mL Vial,3073.3,1690.32,39.96,2658.4,63
HCPCS,Q5129,bevacizumab-adcd 400 MG/16ML Solution 16 mL Vial,11671.28,6419.21,39.96,10095.66,63
HCPCS,Q5130,pegfilgrastim-pbbk 6 MG/0.6ML Solution Prefilled Syringe 0.6 mL Syringe,10510.0,5780.5,137.97,9091.15,63
HCPCS,Q5133,tocilizumab-bavi 200 MG/10ML Solution 10 mL Vial,6009.0,3304.95,5.15,5197.79,63
HCPCS,Q5133,tocilizumab-bavi 400 MG/20ML Solution 20 mL Vial,9334.0,5133.7,5.15,8073.91,63
HCPCS,Q5135,tocilizumab-aazg 200 MG/10ML Solution 10 mL Vial,5302.68,2916.48,3.53,4586.82,63
HCPCS,Q5135,tocilizumab-aazg 400 MG/20ML Solution 20 mL Vial,10590.36,5824.7,3.53,9160.66,63
HCPCS,Q5135,tocilizumab-aazg 80 MG/4ML Solution 4 mL Vial,2130.07,1171.54,3.53,1842.51,63
HCPCS,Q5136,"Inj. denosumab-bbdz, 1 mg",,,27.54,28.36,15
HCPCS,Q5137,"Inj, wezlana, sub cu, 1 mg",,,189.47,233.91,6
HCPCS,Q5138,"Inj, wezlana, iv, 1 mg",,,11.65,360.53,21
HCPCS,Q5140,"Inj adalimumab-fkjp, 1 mg",,,13.18,92.37,21
HCPCS,Q5141,"Inj adalimumab-aaty, 1 mg",,,13.75,46.18,21
HCPCS,Q5142,"Inj adalimumab-ryvk, 1 mg",,,9.05,11.17,21
HCPCS,Q5143,"Inj adalimumab-adbm, 1 mg",,,8.96,11.06,21
HCPCS,Q5144,"Inj, idacio, 1 mg",,,7.69,15.92,21
HCPCS,Q5145,"Inj, abrilada, 1 mg",,,19.47,135.75,21
HCPCS,Q5146,"Inj, hercessi, 10 mg",,,40.03,514.22,23
HCPCS,Q5147,aflibercept-ayyh 2 MG/0.05ML Solution Prefilled Syringe 0.05 mL Syringe,9006.0,4953.3,859.36,7790.19,63
HCPCS,Q5148,"Inj, nyposi 1 mcg",,,0.55,0.57,15
HCPCS,Q5151,eculizumab-aagh 300 mg/30 mL Solution 30 mL Vial,19653.8,10809.59,31.35,17000.54,63
HCPCS,Q5152,eculizumab-aeeb 300 mg/30 mL Solution 30 mL Vial,24084.87,13246.68,40.31,20833.41,63
HCPCS,Q5157,"Inj, denosumab-bmwo, 1 mg",,,28.13,28.97,15
HCPCS,Q5158,"Inj, denosumab-bnht, 1 mg",,,28.72,29.58,15
HCPCS,Q9950,sulfur hexafluoride microsph 45 mcg/ml (after reconstitution) Recon Susp 1 Each Vial,502.35,276.3,16.04,434.53,48
HCPCS,Q9956,perflutren protein A microsphere Suspension 3 mL Vial,689.88,379.44,35.73,596.75,48
HCPCS,Q9957,"Inj perflutren lip micros,ml",,,35.73,278.1,8
HCPCS,Q9958,"HOCM <=149 mg/ml iodine, 1ml",,,0.05,0.47,8
HCPCS,Q9961,"HOCM 250-299mg/ml iodine,1ml",,,0.25,1.96,8
HCPCS,Q9963,diatrizoate meglumine and diatrizoate sodium 66-10 % Solution 30 mL Bottle,89.63,49.3,0.19,77.53,48
HCPCS,Q9965,"LOCM 100-199mg/ml iodine,1ml",,,1.03,12.15,8
HCPCS,Q9966,iohexol 240 mg/mL Solution 50 mL Bottle,142.2,78.21,0.35,123.0,48
HCPCS,Q9967,CONTRAST VISIPAQUE 320 150ML,276.35,152.0,0.13,239.04,48
HCPCS,Q9967,HC OMNIPAQUE 300-349 MG ML PER ML,2.0,1.1,0.13,1.73,48
HCPCS,Q9967,"HC OMNIPAQUE, LOW OCM, 300-399 MG/ML IODINE, 1ML - PROTON",4.0,2.2,0.13,3.46,48
HCPCS,Q9967,"HC OMNIPAQUE, LOW OSM CONTRAST, 300-399 MG/ML IODINE CONCENTRATION, PER ML",4.0,2.2,0.13,3.46,192
HCPCS,Q9967,HC VISIPAQUE 350-399 MG ML PER ML,3.0,1.65,0.13,2.6,48
HCPCS,Q9967,"HC VISIPAQUE, LOW OCM, 300-399 MG/ML IODINE, 1ML- PROTON",4.0,2.2,0.13,3.46,48
HCPCS,Q9967,"HC VISIPAQUE, LOW OSM CONTRAST, 300-399 MG/ML IODINE CONCENTRATION, PER ML",4.0,2.2,0.13,3.46,144
HCPCS,Q9967,iohexol 300 mg/mL Solution 100 mL Bottle,322.8,177.54,0.13,279.22,48
HCPCS,Q9967,iohexol 300 mg/mL Solution 150 mL Bottle,468.58,257.72,0.13,405.32,48
HCPCS,Q9967,iohexol 300 mg/mL Solution 200 mL Bottle,579.0,318.45,0.13,500.84,48
HCPCS,Q9967,iohexol 300 mg/mL Solution 50 mL Bottle,167.23,91.98,0.13,144.65,48
HCPCS,Q9967,iohexol 300 mg/mL Solution 500 mL Bottle,1485.5,817.03,0.13,1284.96,48
HCPCS,Q9968,isosulfan blue 1 % Solution 5 mL Vial,6571.63,3614.4,7.64,5684.46,63
HCPCS,Q9968,methylene blue 1 % Solution 1 mL Vial,136.34,74.99,7.64,117.93,63
HCPCS,Q9968,methylene blue 1 % Solution 10 mL Vial,1149.0,631.95,7.64,993.89,63
HCPCS,Q9969,"HC TC-99M FROM NON-HEU, FULL COST RECOVERY ADD-ON, PER STUDY DOSE",75.0,41.25,8.59,66.0,63
HCPCS,Q9982,flutemetamol f18 diagnostic,,,750.75,1922.58,21
HCPCS,Q9983,florbetaben f18 diagnostic,,,1093.65,1350.19,21
HCPCS,Q9991,Buprenorph xr 100 mg or less,,,1658.66,13341.71,23
HCPCS,Q9992,Buprenorphine xr over 100 mg,,,1658.66,13341.71,23
HCPCS,Q9998,"Inj ustekinumab-aekn, 1 mg",,,40.35,41.56,15
HCPCS,Q9999,Inj ustekinumab-aauz 1 mg,,,33.09,34.08,15
HCPCS,S0080,pentamidine Recon Soln 1 Each Vial,916.21,503.92,274.86,792.52,38
HCPCS,S0189,testosterone 75 MG PELLET 10 Each Box,599.19,329.56,179.76,518.3,38
HCPCS,U0001,2019-ncov diagnostic p,,,34.91,179.6,23
HCPCS,U0002,Covid-19 lab test non-cdc,,,49.87,256.55,23
HCPCS,U0003,Lab/Pathology,,,375.0,375.0,1
HCPCS,U0003,Laboratory,,,375.0,375.0,1
HCPCS,U0004,Lab/Pathology,,,375.0,375.0,1
HCPCS,U0004,Laboratory,,,375.0,375.0,1
HCPCS,U0005,Lab/Pathology,,,125.0,125.0,1
HCPCS,U0005,Laboratory,,,125.0,125.0,1
HCPCS,V2020,Vision svcs frames purchases,,,90.29,93.0,15
HCPCS,V2100,Lens spher single plano 4.00,,,55.8,57.47,15
HCPCS,V2101,Single visn sphere 4.12-7.00,,,53.62,55.23,15
HCPCS,V2102,Singl visn sphere 7.12-20.00,,,92.7,95.48,15
HCPCS,V2103,Spherocylindr 4.00d/12-2.00d,,,46.97,48.38,15
HCPCS,V2104,Spherocylindr 4.00d/2.12-4d,,,48.42,49.87,15
HCPCS,V2105,Spherocylinder 4.00d/4.25-6d,,,57.6,59.33,15
HCPCS,V2106,Spherocylinder 4.00d/>6.00d,,,63.8,65.71,15
HCPCS,V2107,Spherocylinder 4.25d/12-2d,,,56.81,58.51,15
HCPCS,V2108,Spherocylinder 4.25d/2.12-4d,,,56.97,58.68,15
HCPCS,V2109,Spherocylinder 4.25d/4.25-6d,,,79.34,81.72,15
HCPCS,V2110,Spherocylinder 4.25d/over 6d,,,64.08,66.0,15
HCPCS,V2111,Spherocylindr 7.25d/.25-2.25,,,77.66,79.99,15
HCPCS,V2112,Spherocylindr 7.25d/2.25-4d,,,87.73,90.36,15
HCPCS,V2113,Spherocylindr 7.25d/4.25-6d,,,88.72,91.38,15
HCPCS,V2114,Spherocylinder over 12.00d,,,105.11,108.26,15
HCPCS,V2115,Lens lenticular bifocal,,,105.94,109.12,15
HCPCS,V2118,Lens aniseikonic single,,,115.28,118.74,15
HCPCS,V2121,"Lenticular lens, single",,,103.96,107.08,15
HCPCS,V2200,Lens spher bifoc plano 4.00d,,,62.84,64.73,15
HCPCS,V2201,Lens sphere bifocal 4.12-7.0,,,67.33,69.35,15
HCPCS,V2202,Lens sphere bifocal 7.12-20.,,,83.47,85.97,15
HCPCS,V2203,Lens sphcyl bifocal 4.00d/.1,,,64.72,66.66,15
HCPCS,V2204,Lens sphcy bifocal 4.00d/2.1,,,66.59,68.59,15
HCPCS,V2205,Lens sphcy bifocal 4.00d/4.2,,,73.83,76.04,15
HCPCS,V2206,Lens sphcy bifocal 4.00d/ove,,,86.66,89.26,15
HCPCS,V2207,Lens sphcy bifocal 4.25-7d/.,,,73.25,75.45,15
HCPCS,V2208,Lens sphcy bifocal 4.25-7/2.,,,71.98,74.14,15
HCPCS,V2209,Lens sphcy bifocal 4.25-7/4.,,,84.5,87.04,15
HCPCS,V2210,Lens sphcy bifocal 4.25-7/ov,,,91.05,93.78,15
HCPCS,V2211,Lens sphcy bifo 7.25-12/.25-,,,88.64,91.3,15
HCPCS,V2212,Lens sphcyl bifo 7.25-12/2.2,,,92.78,95.56,15
HCPCS,V2213,Lens sphcyl bifo 7.25-12/4.2,,,97.56,100.49,15
HCPCS,V2214,Lens sphcyl bifocal over 12.,,,101.96,105.02,15
HCPCS,V2215,Lens lenticular bifocal,,,127.3,131.12,15
HCPCS,V2218,Lens aniseikonic bifocal,,,129.73,133.62,15
HCPCS,V2219,Lens bifocal seg width over,,,59.84,61.64,15
HCPCS,V2220,Lens bifocal add over 3.25d,,,53.16,54.75,15
HCPCS,V2221,"Lenticular lens, bifocal",,,106.02,109.2,15
HCPCS,V2300,Lens sphere trifocal 4.00d,,,85.9,88.48,15
HCPCS,V2301,Lens sphere trifocal 4.12-7.,,,105.36,108.52,15
HCPCS,V2302,Lens sphere trifocal 7.12-20,,,98.42,101.37,15
HCPCS,V2303,Lens sphcy trifocal 4.0/.12-,,,82.69,85.17,15
HCPCS,V2304,Lens sphcy trifocal 4.0/2.25,,,83.65,86.16,15
HCPCS,V2305,Lens sphcy trifocal 4.0/4.25,,,93.45,96.25,15
HCPCS,V2306,Lens sphcyl trifocal 4.00/>6,,,96.22,99.11,15
HCPCS,V2307,Lens sphcy trifocal 4.25-7/.,,,91.62,94.37,15
HCPCS,V2308,Lens sphc trifocal 4.25-7/2.,,,99.93,102.93,15
HCPCS,V2309,Lens sphc trifocal 4.25-7/4.,,,104.58,107.72,15
HCPCS,V2310,Lens sphc trifocal 4.25-7/>6,,,109.23,112.51,15
HCPCS,V2311,Lens sphc trifo 7.25-12/.25-,,,126.13,129.91,15
HCPCS,V2312,Lens sphc trifo 7.25-12/2.25,,,115.61,119.08,15
HCPCS,V2313,Lens sphc trifo 7.25-12/4.25,,,126.2,129.99,15
HCPCS,V2314,Lens sphcyl trifocal over 12,,,129.0,132.87,15
HCPCS,V2315,Lens lenticular trifocal,,,143.21,147.51,15
HCPCS,V2318,Lens aniseikonic trifocal,,,176.06,181.34,15
HCPCS,V2319,Lens trifocal seg width > 28,,,79.48,81.86,15
HCPCS,V2320,Lens trifocal add over 3.25d,,,83.84,86.36,15
HCPCS,V2321,"Lenticular lens, trifocal",,,141.16,145.39,15
HCPCS,V2410,Lens variab asphericity sing,,,123.41,127.11,15
HCPCS,V2430,Lens variable asphericity bi,,,130.63,134.55,15
HCPCS,V2500,Contact lens pmma spherical,,,110.43,113.74,15
HCPCS,V2501,Cntct lens pmma-toric/prism,,,156.71,161.41,15
HCPCS,V2502,Contact lens pmma bifocal,,,212.34,218.71,15
HCPCS,V2503,Cntct lens pmma color vision,,,205.09,211.24,15
HCPCS,V2510,Cntct gas permeable sphericl,,,147.25,151.67,15
HCPCS,V2511,Cntct toric prism ballast,,,218.26,224.81,15
HCPCS,V2512,Cntct lens gas permbl bifocl,,,251.23,258.77,15
HCPCS,V2513,Contact lens extended wear,,,253.09,260.68,15
HCPCS,V2520,Contact lens hydrophilic,,,146.73,151.13,15
HCPCS,V2521,Cntct lens hydrophilic toric,,,290.57,299.29,15
HCPCS,V2522,Cntct lens hydrophil bifocl,,,212.64,219.02,15
HCPCS,V2523,Cntct lens hydrophil extend,,,223.26,229.96,15
HCPCS,V2524,Cntct lens hydrophil photoch,,,168.13,173.17,15
HCPCS,V2530,Contact lens gas impermeable,,,356.93,367.64,15
HCPCS,V2531,Contact lens gas permeable,,,653.64,673.25,15
HCPCS,V2623,Plastic eye prosth custom,,,1131.79,1165.74,15
HCPCS,V2624,Polishing artifical eye,,,73.07,75.26,15
HCPCS,V2625,Enlargemnt of eye prosthesis,,,578.67,596.03,15
HCPCS,V2626,Reduction of eye prosthesis,,,239.46,246.64,15
HCPCS,V2627,Scleral cover shell,,,1716.72,1768.22,15
HCPCS,V2628,Fabrication & fitting,,,365.17,376.13,15
HCPCS,V2630,Anter chamber intraocul lens,,,142.87,147.16,15
HCPCS,V2631,Iris support intraoclr lens,,,142.87,147.16,15
HCPCS,V2632,IOL PC AR40E -10.5D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC AR40E 15.5D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC AR40E 17.5D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC AR40E 18.5D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC AR40E 19.5D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC AR40E 20.5D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC AR40E 22.5D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 10.5D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 12.0D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 13.0D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 14.0D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 14.5D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 15.5D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 16.5D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 17.5D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 18.0D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 18.5D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 19.0D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 19.5D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 20.0D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 20.5D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 21.0D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 21.5D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 22.0D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 23.0D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 23.5D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 24.0D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 24.5D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 25.0D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 26.0D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 27.5D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 28.0D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 31.0D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC DCB00 W/TECNIS 9.0D,575.0,316.25,142.87,506.0,50
HCPCS,V2632,IOL PC EC-3 PAL 18.0D,787.5,433.13,142.87,693.0,50
HCPCS,V2632,IOL PC EC-3 PAL 21.5D,787.5,433.13,142.87,693.0,50
HCPCS,V2632,IOL PC EYHANCE DIB00 10.5D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 11.5D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 12.0D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 12.5D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 13.5D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 14.0D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 14.5D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 15.0D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 15.5D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 16.0D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 16.5D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 17.0D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 17.5D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 18.0D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 18.5D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 19.0D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 19.5D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 20.0D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 20.5D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 21.0D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 21.5D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 22.0D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 22.5D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 23.0D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 23.5D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 24.0D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 24.5D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 25.0D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 25.5D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 26.0D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 26.5D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 28.5D,630.0,346.5,142.87,554.4,50
HCPCS,V2632,IOL PC EYHANCE DIB00 29.5D,630.0,346.5,142.87,554.4,50
HCPCS,V2700,Balance lens,,,53.82,55.43,15
HCPCS,V2710,Glass/plastic slab off prism,,,88.23,90.88,15
HCPCS,V2715,Prism lens/es,,,17.3,17.82,15
HCPCS,V2718,HC FRESNEL PRISM LENS,278.0,152.9,37.36,240.47,159
HCPCS,V2730,Special base curve,,,31.27,32.21,15
HCPCS,V2744,Tint photochromatic lens/es,,,21.4,22.04,15
HCPCS,V2745,"Tint, any color/solid/grad",,,12.32,12.69,15
HCPCS,V2750,Anti-reflective coating,,,24.02,24.74,15
HCPCS,V2755,UV lens/es,,,20.11,20.71,15
HCPCS,V2760,Scratch resistant coating,,,19.82,20.41,15
HCPCS,V2762,"Polarization, any lens",,,71.96,74.12,15
HCPCS,V2770,Occluder lens/es,,,23.42,24.12,15
HCPCS,V2780,Oversize lens/es,,,15.04,15.49,15
HCPCS,V2782,"Lens, 1.54-1.65 p/1.60-1.79g",,,77.71,80.04,15
HCPCS,V2783,"Lens, >= 1.66 p/>=1.80 g",,,87.64,90.27,15
HCPCS,V2784,Lens polycarb or equal,,,56.99,58.7,15
HCPCS,V2785,IMPL TISSUE CORNEA,12450.0,6847.5,3735.0,10956.0,35
HCPCS,V2785,IMPL TISSUE CORNEA PRECUT,13365.0,7350.75,4009.5,11761.2,35
HCPCS,V2790,HC AMBIODISK AMNIOTIC MEMBRANE,2965.0,1630.75,889.5,2609.2,70
HCPCS,V2790,HC PROKERA AMNIOTIC MEMBRANE,4971.5,2734.33,1491.45,4374.92,70
HCPCS,V5014,HC HEARING AID RECASE MONO DI,100.0,55.0,30.0,471.0,38
HCPCS,V5014,HC HEARING AID REPR DIGITAL MONAURAL,300.0,165.0,90.0,471.0,38
HCPCS,V5014,HC RECEIVER,100.0,55.0,30.0,471.0,38
HCPCS,V5014,HC RECHARGEABLE BATTERY ONE- IN HOUSE REPLACEMENT,50.0,27.5,15.0,471.0,38
HCPCS,V5040,"HC ADHEAR SYSTEM, HEARING AID, MONAURAL, BONE CONDUCTION",4450.0,2447.5,1335.0,3849.25,38
HCPCS,V5090,HC ADHEAR BINAURAL DISPENSING FEE,345.0,189.75,103.5,298.43,38
HCPCS,V5110,HC NON-HEARING AID DISPENSING FEE BILAT,350.0,192.5,105.0,471.0,38
HCPCS,V5160,HC BINAURAL HEARING AID DISPENSING FEE,600.0,330.0,180.0,519.0,38
HCPCS,V5171,"HC TRANSMITTER ONLY, HEARING AID, CONTRALATERAL ROUTING DEV, MONAURAL, ITE",1000.0,550.0,300.0,865.0,38
HCPCS,V5172,"HC TRANSMITTER ONLY, HEARING AID, CONTRALATERAL ROUTING DEV, MONAURAL, ITC",1000.0,550.0,300.0,865.0,38
HCPCS,V5181,"HC TRANSMITTER ONLY, HEARING AID, CONTRALATERAL ROUTING DEV, MONAURAL, BTE",1000.0,550.0,300.0,865.0,38
HCPCS,V5200,"HC DISPENSING FEE, CONTRALATERAL, MONAURAL",400.0,220.0,120.0,346.0,38
HCPCS,V5211,"HC ADVANCED, HEARING AID, CONTRALATERAL ROUTING SYS, BINAURAL, ITE/ITE",3200.0,1760.0,960.0,2768.0,38
HCPCS,V5211,"HC ECONOMY, HEARING AID, CONTRALATERAL ROUTING SYS, BINAURAL, ITE/ITE",2100.0,1155.0,630.0,1816.5,38
HCPCS,V5211,"HC PREMIUM, HEARING AID, CONTRALATERAL ROUTING SYS, BINAURAL, ITE/ITE",4100.0,2255.0,1230.0,3546.5,38
HCPCS,V5211,"HC STANDARD, HEARING AID, CONTRALATERAL ROUTING SYS, BINAURAL, ITE/ITE",2600.0,1430.0,780.0,2249.0,38
HCPCS,V5212,"HC ADVANCED, HEARING AID, CONTRALATERAL ROUTING SYS, BINAURAL, ITE/ITC",3200.0,1760.0,960.0,2768.0,38
HCPCS,V5212,"HC ECONOMY, HEARING AID, CONTRALATERAL ROUTING SYS, BINAURAL, ITE/ITC",2100.0,1155.0,630.0,1816.5,38
HCPCS,V5212,"HC PREMIUM, HEARING AID, CONTRALATERAL ROUTING SYS, BINAURAL, ITE/ITC",4100.0,2255.0,1230.0,3546.5,38
HCPCS,V5212,"HC STANDARD, HEARING AID, CONTRALATERAL ROUTING SYS, BINAURAL, ITE/ITC",2600.0,1430.0,780.0,2249.0,38
HCPCS,V5213,"HC ADVANCED, HEARING AID, CONTRALATERAL ROUTING SYS, BINAURAL, ITE/BTE",3200.0,1760.0,960.0,2768.0,38
HCPCS,V5213,"HC ECONOMY, HEARING AID, CONTRALATERAL ROUTING SYS, BINAURAL, ITE/BTE",2100.0,1155.0,630.0,1816.5,38
HCPCS,V5213,"HC PREMIUM, HEARING AID, CONTRALATERAL ROUTING SYS, BINAURAL, ITE/BTE",4100.0,2255.0,1230.0,3546.5,38
HCPCS,V5213,"HC STANDARD, HEARING AID, CONTRALATERAL ROUTING SYS, BINAURAL, ITE/BTE",2600.0,1430.0,780.0,2249.0,38
HCPCS,V5214,"HC ADVANCED, HEARING AID, CONTRALATERAL ROUTING SYS, BINAURAL, ITC/ITC",3200.0,1760.0,960.0,2768.0,38
HCPCS,V5214,"HC ECONOMY, HEARING AID, CONTRALATERAL ROUTING SYS, BINAURAL, ITC/ITC",2100.0,1155.0,630.0,1816.5,38
HCPCS,V5214,"HC PREMIUM, HEARING AID, CONTRALATERAL ROUTING SYS, BINAURAL, ITC/ITC",4100.0,2255.0,1230.0,3546.5,38
HCPCS,V5214,"HC STANDARD, HEARING AID, CONTRALATERAL ROUTING SYS, BINAURAL, ITC/ITC",2600.0,1430.0,780.0,2249.0,38
HCPCS,V5215,"HC ADVANCED, HEARING AID, CONTRALATERAL ROUTING SYS, BINAURAL, ITC/BTE",3200.0,1760.0,960.0,2768.0,38
HCPCS,V5215,"HC ECONOMY, HEARING AID, CONTRALATERAL ROUTING SYS, BINAURAL, ITC/BTE",2100.0,1155.0,630.0,1816.5,38
HCPCS,V5215,"HC PREMIUM, HEARING AID, CONTRALATERAL ROUTING SYS, BINAURAL, ITC/BTE",4100.0,2255.0,1230.0,3546.5,38
HCPCS,V5215,"HC STANDARD, HEARING AID, CONTRALATERAL ROUTING SYS, BINAURAL, ITC/BTE",2600.0,1430.0,780.0,2249.0,38
HCPCS,V5221,"HC ADVANCED, HEARING AID, CONTRALATERAL ROUTING SYS, BINAURAL, BTE/BTE",3200.0,1760.0,960.0,2768.0,38
HCPCS,V5221,"HC ADVANCED, HEARING AID, CONTRALATERAL ROUTING SYS/DEV, BTE",2600.0,1430.0,780.0,2249.0,38
HCPCS,V5221,"HC ECONOMY, HEARING AID, CONTRALATERAL ROUTING SYS, BINAURAL, BTE/BTE",2100.0,1155.0,630.0,1816.5,38
HCPCS,V5221,"HC ECONOMY, HEARING AID, CONTRALATERAL ROUTING SYS/DEV, BTE",4100.0,2255.0,1230.0,3546.5,38
HCPCS,V5221,"HC PREMIUM, HEARING AID, CONTRALATERAL ROUTING SYS, BINAURAL, BTE/BTE",4100.0,2255.0,1230.0,3546.5,38
HCPCS,V5221,"HC PREMIUM, HEARING AID, CONTRALATERAL ROUTING SYS/DEV, BTE",2100.0,1155.0,630.0,1816.5,38
HCPCS,V5221,"HC STANDARD, HEARING AID, CONTRALATERAL ROUTING SYS, BINAURAL, BTE/BTE",2600.0,1430.0,780.0,2249.0,38
HCPCS,V5221,"HC STANDARD, HEARING AID, CONTRALATERAL ROUTING SYS/DEV, BTE",3200.0,1760.0,960.0,2768.0,38
HCPCS,V5240,"HC DISPENSING FEE, CONTRALATERAL ROUTING SYS, BINAURAL",600.0,330.0,180.0,519.0,38
HCPCS,V5241,HC MONAURAL HEARING AID DISPENSING FEE,400.0,220.0,120.0,346.0,38
HCPCS,V5256,HC HEARING AID DIGITAL MONAURAL ITE ADVANCED,2200.0,1210.0,660.0,1903.0,38
HCPCS,V5256,HC HEARING AID DIGITAL MONAURAL ITE ECONOMY,1100.0,605.0,330.0,951.5,38
HCPCS,V5256,HC HEARING AID DIGITAL MONAURAL ITE PREMIUM,3100.0,1705.0,930.0,2681.5,38
HCPCS,V5256,HC HEARING AID DIGITAL MONAURAL ITE STANDARD,1600.0,880.0,480.0,1384.0,38
HCPCS,V5257,HC ADVANCED BIONICS LINK HEARING AID,1275.0,701.25,382.5,1102.88,38
HCPCS,V5257,HC HEARING AID DIGITAL MONAURAL BTE ADVANCED,2200.0,1210.0,660.0,1903.0,38
HCPCS,V5257,HC HEARING AID DIGITAL MONAURAL BTE ECONOMY,1100.0,605.0,330.0,951.5,38
HCPCS,V5257,HC HEARING AID DIGITAL MONAURAL BTE PREMIUM,3100.0,1705.0,930.0,2681.5,38
HCPCS,V5257,HC HEARING AID DIGITAL MONAURAL BTE STANDARD,1600.0,880.0,480.0,1384.0,38
HCPCS,V5257,HC HEARING AID ENTRY MONAURAL AND LINK HEARING AID,1275.0,701.25,382.5,1102.88,38
HCPCS,V5260,HC HEARING AID DIGITAL BINAURAL ITE ADVANCED,4400.0,2420.0,1320.0,3806.0,38
HCPCS,V5260,HC HEARING AID DIGITAL BINAURAL ITE ECONOMY,2200.0,1210.0,660.0,1903.0,38
HCPCS,V5260,HC HEARING AID DIGITAL BINAURAL ITE PREMIUM,6200.0,3410.0,1860.0,5363.0,38
HCPCS,V5260,HC HEARING AID DIGITAL BINAURAL ITE STANDARD,3200.0,1760.0,960.0,2768.0,38
HCPCS,V5261,HC HEARING AID DIGITAL BINAURAL BTE ADVANCED,4400.0,2420.0,1320.0,3806.0,38
HCPCS,V5261,HC HEARING AID DIGITAL BINAURAL BTE ECONOMY,2200.0,1210.0,660.0,1903.0,38
HCPCS,V5261,HC HEARING AID DIGITAL BINAURAL BTE PREMIUM,6200.0,3410.0,1860.0,5363.0,38
HCPCS,V5261,HC HEARING AID DIGITAL BINAURAL BTE STANDARD,3200.0,1760.0,960.0,2768.0,38
HCPCS,V5264,HC EARMOLD MONAURAL NON-TAXABLE,100.0,55.0,30.0,86.5,38
HCPCS,V5266,HC HEARING AID BATTERIES 6 PACK,10.0,5.5,3.0,8.65,38
HCPCS,V5266,HC HEARING AID BATTERY BOX OF 60,50.0,27.5,15.0,43.25,38
HCPCS,V5267,"HC HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOS",350.0,192.5,105.0,302.75,38
HCPCS,V5274,HC POCKET TALKER,250.0,137.5,75.0,216.25,38
HCPCS,V5275,HC SILICONE IMPRESSION OF THE EAR,50.0,27.5,15.0,43.25,38
HCPCS,q5133,tocilizumab-bavi 80 MG/4ML Solution 4 mL Vial,2412.6,1326.93,723.78,2086.9,38
MS-DRG,001,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC,,,256726.92,1042629.2,28
MS-DRG,002,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC,,,105063.23,421599.62,28
MS-DRG,003,"ECMO OR TRACHEOSTOMY WITH MV &gt;96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES",,,194954.24,789683.57,31
MS-DRG,004,"TRACHEOSTOMY WITH MV &gt;96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES",,,127956.21,515341.34,31
MS-DRG,005,LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT,,,95783.75,383602.15,28
MS-DRG,006,LIVER TRANSPLANT WITHOUT MCC,,,44234.58,172519.59,28
MS-DRG,007,LUNG TRANSPLANT,,,119767.95,481812.19,31
MS-DRG,008,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT,,,53026.14,208519.14,28
MS-DRG,010,PANCREAS TRANSPLANT,,,67301.09,266971.92,31
MS-DRG,011,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC",,,51658.72,202919.79,31
MS-DRG,012,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC",,,40409.38,156856.28,31
MS-DRG,013,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC",,,28286.88,107217.37,31
MS-DRG,014,ALLOGENEIC BONE MARROW TRANSPLANT,,,111297.11,447125.97,28
MS-DRG,016,AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC,,,55979.99,220614.49,28
MS-DRG,017,AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC,,,51460.62,202108.72,28
MS-DRG,018,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,394460.02,1606616.07,31
MS-DRG,019,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS,,,66927.66,265442.79,31
MS-DRG,020,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC,,,73598.57,292758.7,31
MS-DRG,021,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC,,,50202.23,196955.83,31
MS-DRG,022,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC,,,30972.72,118215.17,31
MS-DRG,023,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR,,,54168.25,213195.81,31
MS-DRG,024,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC,,,37646.36,145542.24,31
MS-DRG,025,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC,,,43414.13,169159.97,31
MS-DRG,026,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC,,,30353.05,115677.79,31
MS-DRG,027,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC,,,25025.96,93864.49,31
MS-DRG,028,SPINAL PROCEDURES WITH MCC,,,56694.16,223538.8,31
MS-DRG,029,SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS,,,33100.65,126928.58,31
MS-DRG,030,SPINAL PROCEDURES WITHOUT CC/MCC,,,22048.5,81672.42,31
MS-DRG,031,VENTRICULAR SHUNT PROCEDURES WITH MCC,,,42812.61,166697.0,31
MS-DRG,032,VENTRICULAR SHUNT PROCEDURES WITH CC,,,21465.17,79283.86,31
MS-DRG,033,VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC,,,17212.04,61868.19,31
MS-DRG,034,CAROTID ARTERY STENT PROCEDURES WITH MCC,,,37272.02,144009.39,31
MS-DRG,035,CAROTID ARTERY STENT PROCEDURES WITH CC,,,23822.99,88938.55,31
MS-DRG,036,CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC,,,19755.19,72281.87,31
MS-DRG,037,EXTRACRANIAL PROCEDURES WITH MCC,,,32014.87,122482.58,31
MS-DRG,038,EXTRACRANIAL PROCEDURES WITH CC,,,16845.86,60368.83,31
MS-DRG,039,EXTRACRANIAL PROCEDURES WITHOUT CC/MCC,,,12783.55,43734.48,31
MS-DRG,040,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC",,,37185.68,143655.95,31
MS-DRG,041,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR",,,22080.29,81802.63,31
MS-DRG,042,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC",,,17800.81,64279.08,31
MS-DRG,052,SPINAL DISORDERS AND INJURIES WITH CC/MCC,,,18560.4,67389.42,31
MS-DRG,053,SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC,,,10999.97,36431.14,31
MS-DRG,054,NERVOUS SYSTEM NEOPLASMS WITH MCC,,,15976.35,56808.31,31
MS-DRG,055,NERVOUS SYSTEM NEOPLASMS WITHOUT MCC,,,11367.04,37934.22,31
MS-DRG,056,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC,,,23210.57,86430.94,31
MS-DRG,057,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC,,,13874.76,48202.8,31
MS-DRG,058,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC,,,17635.45,63601.95,31
MS-DRG,059,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC,,,13377.77,46167.68,31
MS-DRG,060,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC,,,10460.27,34221.16,31
MS-DRG,061,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC",,,27153.88,102577.91,31
MS-DRG,062,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC",,,18068.83,65376.63,31
MS-DRG,063,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC",,,14857.87,52228.38,31
MS-DRG,064,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC,,,20374.85,74819.26,31
MS-DRG,065,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS,,,11282.54,37588.21,31
MS-DRG,066,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC,,,8321.41,25463.1,31
MS-DRG,067,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC,,,15447.55,54642.98,31
MS-DRG,068,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC,,,9956.91,32160.0,31
MS-DRG,069,TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC,,,9360.87,29719.35,31
MS-DRG,070,OTHER CEREBROVASCULAR DISORDERS WITH MCC,,,17229.3,61938.88,31
MS-DRG,071,OTHER CEREBROVASCULAR DISORDERS WITH CC,,,11425.19,38172.33,31
MS-DRG,072,OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC,,,8973.79,28134.42,31
MS-DRG,073,CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC,,,16679.6,59687.98,31
MS-DRG,074,CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC,,,11468.79,38350.91,31
MS-DRG,075,VIRAL MENINGITIS WITH CC/MCC,,,19525.33,71340.59,31
MS-DRG,076,VIRAL MENINGITIS WITHOUT CC/MCC,,,9600.74,30701.57,31
MS-DRG,080,NONTRAUMATIC STUPOR AND COMA WITH MCC,,,18548.6,67341.05,31
MS-DRG,081,NONTRAUMATIC STUPOR AND COMA WITHOUT MCC,,,10240.37,33320.8,31
MS-DRG,082,TRAUMATIC STUPOR AND COMA &gt;1 HOUR WITH MCC,,,22869.87,85035.75,31
MS-DRG,083,TRAUMATIC STUPOR AND COMA &gt;1 HOUR WITH CC,,,14785.17,51930.74,31
MS-DRG,084,TRAUMATIC STUPOR AND COMA &gt;1 HOUR WITHOUT CC/MCC,,,10787.35,35560.54,31
MS-DRG,085,TRAUMATIC STUPOR AND COMA &lt;1 HOUR WITH MCC,,,22745.39,84526.04,31
MS-DRG,086,TRAUMATIC STUPOR AND COMA &lt;1 HOUR WITH CC,,,13939.28,48466.95,31
MS-DRG,087,TRAUMATIC STUPOR AND COMA &lt;1 HOUR WITHOUT CC/MCC,,,10413.92,34031.41,31
MS-DRG,088,CONCUSSION WITH MCC,,,14385.39,50293.72,31
MS-DRG,089,CONCUSSION WITH CC,,,12084.83,40873.41,31
MS-DRG,090,CONCUSSION WITHOUT CC/MCC,,,9582.55,30627.16,31
MS-DRG,091,OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC,,,18059.74,65339.42,31
MS-DRG,092,OTHER DISORDERS OF NERVOUS SYSTEM WITH CC,,,11397.94,38060.72,31
MS-DRG,093,OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC,,,9338.15,29626.34,31
MS-DRG,094,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC,,,34080.11,130939.28,31
MS-DRG,095,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC,,,25537.49,95959.14,31
MS-DRG,096,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC,,,25537.49,95959.14,31
MS-DRG,097,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC,,,34919.65,134377.02,31
MS-DRG,098,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC,,,22954.36,85381.75,31
MS-DRG,099,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC,,,14481.71,50688.09,31
MS-DRG,100,SEIZURES WITH MCC,,,19700.67,72058.64,31
MS-DRG,101,SEIZURES WITHOUT MCC,,,10303.98,33581.23,31
MS-DRG,102,HEADACHES WITH MCC,,,12287.45,41703.08,31
MS-DRG,103,HEADACHES WITHOUT MCC,,,9701.58,31114.54,31
MS-DRG,113,ORBITAL PROCEDURES WITH CC/MCC,,,23465.0,87472.68,31
MS-DRG,114,ORBITAL PROCEDURES WITHOUT CC/MCC,,,14396.31,50338.37,31
MS-DRG,115,EXTRAOCULAR PROCEDURES EXCEPT ORBIT,,,16049.04,57105.95,31
MS-DRG,116,INTRAOCULAR PROCEDURES WITH CC/MCC,,,18531.31,67270.36,31
MS-DRG,117,INTRAOCULAR PROCEDURES WITHOUT CC/MCC,,,11960.36,40363.7,31
MS-DRG,121,ACUTE MAJOR EYE INFECTIONS WITH CC/MCC,,,12672.69,43280.58,31
MS-DRG,122,ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC,,,9242.75,29235.69,31
MS-DRG,123,NEUROLOGICAL EYE DISORDERS,,,9359.05,29711.91,31
MS-DRG,124,OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT,,,14124.63,49225.94,31
MS-DRG,125,OTHER DISORDERS OF THE EYE WITHOUT MCC,,,9079.21,28566.0,31
MS-DRG,135,SINUS AND MASTOID PROCEDURES WITH CC/MCC,,,21819.52,80734.85,31
MS-DRG,136,SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC,,,11327.97,37774.24,31
MS-DRG,137,MOUTH PROCEDURES WITH CC/MCC,,,15670.15,55554.51,31
MS-DRG,138,MOUTH PROCEDURES WITHOUT CC/MCC,,,10154.98,32971.07,31
MS-DRG,139,SALIVARY GLAND PROCEDURES,,,13330.52,45974.22,31
MS-DRG,140,MAJOR HEAD AND NECK PROCEDURES WITH MCC,,,40857.33,158690.49,31
MS-DRG,141,MAJOR HEAD AND NECK PROCEDURES WITH CC,,,21920.39,81147.83,31
MS-DRG,142,MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC,,,16607.83,59394.06,31
MS-DRG,143,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC",,,36144.44,139392.25,31
MS-DRG,144,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC",,,17848.05,64472.54,31
MS-DRG,145,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC",,,13027.04,44731.57,31
MS-DRG,146,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC",,,21341.59,78777.87,31
MS-DRG,147,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC",,,13655.79,47306.16,31
MS-DRG,148,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC",,,9345.41,29656.11,31
MS-DRG,149,DYSEQUILIBRIUM,,,8931.99,27963.28,31
MS-DRG,150,EPISTAXIS WITH MCC,,,14200.95,49538.46,31
MS-DRG,151,EPISTAXIS WITHOUT MCC,,,8772.09,27308.47,31
MS-DRG,152,OTITIS MEDIA AND URI WITH MCC,,,12844.41,43983.75,31
MS-DRG,153,OTITIS MEDIA AND URI WITHOUT MCC,,,8810.26,27464.73,31
MS-DRG,154,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC",,,16308.89,58170.02,31
MS-DRG,155,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC",,,10430.28,34098.38,31
MS-DRG,156,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC",,,8382.29,25712.38,31
MS-DRG,157,DENTAL AND ORAL DISEASES WITH MCC,,,17701.77,63873.54,31
MS-DRG,158,DENTAL AND ORAL DISEASES WITH CC,,,10369.4,33849.11,31
MS-DRG,159,DENTAL AND ORAL DISEASES WITHOUT CC/MCC,,,8540.41,26359.74,31
MS-DRG,163,MAJOR CHEST PROCEDURES WITH MCC,,,42824.44,166745.37,31
MS-DRG,164,MAJOR CHEST PROCEDURES WITH CC,,,25035.95,93905.42,31
MS-DRG,165,MAJOR CHEST PROCEDURES WITHOUT CC/MCC,,,19495.33,71217.81,31
MS-DRG,166,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC,,,36063.57,139061.13,31
MS-DRG,167,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC,,,18488.6,67095.5,31
MS-DRG,168,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,,14518.05,50836.91,31
MS-DRG,173,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM,,,29146.43,110736.96,31
MS-DRG,175,PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE,,,14583.48,51104.79,31
MS-DRG,176,PULMONARY EMBOLISM WITHOUT MCC,,,9417.18,29950.03,31
MS-DRG,177,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC,,,16301.61,58140.25,31
MS-DRG,178,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC,,,10970.91,36312.08,31
MS-DRG,179,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC,,,8962.9,28089.78,31
MS-DRG,180,RESPIRATORY NEOPLASMS WITH MCC,,,18148.8,65704.03,31
MS-DRG,181,RESPIRATORY NEOPLASMS WITH CC,,,11834.06,39846.56,31
MS-DRG,182,RESPIRATORY NEOPLASMS WITHOUT CC/MCC,,,8951.98,28045.13,31
MS-DRG,183,MAJOR CHEST TRAUMA WITH MCC,,,16003.62,56919.93,31
MS-DRG,184,MAJOR CHEST TRAUMA WITH CC,,,11771.37,39589.84,31
MS-DRG,185,MAJOR CHEST TRAUMA WITHOUT CC/MCC,,,9249.1,29261.73,31
MS-DRG,186,PLEURAL EFFUSION WITH MCC,,,16263.47,57983.99,31
MS-DRG,187,PLEURAL EFFUSION WITH CC,,,11089.93,36799.47,31
MS-DRG,188,PLEURAL EFFUSION WITHOUT CC/MCC,,,8619.44,26683.43,31
MS-DRG,189,PULMONARY EDEMA AND RESPIRATORY FAILURE,,,13327.79,45963.06,31
MS-DRG,190,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC,,,12167.51,41211.98,31
MS-DRG,191,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC,,,9762.47,31363.82,31
MS-DRG,192,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC,,,7936.19,23885.61,31
MS-DRG,193,SIMPLE PNEUMONIA AND PLEURISY WITH MCC,,,14045.56,48902.25,31
MS-DRG,194,SIMPLE PNEUMONIA AND PLEURISY WITH CC,,,9425.38,29983.51,31
MS-DRG,195,SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC,,,7813.52,23383.34,31
MS-DRG,196,INTERSTITIAL LUNG DISEASE WITH MCC,,,19250.01,70213.28,31
MS-DRG,197,INTERSTITIAL LUNG DISEASE WITH CC,,,10726.47,35311.27,31
MS-DRG,198,INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC,,,8610.35,26646.22,31
MS-DRG,199,PNEUMOTHORAX WITH MCC,,,18131.53,65633.34,31
MS-DRG,200,PNEUMOTHORAX WITH CC,,,12091.2,40899.46,31
MS-DRG,201,PNEUMOTHORAX WITHOUT CC/MCC,,,8600.37,26605.3,31
MS-DRG,202,BRONCHITIS AND ASTHMA WITH CC/MCC,,,10927.28,36133.5,31
MS-DRG,203,BRONCHITIS AND ASTHMA WITHOUT CC/MCC,,,8190.59,24927.35,31
MS-DRG,204,RESPIRATORY SIGNS AND SYMPTOMS,,,9439.0,30039.32,31
MS-DRG,205,OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC,,,18739.39,68122.36,31
MS-DRG,206,OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC,,,10653.78,35013.63,31
MS-DRG,207,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT &gt;96 HOURS,,,60568.38,239403.01,31
MS-DRG,208,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT &lt;=96 HOURS,,,27077.57,102265.38,31
MS-DRG,209,COMPLEX AORTIC ARCH PROCEDURES,,,104945.11,421115.95,31
MS-DRG,212,CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES,,,100904.58,404570.89,31
MS-DRG,213,ENDOVASCULAR ABDOMINAL AORTA WITH ILIAC BRANCH PROCEDURES,,,53955.64,212325.21,31
MS-DRG,215,OTHER HEART ASSIST SYSTEM IMPLANT,,,92571.86,370450.19,31
MS-DRG,216,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC,,,90989.08,363969.07,31
MS-DRG,217,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC,,,61845.89,244634.04,31
MS-DRG,218,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC,,,61845.89,244634.04,31
MS-DRG,219,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC,,,71867.69,285671.15,31
MS-DRG,220,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC,,,50556.58,198406.82,31
MS-DRG,221,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC,,,47898.03,187520.64,31
MS-DRG,228,OTHER CARDIOTHORACIC PROCEDURES WITH MCC,,,47054.86,184068.02,31
MS-DRG,229,OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC,,,30719.2,117177.15,31
MS-DRG,231,CORONARY BYPASS WITH PTCA WITH MCC,,,78696.69,313634.43,31
MS-DRG,232,CORONARY BYPASS WITH PTCA WITHOUT MCC,,,57187.53,225559.03,31
MS-DRG,233,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC,,,71566.94,284439.67,31
MS-DRG,234,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC,,,51736.85,203239.75,31
MS-DRG,235,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC,,,55424.84,218341.26,31
MS-DRG,236,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC,,,40162.25,155844.3,31
MS-DRG,239,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC,,,46821.34,183111.85,31
MS-DRG,240,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC,,,28002.53,106052.85,31
MS-DRG,241,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC,,,14681.6,51506.6,31
MS-DRG,242,PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC,,,31112.63,118788.12,31
MS-DRG,243,PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC,,,21464.26,79280.13,31
MS-DRG,244,PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC,,,18525.86,67248.04,31
MS-DRG,245,AICD GENERATOR PROCEDURES,,,43556.77,169744.09,31
MS-DRG,250,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC,,,21933.09,81199.91,31
MS-DRG,251,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC,,,15681.95,55602.87,31
MS-DRG,252,OTHER VASCULAR PROCEDURES WITH MCC,,,33797.53,129782.2,31
MS-DRG,253,OTHER VASCULAR PROCEDURES WITH CC,,,25686.51,96569.3,31
MS-DRG,254,OTHER VASCULAR PROCEDURES WITHOUT CC/MCC,,,18291.44,66288.15,31
MS-DRG,255,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC,,,26611.44,100356.77,31
MS-DRG,256,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC,,,17530.03,63170.37,31
MS-DRG,257,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC,,,12026.66,40635.3,31
MS-DRG,258,CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC,,,30651.98,116901.83,31
MS-DRG,259,CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC,,,20475.71,75232.23,31
MS-DRG,260,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC,,,31657.79,121020.42,31
MS-DRG,261,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC,,,19280.02,70336.05,31
MS-DRG,262,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC,,,16912.21,60640.43,31
MS-DRG,263,VEIN LIGATION AND STRIPPING,,,29882.39,113750.57,31
MS-DRG,264,OTHER CIRCULATORY SYSTEM O.R. PROCEDURES,,,32455.53,124287.02,31
MS-DRG,265,AICD LEAD PROCEDURES,,,34977.79,134615.13,31
MS-DRG,266,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC,,,57785.37,228007.12,31
MS-DRG,267,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC,,,45359.43,177125.56,31
MS-DRG,268,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC,,,64595.29,255892.27,31
MS-DRG,269,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC,,,40474.81,157124.16,31
MS-DRG,270,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC,,,50043.24,196304.74,31
MS-DRG,271,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC,,,34415.39,132312.14,31
MS-DRG,272,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC,,,25299.45,94984.37,31
MS-DRG,273,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC,,,39587.1,153489.23,31
MS-DRG,274,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC,,,32011.24,122467.7,31
MS-DRG,275,CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC,,,66889.49,265286.53,31
MS-DRG,276,CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR,,,56678.7,223475.55,31
MS-DRG,277,CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC,,,44066.49,171831.29,31
MS-DRG,278,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC,,,52677.25,207090.47,31
MS-DRG,279,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC,,,34870.58,134176.11,31
MS-DRG,280,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC",,,16677.77,59680.54,31
MS-DRG,281,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC",,,10453.9,34195.12,31
MS-DRG,282,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC",,,8673.06,26902.94,31
MS-DRG,283,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC",,,20100.46,73695.66,31
MS-DRG,284,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC",,,8392.3,25753.3,31
MS-DRG,285,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC",,,7544.58,22282.07,31
MS-DRG,286,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC",,,22208.38,82327.22,31
MS-DRG,287,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC",,,11825.88,39813.07,31
MS-DRG,288,ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC,,,26691.43,100684.17,31
MS-DRG,289,ACUTE AND SUBACUTE ENDOCARDITIS WITH CC,,,17611.83,63505.21,31
MS-DRG,290,ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC,,,10550.21,34589.49,31
MS-DRG,291,HEART FAILURE AND SHOCK WITH MCC,,,13767.56,47763.78,31
MS-DRG,292,HEART FAILURE AND SHOCK WITH CC,,,9816.97,31587.05,31
MS-DRG,293,HEART FAILURE AND SHOCK WITHOUT CC/MCC,,,7245.65,21058.03,31
MS-DRG,296,"CARDIAC ARREST, UNEXPLAINED WITH MCC",,,16294.35,58110.49,31
MS-DRG,297,"CARDIAC ARREST, UNEXPLAINED WITH CC",,,7863.49,23587.97,31
MS-DRG,298,"CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC",,,6238.01,16932.0,31
MS-DRG,299,PERIPHERAL VASCULAR DISORDERS WITH MCC,,,16937.65,60744.6,31
MS-DRG,300,PERIPHERAL VASCULAR DISORDERS WITH CC,,,11802.27,39716.34,31
MS-DRG,301,PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC,,,8642.17,26776.44,31
MS-DRG,302,ATHEROSCLEROSIS WITH MCC,,,12975.27,44519.5,31
MS-DRG,303,ATHEROSCLEROSIS WITHOUT MCC,,,8219.66,25046.41,31
MS-DRG,304,HYPERTENSION WITH MCC,,,12915.29,44273.95,31
MS-DRG,305,HYPERTENSION WITHOUT MCC,,,8963.8,28093.5,31
MS-DRG,306,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC,,,16420.66,58627.64,31
MS-DRG,307,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC,,,10400.31,33975.61,31
MS-DRG,308,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC,,,13042.48,44794.82,31
MS-DRG,309,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC,,,8787.54,27371.72,31
MS-DRG,310,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC,,,7246.56,21061.75,31
MS-DRG,311,ANGINA PECTORIS,,,8480.44,26114.19,31
MS-DRG,312,SYNCOPE AND COLLAPSE,,,10022.32,32427.88,31
MS-DRG,313,CHEST PAIN,,,8644.88,26787.6,31
MS-DRG,314,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC,,,21049.04,77579.87,31
MS-DRG,315,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC,,,10855.51,35839.58,31
MS-DRG,316,OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC,,,8300.54,25377.53,31
MS-DRG,317,CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION,,,62856.23,248771.23,31
MS-DRG,318,PERCUTANEOUS CORONARY ATHERECTOMY WITHOUT INTRALUMINAL DEVICE,,,24111.01,90117.95,31
MS-DRG,319,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC,,,42652.72,166042.19,31
MS-DRG,320,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC,,,23957.45,89489.19,31
MS-DRG,321,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES,,,26824.06,101227.36,31
MS-DRG,322,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC,,,18121.54,65592.42,31
MS-DRG,323,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC,,,41421.55,161000.92,31
MS-DRG,324,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC,,,30732.84,117232.96,31
MS-DRG,325,CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE,,,31272.55,119442.93,31
MS-DRG,326,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC",,,47418.31,185556.22,31
MS-DRG,327,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC",,,24310.89,90936.46,31
MS-DRG,328,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC",,,16661.43,59613.57,31
MS-DRG,329,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,,,43866.61,171012.78,31
MS-DRG,330,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,,,23883.86,89187.83,31
MS-DRG,331,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,,,17393.76,62612.29,31
MS-DRG,332,RECTAL RESECTION WITH MCC,,,35000.52,134708.14,31
MS-DRG,333,RECTAL RESECTION WITH CC,,,23384.13,87141.55,31
MS-DRG,334,RECTAL RESECTION WITHOUT CC/MCC,,,16984.88,60938.07,31
MS-DRG,335,PERITONEAL ADHESIOLYSIS WITH MCC,,,34548.04,132855.33,31
MS-DRG,336,PERITONEAL ADHESIOLYSIS WITH CC,,,21262.55,78454.18,31
MS-DRG,337,PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC,,,16049.94,57109.68,31
MS-DRG,344,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,,,25570.21,96093.07,31
MS-DRG,345,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,,,15774.63,55982.36,31
MS-DRG,346,MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,,,12880.76,44132.57,31
MS-DRG,347,ANAL AND STOMAL PROCEDURES WITH MCC,,,22960.73,85407.8,31
MS-DRG,348,ANAL AND STOMAL PROCEDURES WITH CC,,,13994.71,48693.9,31
MS-DRG,349,ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC,,,10013.23,32390.67,31
MS-DRG,350,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC,,,24744.29,92711.14,31
MS-DRG,351,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC,,,15954.55,56719.02,31
MS-DRG,352,INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC,,,12713.57,43448.0,31
MS-DRG,353,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC,,,28470.45,107968.91,31
MS-DRG,354,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC,,,17389.2,62593.69,31
MS-DRG,355,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC,,,14323.61,50040.73,31
MS-DRG,356,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC,,,42015.77,163434.12,31
MS-DRG,357,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC,,,23232.4,86520.23,31
MS-DRG,358,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,,14804.26,52008.87,31
MS-DRG,359,PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITH MCC,,,33345.97,127933.11,31
MS-DRG,360,PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITHOUT MCC,,,24039.21,89824.03,31
MS-DRG,368,MAJOR ESOPHAGEAL DISORDERS WITH MCC,,,16566.92,59226.64,31
MS-DRG,369,MAJOR ESOPHAGEAL DISORDERS WITH CC,,,11190.77,37212.44,31
MS-DRG,370,MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC,,,8470.45,26073.26,31
MS-DRG,371,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC,,,18213.29,65968.19,31
MS-DRG,372,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC,,,11379.76,37986.31,31
MS-DRG,373,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC,,,8712.14,27062.92,31
MS-DRG,374,DIGESTIVE MALIGNANCY WITH MCC,,,21535.13,79570.33,31
MS-DRG,375,DIGESTIVE MALIGNANCY WITH CC,,,13093.37,45003.17,31
MS-DRG,376,DIGESTIVE MALIGNANCY WITHOUT CC/MCC,,,10501.15,34388.58,31
MS-DRG,377,GASTROINTESTINAL HEMORRHAGE WITH MCC,,,18712.13,68010.74,31
MS-DRG,378,GASTROINTESTINAL HEMORRHAGE WITH CC,,,11013.59,36486.94,31
MS-DRG,379,GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC,,,7830.8,23454.03,31
MS-DRG,380,COMPLICATED PEPTIC ULCER WITH MCC,,,19931.46,73003.65,31
MS-DRG,381,COMPLICATED PEPTIC ULCER WITH CC,,,11947.63,40311.62,31
MS-DRG,382,COMPLICATED PEPTIC ULCER WITHOUT CC/MCC,,,9377.21,29786.32,31
MS-DRG,383,UNCOMPLICATED PEPTIC ULCER WITH MCC,,,14647.98,51368.94,31
MS-DRG,384,UNCOMPLICATED PEPTIC ULCER WITHOUT MCC,,,9869.67,31802.83,31
MS-DRG,385,INFLAMMATORY BOWEL DISEASE WITH MCC,,,16479.7,58869.47,31
MS-DRG,386,INFLAMMATORY BOWEL DISEASE WITH CC,,,10973.62,36323.24,31
MS-DRG,387,INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC,,,8293.26,25347.77,31
MS-DRG,388,GASTROINTESTINAL OBSTRUCTION WITH MCC,,,15521.15,54944.34,31
MS-DRG,389,GASTROINTESTINAL OBSTRUCTION WITH CC,,,9279.1,29384.51,31
MS-DRG,390,GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC,,,7045.76,20239.52,31
MS-DRG,391,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC",,,13626.72,47187.1,31
MS-DRG,392,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC",,,9186.41,29005.02,31
MS-DRG,393,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC,,,16634.18,59501.96,31
MS-DRG,394,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC,,,10604.73,34812.72,31
MS-DRG,395,OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,,,7999.78,24146.05,31
MS-DRG,397,APPENDIX PROCEDURES WITH MCC,,,23862.96,89102.25,31
MS-DRG,398,APPENDIX PROCEDURES WITH CC,,,15855.51,56313.49,31
MS-DRG,399,APPENDIX PROCEDURES WITHOUT CC/MCC,,,12503.69,42588.56,31
MS-DRG,402,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,38633.09,149582.7,31
MS-DRG,405,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC",,,51807.74,203529.95,31
MS-DRG,406,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC",,,28454.08,107901.94,31
MS-DRG,407,"PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC",,,22270.19,82580.22,31
MS-DRG,408,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC,,,34499.89,132658.15,31
MS-DRG,409,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC,,,21885.85,81006.45,31
MS-DRG,410,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC,,,16528.77,59070.38,31
MS-DRG,411,CHOLECYSTECTOMY WITH C.D.E. WITH MCC,,,32116.65,122899.28,31
MS-DRG,412,CHOLECYSTECTOMY WITH C.D.E. WITH CC,,,21206.23,78223.51,31
MS-DRG,413,CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC,,,17190.22,61778.9,31
MS-DRG,414,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC,,,34472.63,132546.53,31
MS-DRG,415,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC,,,20880.94,76891.57,31
MS-DRG,416,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC,,,14489.87,50721.58,31
MS-DRG,417,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC,,,23785.72,88786.01,31
MS-DRG,418,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC,,,17472.82,62935.98,31
MS-DRG,419,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC,,,14512.59,50814.59,31
MS-DRG,420,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC,,,33059.76,126761.16,31
MS-DRG,421,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC,,,17889.86,64643.69,31
MS-DRG,422,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC,,,14818.79,52068.4,31
MS-DRG,423,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC,,,39836.97,154512.37,31
MS-DRG,424,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC,,,21982.15,81400.82,31
MS-DRG,425,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC,,,15734.65,55818.66,31
MS-DRG,426,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,102241.14,410043.75,31
MS-DRG,427,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC,,,67690.88,268568.01,31
MS-DRG,428,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC,,,53184.25,209166.51,31
MS-DRG,429,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC,,,83963.82,335202.17,31
MS-DRG,430,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC,,,54502.61,214564.96,31
MS-DRG,432,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC,,,19985.98,73226.88,31
MS-DRG,433,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC,,,11699.59,39295.92,31
MS-DRG,434,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC,,,8576.74,26508.56,31
MS-DRG,435,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC,,,18791.18,68334.42,31
MS-DRG,436,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC,,,12380.11,42082.58,31
MS-DRG,437,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC,,,9856.03,31747.03,31
MS-DRG,438,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC,,,16914.93,60651.59,31
MS-DRG,439,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC,,,9746.1,31296.85,31
MS-DRG,440,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC,,,7749.03,23119.19,31
MS-DRG,441,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC",,,18409.57,66771.81,31
MS-DRG,442,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC",,,10873.68,35913.99,31
MS-DRG,443,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC",,,8460.45,26032.34,31
MS-DRG,444,DISORDERS OF THE BILIARY TRACT WITH MCC,,,17284.72,62165.83,31
MS-DRG,445,DISORDERS OF THE BILIARY TRACT WITH CC,,,12046.68,40717.15,31
MS-DRG,446,DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC,,,9619.81,30779.7,31
MS-DRG,447,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,62811.72,248588.93,31
MS-DRG,448,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,,,40634.72,157778.96,31
MS-DRG,450,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,50527.5,198287.77,31
MS-DRG,451,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,,,31454.27,120187.03,31
MS-DRG,456,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC",,,78455.92,312648.5,31
MS-DRG,457,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC",,,56283.47,221857.14,31
MS-DRG,458,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC",,,40015.05,155241.58,31
MS-DRG,461,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC,,,52284.74,205483.22,31
MS-DRG,462,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC,,,26271.64,98965.3,31
MS-DRG,463,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC,,,53888.39,212049.9,31
MS-DRG,464,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC,,,30403.02,115882.41,31
MS-DRG,465,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,,18673.06,67850.76,31
MS-DRG,466,REVISION OF HIP OR KNEE REPLACEMENT WITH MCC,,,49399.04,193666.91,31
MS-DRG,467,REVISION OF HIP OR KNEE REPLACEMENT WITH CC,,,34145.52,131207.15,31
MS-DRG,468,REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC,,,27071.21,102239.34,31
MS-DRG,469,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT,,,29662.51,112850.21,31
MS-DRG,470,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC,,,19628.92,71764.72,31
MS-DRG,471,CERVICAL SPINAL FUSION WITH MCC,,,45976.36,179651.78,31
MS-DRG,472,CERVICAL SPINAL FUSION WITH CC,,,28871.12,109609.65,31
MS-DRG,473,CERVICAL SPINAL FUSION WITHOUT CC/MCC,,,24284.54,90828.57,31
MS-DRG,474,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC,,,41108.1,159717.34,31
MS-DRG,475,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC,,,22779.9,84667.42,31
MS-DRG,476,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,,12826.25,43909.34,31
MS-DRG,477,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,,,33491.36,128528.39,31
MS-DRG,478,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC,,,24447.18,91494.54,31
MS-DRG,479,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC,,,18992.87,69160.37,31
MS-DRG,480,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC,,,28564.03,108352.12,31
MS-DRG,481,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC,,,21133.54,77925.87,31
MS-DRG,482,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC,,,16922.2,60681.36,31
MS-DRG,483,MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES,,,27288.36,103128.54,31
MS-DRG,485,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC,,,31424.29,120064.26,31
MS-DRG,486,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC,,,21102.64,77799.38,31
MS-DRG,487,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,,,16333.43,58270.47,31
MS-DRG,488,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC,,,18175.15,65811.92,31
MS-DRG,489,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,,,12250.19,41550.54,31
MS-DRG,492,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC",,,35462.99,136601.88,31
MS-DRG,493,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC",,,25145.9,94355.6,31
MS-DRG,494,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC",,,20333.96,74651.83,31
MS-DRG,495,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC,,,35045.96,134894.17,31
MS-DRG,496,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC,,,18493.15,67114.1,31
MS-DRG,497,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC,,,13081.55,44954.8,31
MS-DRG,498,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC,,,29513.51,112240.04,31
MS-DRG,499,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC,,,20409.37,74960.63,31
MS-DRG,500,SOFT TISSUE PROCEDURES WITH MCC,,,30858.24,117746.38,31
MS-DRG,501,SOFT TISSUE PROCEDURES WITH CC,,,17986.15,65038.06,31
MS-DRG,502,SOFT TISSUE PROCEDURES WITHOUT CC/MCC,,,14331.79,50074.21,31
MS-DRG,503,FOOT PROCEDURES WITH MCC,,,27462.81,103842.88,31
MS-DRG,504,FOOT PROCEDURES WITH CC,,,19086.46,69543.59,31
MS-DRG,505,FOOT PROCEDURES WITHOUT CC/MCC,,,18392.31,66701.12,31
MS-DRG,506,MAJOR THUMB OR JOINT PROCEDURES,,,14361.77,50196.99,31
MS-DRG,507,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC,,,18515.87,67207.11,31
MS-DRG,508,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC,,,15862.77,56343.25,31
MS-DRG,510,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC",,,29547.13,112377.7,31
MS-DRG,511,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC",,,20996.35,77364.08,31
MS-DRG,512,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC",,,17143.89,61589.16,31
MS-DRG,513,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC",,,16407.03,58571.83,31
MS-DRG,514,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC",,,11391.57,38034.67,31
MS-DRG,515,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC,,,31059.03,118568.61,31
MS-DRG,516,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC,,,20984.53,77315.71,31
MS-DRG,517,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC,,,16065.39,57172.92,31
MS-DRG,518,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR,,,36059.94,139046.25,31
MS-DRG,519,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC,,,20276.73,74417.44,31
MS-DRG,520,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC,,,15676.49,55580.55,31
MS-DRG,521,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC,,,28181.51,106785.79,31
MS-DRG,522,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC,,,21344.34,78789.03,31
MS-DRG,533,FRACTURES OF FEMUR WITH MCC,,,16347.07,58326.28,31
MS-DRG,534,FRACTURES OF FEMUR WITHOUT MCC,,,9427.19,29990.95,31
MS-DRG,535,FRACTURES OF HIP AND PELVIS WITH MCC,,,13751.18,47696.81,31
MS-DRG,536,FRACTURES OF HIP AND PELVIS WITHOUT MCC,,,9440.81,30046.76,31
MS-DRG,537,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC",,,10773.73,35504.73,31
MS-DRG,538,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC",,,8647.62,26798.76,31
MS-DRG,539,OSTEOMYELITIS WITH MCC,,,19999.6,73282.69,31
MS-DRG,540,OSTEOMYELITIS WITH CC,,,13881.13,48228.84,31
MS-DRG,541,OSTEOMYELITIS WITHOUT CC/MCC,,,9257.3,29295.22,31
MS-DRG,542,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC,,,18153.34,65722.63,31
MS-DRG,543,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC,,,11443.36,38246.74,31
MS-DRG,544,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC,,,8959.25,28074.89,31
MS-DRG,545,CONNECTIVE TISSUE DISORDERS WITH MCC,,,24651.63,92331.65,31
MS-DRG,546,CONNECTIVE TISSUE DISORDERS WITH CC,,,12582.74,42912.25,31
MS-DRG,547,CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,,9700.68,31110.82,31
MS-DRG,548,SEPTIC ARTHRITIS WITH MCC,,,19647.07,71839.13,31
MS-DRG,549,SEPTIC ARTHRITIS WITH CC,,,13071.56,44913.88,31
MS-DRG,550,SEPTIC ARTHRITIS WITHOUT CC/MCC,,,10045.04,32520.89,31
MS-DRG,551,MEDICAL BACK PROBLEMS WITH MCC,,,17331.97,62359.3,31
MS-DRG,552,MEDICAL BACK PROBLEMS WITHOUT MCC,,,10837.34,35765.17,31
MS-DRG,553,BONE DISEASES AND ARTHROPATHIES WITH MCC,,,13881.13,48228.84,31
MS-DRG,554,BONE DISEASES AND ARTHROPATHIES WITHOUT MCC,,,9645.25,30883.87,31
MS-DRG,555,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,,,14112.81,49177.57,31
MS-DRG,556,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC,,,9649.8,30902.47,31
MS-DRG,557,"TENDONITIS, MYOSITIS AND BURSITIS WITH MCC",,,15612.91,55320.11,31
MS-DRG,558,"TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC",,,10218.58,33231.51,31
MS-DRG,559,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC",,,19047.39,69383.6,31
MS-DRG,560,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC",,,12334.68,41896.55,31
MS-DRG,561,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC",,,9407.2,29909.1,31
MS-DRG,562,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC",,,15048.66,53009.68,31
MS-DRG,563,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC",,,10239.48,33317.08,31
MS-DRG,564,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC,,,16128.09,57429.64,31
MS-DRG,565,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC,,,10956.36,36252.55,31
MS-DRG,566,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC,,,8911.1,27877.71,31
MS-DRG,570,SKIN DEBRIDEMENT WITH MCC,,,28825.7,109423.63,31
MS-DRG,571,SKIN DEBRIDEMENT WITH CC,,,17453.72,62857.85,31
MS-DRG,572,SKIN DEBRIDEMENT WITHOUT CC/MCC,,,12518.25,42648.09,31
MS-DRG,573,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC,,,61628.73,243744.84,31
MS-DRG,574,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC,,,33643.99,129153.44,31
MS-DRG,575,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,,,18430.47,66857.39,31
MS-DRG,576,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC,,,46635.07,182349.15,31
MS-DRG,577,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC,,,26187.13,98619.29,31
MS-DRG,578,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,,,16698.69,59766.11,31
MS-DRG,579,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC",,,31527.89,120488.39,31
MS-DRG,580,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC",,,17803.54,64290.24,31
MS-DRG,581,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC",,,15214.94,53690.54,31
MS-DRG,582,MASTECTOMY FOR MALIGNANCY WITH CC/MCC,,,19608.0,71679.15,31
MS-DRG,583,MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC,,,17770.81,64156.3,31
MS-DRG,584,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC",,,21553.29,79644.74,31
MS-DRG,585,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC",,,19630.71,71772.17,31
MS-DRG,592,SKIN ULCERS WITH MCC,,,19687.05,72002.84,31
MS-DRG,593,SKIN ULCERS WITH CC,,,12881.67,44136.29,31
MS-DRG,594,SKIN ULCERS WITHOUT CC/MCC,,,9978.69,32249.29,31
MS-DRG,595,MAJOR SKIN DISORDERS WITH MCC,,,21371.58,78900.64,31
MS-DRG,596,MAJOR SKIN DISORDERS WITHOUT MCC,,,11938.56,40274.41,31
MS-DRG,597,MALIGNANT BREAST DISORDERS WITH MCC,,,17250.19,62024.46,31
MS-DRG,598,MALIGNANT BREAST DISORDERS WITH CC,,,12381.94,42090.02,31
MS-DRG,599,MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,,,9093.73,28625.53,31
MS-DRG,600,NON-MALIGNANT BREAST DISORDERS WITH CC/MCC,,,11566.93,38752.73,31
MS-DRG,601,NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,,,7600.01,22509.03,31
MS-DRG,602,CELLULITIS WITH MCC,,,15016.87,52879.47,31
MS-DRG,603,CELLULITIS WITHOUT MCC,,,10015.97,32401.83,31
MS-DRG,604,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC",,,15478.44,54769.48,31
MS-DRG,605,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC",,,10425.75,34079.78,31
MS-DRG,606,MINOR SKIN DISORDERS WITH MCC,,,15851.87,56298.61,31
MS-DRG,607,MINOR SKIN DISORDERS WITHOUT MCC,,,10338.52,33722.61,31
MS-DRG,614,ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC,,,22017.6,81545.92,31
MS-DRG,615,ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC,,,14816.97,52060.96,31
MS-DRG,616,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",,,33789.36,129748.72,31
MS-DRG,617,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",,,19096.46,69584.51,31
MS-DRG,618,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",,,14989.61,52767.85,31
MS-DRG,619,O.R. PROCEDURES FOR OBESITY WITH MCC,,,28337.8,107425.72,31
MS-DRG,620,O.R. PROCEDURES FOR OBESITY WITH CC,,,16643.25,59539.16,31
MS-DRG,621,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC,,,15808.26,56120.02,31
MS-DRG,622,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",,,34441.72,132420.04,31
MS-DRG,623,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",,,18402.3,66742.05,31
MS-DRG,624,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",,,13477.72,46576.94,31
MS-DRG,625,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC",,,29543.5,112362.82,31
MS-DRG,626,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC",,,15726.46,55785.18,31
MS-DRG,627,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC",,,14171.88,49419.4,31
MS-DRG,628,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC",,,35964.54,138655.59,31
MS-DRG,629,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC",,,21899.48,81062.25,31
MS-DRG,630,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC",,,15363.94,54300.7,31
MS-DRG,637,DIABETES WITH MCC,,,15156.79,53452.42,31
MS-DRG,638,DIABETES WITH CC,,,10245.83,33343.12,31
MS-DRG,639,DIABETES WITHOUT CC/MCC,,,7747.21,23111.75,31
MS-DRG,640,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC",,,14238.22,49691.0,31
MS-DRG,641,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC",,,9173.68,28952.93,31
MS-DRG,642,INBORN AND OTHER DISORDERS OF METABOLISM,,,15024.13,52909.23,31
MS-DRG,643,ENDOCRINE DISORDERS WITH MCC,,,17059.4,61243.15,31
MS-DRG,644,ENDOCRINE DISORDERS WITH CC,,,11416.1,38135.13,31
MS-DRG,645,ENDOCRINE DISORDERS WITHOUT CC/MCC,,,9083.75,28584.6,31
MS-DRG,650,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC,,,44819.71,174915.59,31
MS-DRG,651,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC,,,35773.74,137874.29,31
MS-DRG,652,KIDNEY TRANSPLANT,,,31446.1,120153.55,28
MS-DRG,653,MAJOR BLADDER PROCEDURES WITH MCC,,,49317.26,193332.06,31
MS-DRG,654,MAJOR BLADDER PROCEDURES WITH CC,,,27537.32,104147.96,31
MS-DRG,655,MAJOR BLADDER PROCEDURES WITHOUT CC/MCC,,,21334.33,78748.1,31
MS-DRG,656,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC,,,31030.87,118453.28,31
MS-DRG,657,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC,,,18730.31,68085.15,31
MS-DRG,658,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC,,,16202.58,57734.72,31
MS-DRG,659,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC,,,25189.5,94534.18,31
MS-DRG,660,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC,,,14111.93,49173.85,31
MS-DRG,661,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC,,,11510.58,38522.06,31
MS-DRG,662,MINOR BLADDER PROCEDURES WITH MCC,,,29919.66,113903.11,31
MS-DRG,663,MINOR BLADDER PROCEDURES WITH CC,,,15915.48,56559.04,31
MS-DRG,664,MINOR BLADDER PROCEDURES WITHOUT CC/MCC,,,11615.11,38949.91,31
MS-DRG,665,PROSTATECTOMY WITH MCC,,,30462.09,116124.25,31
MS-DRG,666,PROSTATECTOMY WITH CC,,,17997.06,65082.71,31
MS-DRG,667,PROSTATECTOMY WITHOUT CC/MCC,,,12153.87,41156.17,31
MS-DRG,668,TRANSURETHRAL PROCEDURES WITH MCC,,,28634.0,108638.6,31
MS-DRG,669,TRANSURETHRAL PROCEDURES WITH CC,,,16204.42,57742.16,31
MS-DRG,670,TRANSURETHRAL PROCEDURES WITHOUT CC/MCC,,,10982.71,36360.45,31
MS-DRG,671,URETHRAL PROCEDURES WITH CC/MCC,,,18412.29,66782.98,31
MS-DRG,672,URETHRAL PROCEDURES WITHOUT CC/MCC,,,11911.3,40162.8,31
MS-DRG,673,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC,,,40278.56,156320.53,31
MS-DRG,674,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC,,,23351.43,87007.61,31
MS-DRG,675,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC,,,17016.69,61068.29,31
MS-DRG,682,RENAL FAILURE WITH MCC,,,15559.3,55100.61,31
MS-DRG,683,RENAL FAILURE WITH CC,,,10060.48,32584.14,31
MS-DRG,684,RENAL FAILURE WITHOUT CC/MCC,,,7557.3,22334.16,31
MS-DRG,686,KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC,,,18491.35,67106.66,31
MS-DRG,687,KIDNEY AND URINARY TRACT NEOPLASMS WITH CC,,,11623.25,38983.4,31
MS-DRG,688,KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC,,,9283.64,29403.11,31
MS-DRG,689,KIDNEY AND URINARY TRACT INFECTIONS WITH MCC,,,12645.44,43168.96,31
MS-DRG,690,KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC,,,9458.08,30117.45,31
MS-DRG,693,URINARY STONES WITH MCC,,,14319.07,50022.12,31
MS-DRG,694,URINARY STONES WITHOUT MCC,,,9205.49,29083.15,31
MS-DRG,695,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC,,,12495.5,42555.08,31
MS-DRG,696,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC,,,8363.21,25634.25,31
MS-DRG,697,URETHRAL STRICTURE,,,11895.84,40099.55,31
MS-DRG,698,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC,,,17134.8,61551.95,31
MS-DRG,699,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC,,,11325.25,37763.08,31
MS-DRG,700,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC,,,8371.4,25667.73,31
MS-DRG,707,MAJOR MALE PELVIC PROCEDURES WITH CC/MCC,,,20277.65,74421.16,31
MS-DRG,708,MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC,,,16042.68,57079.91,31
MS-DRG,709,PENIS PROCEDURES WITH CC/MCC,,,23246.92,86579.76,31
MS-DRG,710,PENIS PROCEDURES WITHOUT CC/MCC,,,14834.23,52131.65,31
MS-DRG,711,TESTES PROCEDURES WITH CC/MCC,,,21036.32,77527.78,31
MS-DRG,712,TESTES PROCEDURES WITHOUT CC/MCC,,,12094.82,40914.34,31
MS-DRG,713,TRANSURETHRAL PROSTATECTOMY WITH CC/MCC,,,15762.83,55934.0,31
MS-DRG,714,TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC,,,11710.48,39340.57,31
MS-DRG,715,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC,,,22431.0,83238.75,31
MS-DRG,716,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC,,,15468.44,54728.56,31
MS-DRG,717,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC,,,19280.02,70336.05,31
MS-DRG,718,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC,,,14306.35,49970.04,31
MS-DRG,722,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC",,,18545.86,67329.89,31
MS-DRG,723,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC",,,12485.52,42514.15,31
MS-DRG,724,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,,8060.66,24395.32,31
MS-DRG,725,BENIGN PROSTATIC HYPERTROPHY WITH MCC,,,12735.39,43537.29,31
MS-DRG,726,BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC,,,8663.08,26862.01,31
MS-DRG,727,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC,,,15576.56,55171.29,31
MS-DRG,728,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC,,,9473.53,30180.7,31
MS-DRG,729,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC,,,11722.31,39388.93,31
MS-DRG,730,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,,,8208.76,25001.76,31
MS-DRG,734,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC",,,21456.08,79246.65,31
MS-DRG,735,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC",,,14328.15,50059.33,31
MS-DRG,736,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC,,,34580.75,132989.27,31
MS-DRG,737,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC,,,20825.52,76664.62,31
MS-DRG,738,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC,,,15445.72,54635.54,31
MS-DRG,739,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC,,,34656.17,133298.07,31
MS-DRG,740,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC,,,18544.94,67326.17,31
MS-DRG,741,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC,,,15060.48,53058.05,31
MS-DRG,742,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC,,,18773.92,68263.73,31
MS-DRG,743,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC,,,13375.95,46160.24,31
MS-DRG,744,"D&amp;C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC",,,20721.03,76236.77,31
MS-DRG,745,"D&amp;C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC",,,12438.27,42320.69,31
MS-DRG,746,"VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC",,,17886.21,64628.81,31
MS-DRG,747,"VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC",,,9914.19,31985.14,31
MS-DRG,748,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,,14707.94,51614.5,31
MS-DRG,749,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC,,,25432.09,95527.56,31
MS-DRG,750,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,,15512.06,54907.14,31
MS-DRG,754,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC",,,18836.61,68520.45,31
MS-DRG,755,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC",,,11986.7,40471.6,31
MS-DRG,756,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,,10830.06,35735.4,31
MS-DRG,757,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC",,,15113.18,53273.84,31
MS-DRG,758,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC",,,10998.15,36423.7,31
MS-DRG,759,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,,8132.45,24689.24,31
MS-DRG,760,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC,,,11257.11,37484.04,31
MS-DRG,761,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC,,,7286.55,21225.45,31
MS-DRG,768,VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&amp;C,,,5895.0,27606.56,31
MS-DRG,769,POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES,,,17456.43,62869.01,31
MS-DRG,770,"ABORTION WITH D&amp;C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,11213.48,37305.45,31
MS-DRG,776,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES,,,8051.59,24358.11,31
MS-DRG,779,ABORTION WITHOUT D&amp;C,,,9747.01,31300.57,31
MS-DRG,783,CESAREAN SECTION WITH STERILIZATION WITH MCC,,,9824.0,63248.29,31
MS-DRG,784,CESAREAN SECTION WITH STERILIZATION WITH CC,,,9824.0,29233.0,31
MS-DRG,785,CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC,,,9824.0,29233.0,31
MS-DRG,786,CESAREAN SECTION WITHOUT STERILIZATION WITH MCC,,,9824.0,42494.42,31
MS-DRG,787,CESAREAN SECTION WITHOUT STERILIZATION WITH CC,,,9824.0,29233.0,31
MS-DRG,788,CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC,,,9824.0,29233.0,31
MS-DRG,789,"NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY",,,1470.0,46428.28,31
MS-DRG,790,"EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE",,,1627.0,153116.45,31
MS-DRG,791,PREMATURITY WITH MAJOR PROBLEMS,,,1627.0,104567.96,31
MS-DRG,792,PREMATURITY WITHOUT MAJOR PROBLEMS,,,1470.0,63096.29,31
MS-DRG,793,FULL TERM NEONATE WITH MAJOR PROBLEMS,,,1627.0,107417.24,31
MS-DRG,794,NEONATE WITH OTHER SIGNIFICANT PROBLEMS,,,1470.0,38022.14,31
MS-DRG,795,NORMAL NEWBORN,,,1179.0,5147.25,31
MS-DRG,796,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&amp;C WITH MCC,,,5895.0,30064.25,31
MS-DRG,797,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&amp;C WITH CC,,,5895.0,25772.3,31
MS-DRG,798,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&amp;C WITHOUT CC/MCC,,,5895.0,24656.81,31
MS-DRG,799,SPLENIC PROCEDURES WITH MCC,,,43252.39,168497.72,31
MS-DRG,800,SPLENIC PROCEDURES WITH CC,,,27629.09,104523.73,31
MS-DRG,801,SPLENIC PROCEDURES WITHOUT CC/MCC,,,19447.2,71020.62,31
MS-DRG,802,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC,,,38302.37,148228.44,31
MS-DRG,803,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC,,,18992.87,69160.37,31
MS-DRG,804,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC,,,14423.56,50449.98,31
MS-DRG,805,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&amp;C WITH MCC,,,5895.0,27802.35,31
MS-DRG,806,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&amp;C WITH CC,,,5895.0,19666.0,31
MS-DRG,807,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&amp;C WITHOUT CC/MCC,,,5895.0,19666.0,31
MS-DRG,808,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC,,,22163.87,82144.92,31
MS-DRG,809,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC,,,13604.92,47097.81,31
MS-DRG,810,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC,,,11612.36,38938.75,31
MS-DRG,811,RED BLOOD CELL DISORDERS WITH MCC,,,14862.42,52246.98,31
MS-DRG,812,RED BLOOD CELL DISORDERS WITHOUT MCC,,,10445.73,34161.63,31
MS-DRG,813,COAGULATION DISORDERS,,,15961.82,56748.79,31
MS-DRG,814,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC,,,21426.1,79123.87,31
MS-DRG,815,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC,,,11316.16,37725.87,31
MS-DRG,816,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC,,,7845.33,23513.56,31
MS-DRG,817,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC,,,22833.52,84886.93,31
MS-DRG,818,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC,,,12635.44,43128.04,31
MS-DRG,819,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC,,,9916.01,31992.58,31
MS-DRG,820,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC,,,55390.32,218199.88,31
MS-DRG,821,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC,,,22442.81,83287.11,31
MS-DRG,822,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,,,13042.48,44794.82,31
MS-DRG,823,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC,,,43760.29,170577.48,31
MS-DRG,824,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC,,,22688.15,84291.65,31
MS-DRG,825,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC,,,14363.58,50204.43,31
MS-DRG,826,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC,,,44605.28,174037.55,31
MS-DRG,827,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC,,,23102.46,85988.2,31
MS-DRG,828,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,,,17583.65,63389.88,31
MS-DRG,829,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC,,,30814.63,117567.8,31
MS-DRG,830,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC,,,15777.34,55993.53,31
MS-DRG,831,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC,,,13028.86,44739.01,31
MS-DRG,832,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC,,,8659.43,26847.13,31
MS-DRG,833,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC,,,6854.05,19454.49,31
MS-DRG,834,ACUTE LEUKEMIA WITH MCC,,,51983.99,204251.73,31
MS-DRG,835,ACUTE LEUKEMIA WITH CC,,,21054.5,77602.19,31
MS-DRG,836,ACUTE LEUKEMIA WITHOUT CC/MCC,,,13183.33,45371.5,31
MS-DRG,837,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC,,,45754.67,178743.98,31
MS-DRG,838,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT,,,21069.03,77661.72,31
MS-DRG,839,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,,,15222.22,53720.3,31
MS-DRG,840,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC,,,31495.14,120354.45,31
MS-DRG,841,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC,,,16925.83,60696.24,31
MS-DRG,842,LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC,,,11283.45,37591.93,31
MS-DRG,843,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC,,,20227.67,74216.53,31
MS-DRG,844,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC,,,13164.24,45293.37,31
MS-DRG,845,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC,,,9840.6,31683.78,31
MS-DRG,846,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC,,,25658.35,96453.96,31
MS-DRG,847,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC,,,13989.26,48671.58,31
MS-DRG,848,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,,,9820.61,31601.93,31
MS-DRG,849,RADIOTHERAPY,,,26721.4,100806.95,31
MS-DRG,850,ACUTE LEUKEMIA WITH OTHER PROCEDURES,,,80782.83,322176.7,31
MS-DRG,853,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC,,,46974.9,183740.61,31
MS-DRG,854,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC,,,20257.65,74339.31,31
MS-DRG,855,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC,,,15706.48,55703.33,31
MS-DRG,856,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC,,,43432.31,169234.38,31
MS-DRG,857,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC,,,21560.57,79674.51,31
MS-DRG,858,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC,,,14758.81,51822.84,31
MS-DRG,862,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC,,,18673.06,67850.76,31
MS-DRG,863,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC,,,11169.87,37126.87,31
MS-DRG,864,FEVER AND INFLAMMATORY CONDITIONS,,,10168.59,33026.88,31
MS-DRG,865,VIRAL ILLNESS WITH MCC,,,15716.49,55744.25,31
MS-DRG,866,VIRAL ILLNESS WITHOUT MCC,,,10004.17,32353.47,31
MS-DRG,867,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC,,,21121.72,77877.51,31
MS-DRG,868,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC,,,11471.53,38362.08,31
MS-DRG,869,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC,,,8733.01,27148.49,31
MS-DRG,870,SEPTICEMIA OR SEVERE SEPSIS WITH MV &gt;96 HOURS,,,64903.31,257153.52,31
MS-DRG,871,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV &gt;96 HOURS WITH MCC,,,19752.46,72270.71,31
MS-DRG,872,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV &gt;96 HOURS WITHOUT MCC,,,11400.65,38071.88,31
MS-DRG,876,O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS,,,37219.31,143793.6,31
MS-DRG,880,ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION,,,10827.32,35724.24,31
MS-DRG,881,DEPRESSIVE NEUROSES,,,10651.99,35006.18,31
MS-DRG,882,NEUROSES EXCEPT DEPRESSIVE,,,11859.49,39950.73,31
MS-DRG,883,DISORDERS OF PERSONALITY AND IMPULSE CONTROL,,,19968.73,73156.19,31
MS-DRG,884,ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY,,,16721.4,59859.12,31
MS-DRG,885,PSYCHOSES,,,14794.26,51967.94,31
MS-DRG,886,BEHAVIORAL AND DEVELOPMENTAL DISORDERS,,,20959.08,77211.54,31
MS-DRG,887,OTHER MENTAL DISORDER DIAGNOSES,,,11833.16,39842.83,31
MS-DRG,894,"ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA",,,7708.14,22951.76,31
MS-DRG,895,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY",,,14965.06,52667.4,31
MS-DRG,896,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC",,,17958.89,64926.45,31
MS-DRG,897,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC",,,10124.07,32844.57,31
MS-DRG,901,WOUND DEBRIDEMENTS FOR INJURIES WITH MCC,,,40233.13,156134.5,31
MS-DRG,902,WOUND DEBRIDEMENTS FOR INJURIES WITH CC,,,19498.06,71228.97,31
MS-DRG,903,WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC,,,12729.94,43514.97,31
MS-DRG,904,SKIN GRAFTS FOR INJURIES WITH CC/MCC,,,35476.62,136657.69,31
MS-DRG,905,SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC,,,15581.1,55189.9,31
MS-DRG,906,HAND PROCEDURES FOR INJURIES,,,19950.55,73081.78,31
MS-DRG,907,OTHER O.R. PROCEDURES FOR INJURIES WITH MCC,,,36986.71,142841.16,31
MS-DRG,908,OTHER O.R. PROCEDURES FOR INJURIES WITH CC,,,20231.31,74231.42,31
MS-DRG,909,OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC,,,14030.12,48839.0,31
MS-DRG,913,TRAUMATIC INJURY WITH MCC,,,16954.9,60815.29,31
MS-DRG,914,TRAUMATIC INJURY WITHOUT MCC,,,10148.6,32945.03,31
MS-DRG,915,ALLERGIC REACTIONS WITH MCC,,,17381.93,62563.93,31
MS-DRG,916,ALLERGIC REACTIONS WITHOUT MCC,,,8156.98,24789.69,31
MS-DRG,917,POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC,,,16353.41,58352.32,31
MS-DRG,918,POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC,,,9890.57,31888.41,31
MS-DRG,919,COMPLICATIONS OF TREATMENT WITH MCC,,,18737.56,68114.91,31
MS-DRG,920,COMPLICATIONS OF TREATMENT WITH CC,,,11209.85,37290.57,31
MS-DRG,921,COMPLICATIONS OF TREATMENT WITHOUT CC/MCC,,,8357.78,25611.92,31
MS-DRG,922,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC",,,17997.98,65086.43,31
MS-DRG,923,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC",,,11349.78,37863.53,31
MS-DRG,927,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV &gt;96 HOURS WITH SKIN GRAFT,,,196092.69,794345.35,31
MS-DRG,928,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC,,,67273.83,266860.3,31
MS-DRG,929,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC,,,31367.03,119829.86,31
MS-DRG,933,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV &gt;96 HOURS WITHOUT SKIN GRAFT,,,37485.53,144883.71,31
MS-DRG,934,FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY,,,22188.41,82245.37,31
MS-DRG,935,NON-EXTENSIVE BURNS,,,20820.09,76642.3,31
MS-DRG,939,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC,,,35071.4,134998.34,31
MS-DRG,940,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC,,,23335.97,86944.36,31
MS-DRG,941,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC,,,20526.59,75440.58,31
MS-DRG,945,REHABILITATION WITH CC/MCC,,,3084.0,39895.03,31
MS-DRG,946,REHABILITATION WITHOUT CC/MCC,,,3084.0,29543.86,31
MS-DRG,947,SIGNS AND SYMPTOMS WITH MCC,,,13636.71,47228.03,31
MS-DRG,948,SIGNS AND SYMPTOMS WITHOUT MCC,,,9376.31,29782.6,31
MS-DRG,949,AFTERCARE WITH CC/MCC,,,12912.57,44262.79,31
MS-DRG,950,AFTERCARE WITHOUT CC/MCC,,,7806.25,23353.58,31
MS-DRG,951,OTHER FACTORS INFLUENCING HEALTH STATUS,,,7154.79,20685.98,31
MS-DRG,955,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,,63261.49,250430.58,31
MS-DRG,956,"LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA",,,36293.46,140002.42,31
MS-DRG,957,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC,,,71337.07,283498.38,31
MS-DRG,958,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC,,,40390.32,156778.15,31
MS-DRG,959,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,,,28852.95,109535.24,31
MS-DRG,963,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC,,,26942.19,101711.03,31
MS-DRG,964,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC,,,16028.15,57020.38,31
MS-DRG,965,OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,,,10648.33,34991.3,31
MS-DRG,969,HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC,,,57720.86,227742.97,31
MS-DRG,970,HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC,,,26066.3,98124.47,31
MS-DRG,974,HIV WITH MAJOR RELATED CONDITION WITH MCC,,,28325.08,107373.63,31
MS-DRG,975,HIV WITH MAJOR RELATED CONDITION WITH CC,,,13869.3,48180.48,31
MS-DRG,976,HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC,,,10304.89,33584.95,31
MS-DRG,977,HIV WITH OR WITHOUT OTHER RELATED CONDITION,,,13893.83,48280.93,31
MS-DRG,981,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,,,44732.49,174558.42,31
MS-DRG,982,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,,,24440.83,91468.49,31
MS-DRG,983,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,,,17676.32,63769.37,31
MS-DRG,987,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,,,33253.28,127553.62,31
MS-DRG,988,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,,,17036.68,61150.14,31
MS-DRG,989,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,,,12998.87,44616.24,31
NDC,00002021301,insulin regular - sliding scale 100 U/ML Solution 3 mL Vial,56.15,30.89,16.85,48.57,38
NDC,00002021301,insulin regular 100 UNITS/ML Solution 3 mL Vial,56.15,30.89,16.85,48.57,38
NDC,00002021301,insulin regular 100 units/mL Solution 3 mL Vial,56.15,30.89,16.85,48.57,38
NDC,00002120001,florbetapir F-18 500-1900 MBQ/ML Solution 10 millicurie,5897.86,3243.83,1769.36,5190.12,63
NDC,00002418230,baricitinib 2 MG Tab 30 Each Bottle,226.39,124.52,67.92,195.83,38
NDC,00002473230,baricitinib 1 MG Tab 30 Each Bottle,226.39,124.52,67.92,195.83,38
NDC,00002757501,mirikizumab-mrkz 300 MG/15ML Solution 15 mL Vial,33586.27,18472.45,38.97,29052.12,63
NDC,00002758901,bebtelovimab 175 mg/2 mL Solution 2 mL Vial,8830.0,4856.5,2649.0,7637.95,38
NDC,00002762301,PEMEtrexed 25 mg/ml Recon Soln 1 Each Vial,17404.9,9572.7,4.36,15055.24,63
NDC,00002764001,PEMEtrexed 25 mg/ml Recon Soln 1 Each Vial,3663.7,2015.04,4.36,3169.1,63
NDC,00002766901,ramucirumab 100 MG/10ML Solution 10 mL Vial,6646.12,3655.37,62.6,5748.89,63
NDC,00002767801,Ramucirumab 500 MG/50ML Solution 50 mL Vial,30177.88,16597.84,62.6,26103.87,63
NDC,00002822201,insulin lispro human 100 UNIT/ML Solution Pen-injector 3 mL Pen,117.01,64.36,35.1,101.21,38
NDC,00002880359,insulin isophane & regular 70/30 - sliding scale 100 (70-30) UNIT/ML Suspension Pen-injector 3 mL Pen,105.33,57.94,31.6,91.11,38
NDC,00002880359,insulin isophane & regular 70/30 Suspension Pen-injector 3 mL Pen,105.33,57.94,31.6,91.11,38
NDC,00002880559,insulin NPH 100 UNIT/ML Suspension Pen-injector 3 mL Pen,105.32,57.93,31.6,91.1,38
NDC,00002882427,insulin regular human U-500 HIGH CONC 500 units/mL Solution Pen-injector 3 mL Pen,959.43,527.69,287.83,829.91,38
NDC,00003029305,triamcinolone acetonide 40 mg/mL Suspension 1 mL Vial,90.52,49.79,0.77,78.3,48
NDC,00003037113,belatacept 25 mg/mL Recon Soln 1 Each Vial,5252.35,2888.8,3.38,4543.28,63
NDC,00003049420,triamcinolone acetonide 10 MG/ML Suspension 5 mL Vial,98.59,54.23,0.77,85.28,48
NDC,00003052620,PH test Test 1 Each Roll,136.03,74.82,40.81,117.67,38
NDC,00003052711,dasatinib 20 MG Tab 60 Each Bottle,409.95,225.48,122.99,354.61,38
NDC,00003089331,apixaban 2.5 MG Tab 100 Each Box,33.29,18.31,9.99,28.8,38
NDC,00003089421,apixaban 5 MG Tab 60 Each Bottle,33.28,18.31,9.98,28.79,38
NDC,00003089431,apixaban 5 MG Tab 100 Each Box,33.29,18.31,9.99,28.8,38
NDC,00003161412,entecavir 0.05 MG/ML Solution 210 mL Bottle,2889.25,1589.09,866.78,2499.2,38
NDC,00003218713,abatacept 25 mg/mL Recon Soln 1 Each Vial,8188.82,4503.86,37.61,7083.33,63
NDC,00003229111,elotuzumab 25 mg/mL Recon Soln 1 Each Vial,10265.47,5646.01,6.62,8879.63,63
NDC,00003257016,aztreonam Recon Soln 1 Each Vial,371.7,204.44,1.77,321.52,48
NDC,00003373413,nivolumab 240 MG/24ML Solution 24 mL Vial,31943.04,17568.68,27.74,27630.73,63
NDC,00003377211,nivolumab 40 MG/4ML Solution 4 mL Vial,5865.51,3226.04,27.74,5073.67,63
NDC,00003377412,nivolumab 100 MG/10ML Solution 10 mL Vial,13972.25,7684.74,27.74,12086.0,63
NDC,00003452211,Elotuzumab 25 mg/mL Recon Soln 1 Each Vial,13066.97,7186.84,6.62,11302.93,63
NDC,00003712511,nivolumab-relatlimab-rmbw 240-80 mg/20mL Solution 20 mL Vial,62005.28,34102.91,166.45,53634.57,63
NDC,00005010010,meningococcal group B vaccine Suspension Prefilled Syringe 0.5 mL Syringe,654.83,360.16,195.9,566.43,38
NDC,00005200001,pneumococcal 20-valent conjugate 0.5 ML Suspension Prefilled Syringe 0.5 mL Syringe,864.76,475.62,255.9,2112.08,53
NDC,00006022131,SITagliptin phosphate 25 MG Tab 30 Each Bottle,35.7,19.64,10.71,30.88,38
NDC,00006022761,raltegravir potassium 400 MG Tab 60 Each Bottle,88.33,48.59,26.5,76.41,38
NDC,00006027701,SITagliptin 100 MG Tab 1 Each Blister,35.7,19.64,10.71,30.88,38
NDC,00006302604,pembrolizumab 100 MG/4ML Solution 4 mL Vial,24195.65,13307.61,49.46,20929.24,63
NDC,00006307603,letermovir 480 MG Tab 1 Each Blister,663.54,364.95,199.06,573.96,38
NDC,00006412102,human papillomavirus (HPV) 9-valent Suspension Prefilled Syringe 0.5 mL Syringe,967.74,532.26,290.32,837.1,38
NDC,00006482701,varicella virus vaccine (live) 1350 PFU/0.5ML Recon Susp 1 Each Vial,578.97,318.44,173.69,500.81,38
NDC,00006489701,haemophilus b polysac conjugate vaccine 7.5 MCG/0.5 ML Suspension 0.5 mL Vial,118.08,64.95,31.37,102.14,38
NDC,00006499200,hepatitis B vaccine dialysis 40 mcg/mL Suspension 1 mL Vial,1023.67,563.02,135.79,1109.84,53
NDC,00006500401,letermovir 480 MG/24ML Solution 24 mL Vial,2063.98,1135.19,619.19,1785.34,38
NDC,00006542302,Sugammadex Sodium 200 MG/2ML Solution 2 mL Vial,750.16,412.59,225.05,648.89,38
NDC,00006542505,Sugammadex Sodium 500 MG/5ML Solution 5 mL Vial,1361.49,748.82,408.45,1177.69,38
NDC,00008010001,inotuzumab ozogamicin 0.25 mg/ml Recon Soln 1 Each Vial,93937.8,51665.79,2282.27,81256.2,63
NDC,00008084402,pantoprazole 40 MG Pack 30 Each Box,44.9,24.7,13.47,38.84,38
NDC,00008117901,temsirolimus Solution 1 mL Vial,9026.44,4964.55,25.34,7807.87,63
NDC,00008451001,gemtuzumab ozogamicin 1 mg/mL Recon Soln 1 Each Vial,41199.5,22659.73,200.16,35637.57,63
NDC,00009001104,hydrocortisone sodium succinate PF 100 mg Recon Soln 1 Each Vial,173.56,95.46,17.98,150.13,96
NDC,00009001305,hydrocortisone sodium succinate PF 250 mg Recon Soln 1 Each Vial,282.18,155.2,17.98,244.09,48
NDC,00009001612,hydrocortisone sodium succinate PF 500 mg Recon Soln 1 Each Vial,539.64,296.81,161.89,466.79,38
NDC,00009003930,methylPREDNISolone sod succ Recon Soln 1 Each Vial,70.29,38.66,0.21,60.8,63
NDC,00009004725,methylPREDNISolone sod succ Recon Soln 1 Each Vial,87.73,48.26,0.21,75.89,63
NDC,00009029703,gelatin adsorbable FILM 6 Each Box,753.85,414.62,226.16,652.08,38
NDC,00009030602,methylPREDNISolone acetate 80 MG/ML Suspension 5 mL Vial,607.14,333.93,0.11,525.18,63
NDC,00009041701,testosterone cypionate 200 MG/ML Solution 1 mL Vial,257.9,141.85,0.03,223.08,48
NDC,00009043601,arginine 10 % Solution 300 mL Glass Cont,230.0,126.5,69.0,198.95,38
NDC,00009055502,lincomycin HCl 300 MG/ML Solution 10 mL Vial,923.6,507.98,5.78,798.91,48
NDC,00009069801,methylPREDNISolone sod succ 1000 mg Recon Soln 1 Each Vial,278.88,153.39,0.21,241.23,63
NDC,00009074630,medroxyPROGESTERone 150 MG/ML Suspension 1 mL Vial,330.78,181.93,0.43,286.12,48
NDC,00009075801,methylPREDNISolone sod succ 500 mg Recon Soln 1 Each Vial,177.82,97.81,0.21,153.81,63
NDC,00009077526,clindamycin phosphate 600 mg Solution 4 mL Vial,47.08,25.9,1.83,40.72,48
NDC,00009090218,clindamycin 900 mg Solution 6 mL Vial,57.0,31.35,1.83,49.31,48
NDC,00009307301,methylPREDNISolone acetate 40 MG/ML Suspension 1 mL Vial,93.84,51.62,0.11,81.17,63
NDC,00009316906,alprostadil 500 MCG/ML Solution 1 mL Ampule,929.46,511.21,278.84,803.98,38
NDC,00009379401,ibutilide 1 MG/10ML Solution 10 mL Vial,3038.08,1670.95,160.53,2627.94,63
NDC,00009470913,medroxyPROGESTERone acetate 104 MG/0.65ML Suspension Prefilled Syringe 0.65 mL Syringe,330.78,181.93,0.43,286.12,48
NDC,00009509101,epiRUBicin 50 MG/25ML Solution 25 mL Vial,256.07,140.84,1.4,221.5,48
NDC,00009722402,antithymocyte globulin (atg) (horse) 50 MG/ML Solution 5 mL Ampule,21267.5,11697.13,3739.82,33838.49,63
NDC,00009752905,Irinotecan HCl 300 MG/15ML Solution 15 mL Vial,564.32,310.38,1.69,488.14,48
NDC,00013257691,IDArubicin 5 MG/5ML Solution 5 mL Vial,283.33,155.84,40.19,250.09,48
NDC,00013258691,IDArubicin 10 MG/10ML Solution 10 mL Vial,536.57,295.12,40.19,464.13,48
NDC,00019905040,indium In-111 pentetreotide Kit 6 millicurie,11116.9,6114.3,1914.61,9782.87,63
NDC,00023031304,sulfacetamide/prednisoLONE 10-0.2 % Ointment 3.5 g Tube,511.47,281.31,153.44,442.42,38
NDC,00023114501,onabotulinumtoxinA 100 units Recon Soln 1 Each Vial,3503.4,1926.87,5.77,3030.44,63
NDC,00023114501,onabotulinumtoxinA 2.5 units Injection 0.12 mL Syringe,143.63,79.0,5.77,124.24,63
NDC,00023114501,onabotulinumtoxinA 2.5 units Injection 0.2 mL Syringe,205.2,112.86,5.77,177.5,63
NDC,00023114501,onabotulinumtoxinA 2.5 units Injection 0.3 mL Syringe,275.58,151.57,5.77,238.38,63
NDC,00023114501,onabotulinumtoxinA 2.5 units Injection 0.4 mL Syringe,395.4,217.47,5.77,342.02,63
NDC,00023114501,onabotulinumtoxinA 5   units Injection 0.2 mL Syringe,395.4,217.47,5.77,342.02,63
NDC,00023114501,onabotulinumtoxinA 5   units Injection 0.8 mL Syringe,1384.44,761.45,5.77,1197.54,63
NDC,00023334807,dexAMETHasone 0.7 MG Implant 1 Each Box,7429.2,4086.06,176.49,6426.26,63
NDC,00023341630,carboxymethylcellulose/glycerin PF 0.5-0.9 % Solution 0.4 mL Plas Cont,3.48,1.92,1.04,3.01,38
NDC,00023391950,onabotulinumtoxin A - cosmetic 50 units Recon Soln 1 Each Vial,1969.8,1083.39,5.77,1703.88,63
NDC,00023392102,onabotulinumtoxinA 200 units Recon Soln 1 Each Vial,6991.8,3845.49,5.77,6047.91,63
NDC,00023455430,carboxymethylcellulose sodium PF 1 % Gel 0.4 mL Plas Cont,3.51,1.94,1.05,3.04,38
NDC,00023599002,testosterone 2 MG/24HR PATCH 24 HR 1 Each Box,33.73,18.56,10.12,29.18,38
NDC,00023599204,testosterone 4 MG/24HR PATCH 24 HR 1 Each Package,61.43,33.79,18.43,53.14,38
NDC,00023608210,iron dextran complex 50 MG/ML Solution 2 mL Vial,238.7,131.29,14.94,206.48,63
NDC,00023920515,carboxymethylcellulose 1 % Gel 15 mL Bottle,50.4,27.72,15.12,43.6,38
NDC,00023923201,onabotulinumtoxinA (Cosmetic) 100 units Recon Soln 1 Each Vial,1579.4,868.67,5.77,1366.18,63
NDC,00023965201,bimatoprost 10 MCG Implant 1 Each Syringe,4865.0,2675.75,180.21,4208.23,63
NDC,00024065401,isatuximab-irfc 100 MG/5ML Solution 5 mL Vial,3818.23,2100.03,68.13,3302.77,63
NDC,00024065601,isatuximab-irfc 500 MG/25ML Solution 25 mL Vial,18143.32,9978.83,68.13,15693.97,63
NDC,00024414260,dronedarone 400 MG Tab 60 Each Bottle,42.45,23.35,12.74,36.72,38
NDC,00024515010,rasburicase 1.5 MG Recon Soln 1 Each Vial,5904.42,3247.44,317.66,5107.32,63
NDC,00024584305,sargramostim (GM-CSF) 250 mcg Recon Soln 1 Each Vial,1502.56,826.41,50.37,1299.71,63
NDC,00024586201,plerixafor 24 MG/1.2ML Solution 1.2 mL Vial,41875.89,23031.74,25.33,36222.64,63
NDC,00026482101,antihemophilic factor VIII recombinant 250 units Recon Soln 1 Each Vial,34.4,18.92,1.27,30.27,63
NDC,00026482101,antihemophilic factor VIII recombinant Kit 1 Each Vial,34.4,18.92,1.27,30.27,63
NDC,00026482401,Antihemophil Factor (rAHF-PFM) 1000 units Recon Soln 1 Each Vial,34.4,18.92,1.27,30.27,63
NDC,00032004670,"pancrelipase (lip/prot/amyl) 6,000 units/capsule Cap DR Particles 100 Each Bottle",13.44,7.4,4.03,11.63,38
NDC,00032004770,pancrelipase (lip/prot/amyl) 12000 units/capsule Cap DR Particles 100 Each Bottle,19.87,10.93,5.96,17.19,38
NDC,00032122401,"pancrelipase (lip/prot/amyl) 24,000 units Cap DR Particles 100 Each Bottle",28.96,15.93,8.69,25.05,38
NDC,00037682410,pramoxine/hydrocortisone 1-1 % Foam 10 g Can,340.39,187.22,102.12,294.44,38
NDC,00046074905,estrogens (conjugated) 5 mg/mL Recon Soln 1 Each Vial,2050.15,1127.59,328.76,2637.5,63
NDC,00046087221,estrogens (conjugated) 0.625 MG/GM Cream 30 g Tube,1392.58,765.92,417.77,1204.58,38
NDC,00046110081,estrogens (conjugated) 0.3 mg Tab 100 Each Bottle,25.09,13.8,7.53,21.7,38
NDC,00046110281,estrogens (conjugated) 0.625 mg Tab 100 Each Bottle,25.09,13.8,7.53,21.7,38
NDC,00046110481,estrogens (conjugated) 1.25 MG Tab 100 Each Bottle,25.09,13.8,7.53,21.7,38
NDC,00049052083,"penicillin G potassium 100,000 units/mL Solution 1 Each Vial",102.69,56.48,30.81,88.83,38
NDC,00049052083,penicillin G potassium 5 million unit Recon Soln 1 Each Vial,102.69,56.48,0.65,88.83,48
NDC,00049052083,penicillin G potassium 5 million units 5 Solution 100 mL Bag,235.6,129.58,70.68,203.79,38
NDC,00049052083,penicillin G potassium Recon Soln 1 Each Vial,102.69,56.48,0.65,88.83,86
NDC,00049319001,voriconazole Recon Soln 1 Each Vial,118.15,64.99,0.84,102.2,48
NDC,00049319028,voriconazole 1% Solution 15 mL Package,924.64,508.56,277.39,799.81,38
NDC,00049319028,voriconazole Recon Soln 1 Each Vial,376.8,207.24,0.84,325.93,48
NDC,00052031510,chorionic gonadotropin 10000 units Recon Soln 1 Each Vial,642.8,353.54,16.89,556.02,48
NDC,00052060202,BCG vaccine 50 MG Recon Susp 1 Each Vial,860.35,473.2,2.57,744.2,48
NDC,00053720102,"alpha-1-proteinase inhibitor (human) 1000 MG Recon Soln 1,000 mg Vial",3309.0,1819.95,2.6,2862.29,63
NDC,00053768032,albumin human 25 % Solution 50 mL Vial,375.0,206.25,45.57,358.29,38
NDC,00054001021,flecainide 25 mg half tablet Tab 0.5 tablet Package,7.86,4.33,2.36,6.8,38
NDC,00054001021,flecainide 50 MG Tab 60 Each Bottle,8.72,4.8,2.62,7.54,38
NDC,00054001125,flecainide 100 MG Tab 100 Each Bottle,9.81,5.4,2.94,8.49,38
NDC,00054002125,lithium carbonate 300 MG Tab CR 100 Each Bottle,9.1,5.01,2.73,7.87,38
NDC,00054004544,ipratropium 0.03 % Solution 30 mL Bottle,146.0,80.3,43.8,126.29,38
NDC,00054004641,ipratropium 0.06 % Solution 15 mL Bottle,146.0,80.3,43.8,126.29,38
NDC,00054005746,digoxin 0.05 MG/ML Solution 60 mL Bottle,426.94,234.82,128.08,369.3,38
NDC,00054017713,buprenorphine 8 MG SL Tab 30 Each Bottle,12.82,7.06,3.85,11.09,38
NDC,00054023525,morphine 15 MG Tab 100 Each Bottle,11.08,6.1,3.32,9.58,38
NDC,00054023763,morphine sulfate 2 mg/ml Solution 500 mL Bottle,67.5,37.13,20.25,58.39,38
NDC,00054024324,codeine 15 MG Tab 100 Each Box,11.62,6.4,3.49,10.05,38
NDC,00054024424,codeine 30 MG Tab 100 Each Box,11.93,6.57,3.58,10.32,38
NDC,00054026424,HYDROmorphone 4 MG Tab 100 Each Box,10.75,5.92,3.23,9.3,38
NDC,00054033425,cevimeline 30 MG Cap 100 Each Bottle,14.75,8.12,4.43,12.76,38
NDC,00054066882,alvimopan 12 MG Cap 30 Each Box,403.01,221.66,120.9,348.6,38
NDC,00054071020,methadone 10 MG Tab 100 Each Box,10.88,5.99,3.26,9.41,38
NDC,00054311763,calcium carbonate 1250 MG/5ML Suspension 5 mL Oral Syringe,8.3,4.57,2.49,7.18,38
NDC,00054317644,dexAMETHasone 1 MG/ML Conc 30 mL Bottle,78.55,43.21,0.05,67.95,48
NDC,00054317763,dexAMETHasone 0.5 MG/5ML Solution 500 mL Bottle,60.8,33.44,0.05,52.59,48
NDC,00054329450,furosemide 10 MG/ML Solution 120 mL Bottle,51.16,28.14,15.35,44.25,38
NDC,00054350049,lidocaine viscous 2 % Solution 100 mL Bottle,58.5,32.18,17.55,50.6,38
NDC,00054350547,lidocaine hcl 4 % Solution 50 mL Bottle,160.0,88.0,48.0,138.4,38
NDC,00054353244,LORazepam 2 MG/ML Conc 30 mL Bottle,75.28,41.41,22.58,65.12,38
NDC,00054356699,midazolam 2 MG/ML Syrup 118 mL Bottle,282.08,155.15,84.62,244.0,38
NDC,00054372263,predniSONE 5 MG/5ML Solution 500 mL Bottle,937.0,515.35,0.01,810.51,48
NDC,00054372763,propranolol 20 MG/5ML Solution 500 mL Bottle,168.05,92.43,50.42,145.36,38
NDC,00054414622,clotrimazole 10 MG Troche 70 Each Bottle,12.94,7.12,3.88,11.19,38
NDC,00054449613,leucovorin 5 MG Tab 30 Each Bottle,10.35,5.7,3.11,8.95,38
NDC,00054449705,leucovorin 10 MG Tab 12 Each Bottle,22.82,12.56,6.85,19.74,38
NDC,00054449810,leucovorin 15 MG Tab 24 Each Bottle,20.3,11.17,6.09,17.56,38
NDC,00054458111,mercaptopurine 50 MG Tab 25 Each Bottle,16.51,9.09,4.95,14.28,38
NDC,00054474225,predniSONE 2.5 MG Tab 100 Each Bottle,8.44,4.65,0.01,7.3,48
NDC,00054817525,dexAMETHasone 4 MG Tab 100 Each Box,10.01,5.51,0.05,8.66,48
NDC,00054817625,dexAMETHasone 2 MG Tab 100 Each Box,8.85,4.87,0.05,7.66,48
NDC,00054817925,dexAMETHasone 0.5 MG Tab 100 Each Box,8.57,4.72,0.05,7.41,48
NDC,00054852625,lithium 150 MG Cap 100 Each Box,8.5,4.68,2.55,7.35,38
NDC,00054872425,predniSONE 5 MG Tab 100 Each Box,8.66,4.77,0.01,7.49,48
NDC,00056016875,warfarin 4 mg Tab 100 Each Box,13.7,7.54,4.11,11.85,38
NDC,00056016975,warfarin 1 mg Tab 100 Each Box,13.19,7.26,3.96,11.41,38
NDC,00056017375,warfarin 7.5 mg Tab 100 Each Box,16.25,8.94,4.88,14.06,38
NDC,00056017475,warfarin 10 mg Tab 100 Each Box,16.59,9.13,4.98,14.35,38
NDC,00056018875,warfarin 3 mg Tab 100 Each Box,13.68,7.53,4.1,11.83,38
NDC,00056018975,warfarin 6 mg Tab 100 Each Box,15.94,8.77,4.78,13.79,38
NDC,00065002315,carbachol 0.01 % Solution 1.5 mL Vial,182.65,100.46,54.8,157.99,38
NDC,00065008515,naphazoline/pheniramine 0.025-0.3 % Solution 15 mL Bottle,47.46,26.11,14.24,41.05,38
NDC,00065035902,cyclopentolate/phenylephrine 0.2-1 % Solution 2 mL Bottle,149.57,82.27,44.87,129.38,38
NDC,00065035905,cyclopentolate/phenylephrine 0.2-1 % Solution 5 mL Bottle,226.38,124.51,67.91,195.82,38
NDC,00065042636,GENTEAL TEARS 0.1-0.2-0.3 % Solution 15 mL Bottle,43.15,23.74,12.95,37.32,38
NDC,00065045407,polyethyl glycol 400/propyl glycol 0.4-0.3 % Gel 10 mL Bottle,56.26,30.95,16.88,48.66,38
NDC,00065064835,tobramycin/dexamethasone 0.3-0.1 % Ointment 3.5 g Tube,694.63,382.05,208.39,600.85,38
NDC,00065074114,tetracaine 0.5 % Solution 4 mL Plas Cont,68.58,37.72,20.57,59.32,38
NDC,00065079515,balanced salt Solution 15 mL Bottle,64.26,35.35,19.28,55.58,38
NDC,00065079550,balanced salt Solution 500 mL Glass Cont,154.75,85.12,46.43,133.86,76
NDC,00065080050,balanced salt plus Solution 500 mL Glass Cont,351.38,193.26,105.41,303.94,38
NDC,00065806401,hypromellose 0.3 % Gel 10 g Tube,45.03,24.77,13.51,38.95,38
NDC,00065924007,difluprednate 0.05 % Emulsion 5 mL Bottle,664.0,365.2,199.2,574.36,38
NDC,00065930501,dextran-hypromellose PF 0.1-0.3 % Solution 28 Each Plas Cont,21.55,11.86,6.47,18.64,38
NDC,00068059701,rifAMPin Recon Soln 1 Each Vial,979.22,538.58,0.8,847.03,48
NDC,00069023801,riTUXimab-pvvr 100 MG/10ML Solution 10 mL Vial,3250.6,1787.83,20.26,2811.77,63
NDC,00069024901,riTUXimab-pvvr 500 MG/50ML Solution 50 mL Vial,15431.2,8487.16,20.26,13347.99,63
NDC,00069029101,filgrastim-aafi 300 mcg/0.5 ml Solution Prefilled Syringe 0.5 mL Syringe,1197.6,658.68,0.25,1035.92,63
NDC,00069029201,filgrastim-aafi 480 mcg/0.8 mL Solution Prefilled Syringe 0.8 mL Syringe,1907.16,1048.94,0.25,1649.69,63
NDC,00069030501,trastuzumab-qyyp 21 mg/mL Recon Soln 1 Each Vial,14601.64,8030.91,16.29,12630.42,63
NDC,00069030801,trastuzumab-qyyp 21 mg/mL Recon Soln 1 Each Vial,5474.95,3011.23,16.29,4735.83,63
NDC,00069031501,bevacizumab-bvzr 100 mg/4mL Solution 4 mL Vial,2785.3,1531.92,19.75,2409.28,63
NDC,00069032401,pegfilgrastim-apgf 6 MG/0.6ML Solution Prefilled Syringe 0.6 mL Syringe,16495.0,9072.25,100.47,14268.18,63
NDC,00069034201,bevacizumab-bvzr 400 mg/16mL Solution 16 mL Vial,11066.2,6086.41,19.75,9572.26,63
NDC,00069034401,RSV bivalent RSVpreF vaccine 120 MCG/0.5ML Recon Soln 1 Each Vial,965.22,530.88,289.57,834.92,38
NDC,00069080901,inFLIXimab-dyyb 100 mg Recon Soln 1 Each Vial,5124.91,2818.71,9.92,4433.05,63
NDC,00069130510,epoetin alfa-epbx 2000 UNIT/ML Solution 1 mL Vial,163.39,89.87,6.42,141.33,63
NDC,00069130701,epoetin alfa-epbx 4000 UNIT/ML Solution 1 mL Vial,279.72,153.85,6.42,241.96,63
NDC,00069130801,epoetin alfa-epbx 10000 UNIT/ML Solution 1 mL Vial,610.62,335.85,6.42,528.19,63
NDC,00069130901,epoetin alfa-epbx 40000 UNIT/ML Solution 1 mL Vial,2397.48,1318.62,6.42,2073.82,63
NDC,00069131101,epoetin alfa-epbx 20000 UNIT/ML Solution 1 mL Vial,1206.24,663.44,6.42,1043.4,63
NDC,00069252201,elranatamab-bcmm 44 MG/1.1ML Solution 1.1 mL Vial,32684.25,17976.34,152.53,28271.88,63
NDC,00069449401,elranatamab-bcmm 76 mg/1.9 mL Solution 1.9 mL Vial,56443.71,31044.05,152.53,48823.81,63
NDC,00069600121,fosphenytoin 500 MG PE/10ML Solution 10 mL Vial,670.02,368.52,7.17,579.57,48
NDC,00071374066,phenytoin ER 30 MG Cap 100 Each Bottle,11.48,6.32,3.44,9.93,38
NDC,00074056111,venetoclax 10 MG Tab 2 Each Box,41.13,22.63,12.34,35.58,38
NDC,00074056611,venetoclax 50 MG Tab 1 Each Box,161.22,88.68,48.37,139.46,38
NDC,00074057611,venetoclax 100 MG Tab 1 Each Box,317.36,174.55,95.21,274.52,38
NDC,00074104328,upadacitinib ER 45 MG Tablet Extended Release 24 Hour 28 Each Bottle,1085.43,596.99,325.63,938.9,38
NDC,00074165801,paricalcitol 5 MCG/ML Solution 1 mL Vial,118.48,65.17,0.77,102.49,48
NDC,00074230630,upadacitinib ER 15 MG Tablet Extended Release 24 Hour 30 Each Bottle,545.22,299.88,163.57,471.62,38
NDC,00074231030,upadacitinib ER 30 MG Tablet Extended Release 24 Hour 30 Each Bottle,545.22,299.88,163.57,471.62,38
NDC,00074334603,leuprolide acetate (3 month) 22.5 MG Kit 1 Each Box,26414.41,14527.93,155.23,22848.46,63
NDC,00074347303,leuprolide acetate 45 MG Kit 1 Each Box,52814.76,29048.12,155.23,45684.77,63
NDC,00074364103,leuprolide acetate 3.75 MG Kit 1 Each Box,9740.99,5357.55,1431.1,11725.43,63
NDC,00074364171,leuprolide acetate 3.75 MG Kit 1 Each Box,9740.99,5357.55,1431.1,11725.43,63
NDC,00074364203,leuprolide acetate 7.5 MG Kit 1 Each Box,9024.5,4963.48,155.23,7806.19,63
NDC,00074366303,leuprolide acetate (3 month) 11.25 MG Kit 1 Each Box,22704.15,12487.29,1431.1,19639.09,63
NDC,00074368303,leuprolide acetate (4 month) 30 MG Kit 1 Each Box,35214.32,19367.88,155.23,30460.39,63
NDC,00074395646,lopinavir/ritonavir 400-100 mg/5 mL Solution 160 mL Bottle,1543.0,848.65,462.9,1334.7,38
NDC,00074445651,Sevoflurane Solution 250 mL Bottle,188.0,103.4,56.4,162.62,38
NDC,00074501501,risankizumab-rzaa 600 MG/10ML Solution 10 mL Vial,43575.34,23966.44,12.94,37692.67,63
NDC,00074714890,levothyroxine 200 MCG Tab 90 Each Bottle,11.97,6.59,3.59,10.35,38
NDC,00078010901,cycloSPORINE 50 MG/ML Solution 5 mL Ampule,433.68,238.53,61.27,490.66,96
NDC,00078033184,basiliximab Recon Soln 1 Each Vial,19158.51,10537.19,3999.0,31539.17,63
NDC,00078043561,zoledronic acid 1 mg/20 mL Solution 100 mL Bottle,4591.85,2525.52,4.82,3971.95,48
NDC,00078043561,zoledronic acid 5 mg/100 mL Solution 100 mL Bottle,4591.85,2525.52,4.82,3971.95,48
NDC,00078050115,rivastigmine 4.6 mg/24hr/patch PATCH 24 HR 30 Each Box,67.74,37.26,20.32,58.6,38
NDC,00078052687,nilotinib 200 MG Cap 28 Each Disp Pack,468.82,257.86,140.65,405.53,38
NDC,00078056845,artemether/lumefantrine 20-120 MG Tab 24 Each Bottle,21.16,11.64,6.35,18.3,38
NDC,00078065920,sacubitril/valsartan 24-26 MG Tab 60 Each Bottle,37.74,20.76,11.32,32.65,38
NDC,00078068361,nelarabine 5 MG/ML Solution 50 mL Vial,3661.68,2013.93,64.2,3167.35,63
NDC,00078068515,eltrombopag olamine 25 MG Tab 30 Each Bottle,631.11,347.12,189.33,545.91,38
NDC,00078068615,eltrombopag olamine 50 MG Tab 30 Each Bottle,1138.06,625.94,341.42,984.42,38
NDC,00078069620,sacubitril/valsartan 97-103 MG Tab 60 Each Bottle,37.74,20.76,11.32,32.65,38
NDC,00078069899,midostaurin 25 MG Cap 56 Each Box,528.0,290.4,158.4,456.72,38
NDC,00078077720,sacubitril/valsartan 49-51 MG Tab 60 Each Bottle,37.74,20.76,11.32,32.65,38
NDC,00078081181,octreotide 10 MG Kit 1 Each Box,14808.41,8144.63,187.49,12809.27,63
NDC,00078081301,Tobramycin 0.3 % Ointment 3.5 g Tube,850.0,467.5,255.0,735.25,38
NDC,00078081881,octreotide 20 MG Kit 1 Each Box,19398.46,10669.16,187.49,16779.67,63
NDC,00078082581,octreotide 30 MG Kit 1 Each Box,29042.75,15973.52,187.49,25121.98,63
NDC,00078084619,tisagenlecleucel-T Suspension 1 Each Flex Cont,2719137.5,1495525.63,485644.63,3903690.92,63
NDC,00078088361,crizanlizumab 100 MG/10ML Solution 10 mL Vial,10312.35,5671.8,110.48,8920.18,63
NDC,00078089778,triamcinolone acetonide (PF) 40 MG/ML Suspension 1 mL Vial,5112.6,2811.93,24.32,4422.4,63
NDC,00078100060,inclisiran 284 MG/1.5ML Solution Prefilled Syringe 1.5 mL Syringe,14498.91,7974.41,10.55,12541.56,63
NDC,00078116861,secukinumab 125 MG/5ML Solution 5 mL Vial,9071.54,4989.35,15.21,7846.88,63
NDC,00085117701,eptifibatide 20 MG/10ML Solution 10 mL Vial,953.74,524.56,21.75,824.99,48
NDC,00085134104,"mometasone furoate 220 mcg/act AEROSOL POWDER, BREATH ACTIVATED 1 Each Inhaler",255.37,140.46,76.61,220.9,38
NDC,00085433101,posaconazole 300 MG/16.7ML Solution 16.7 mL Vial,2879.39,1583.67,863.82,2490.67,48
NDC,00087040203,multivitamin 50 MG/ML Solution 50 mL Bottle,48.7,26.79,14.61,42.13,38
NDC,00087040501,multivitamin with iron 11 MG/ML Solution 50 mL Bottle,40.9,22.5,12.27,35.38,38
NDC,00088221901,insulin glargine 100 UNIT/ML Solution Pen-injector 3 mL Pen,75.63,41.6,22.69,65.42,38
NDC,00093032001,dilTIAZem 90 MG Tab 100 Each Bottle,9.06,4.99,2.72,7.84,38
NDC,00093077198,pravastatin 10 MG Tab 90 Each Bottle,8.87,4.88,2.66,7.67,38
NDC,00093202631,azithromycin 200 MG/5ML Recon Susp 30 mL Bottle,85.48,47.02,25.64,73.94,38
NDC,00093206406,cilostazol 100 MG Tab 60 Each Bottle,9.2,5.06,2.76,7.96,38
NDC,00093206506,cilostazol 50 MG Tab 60 Each Bottle,9.05,4.98,2.72,7.83,38
NDC,00093220401,metoclopramide 5 MG Tab 100 Each Bottle,8.24,4.54,2.47,7.13,38
NDC,00093226801,amoxicillin 250 MG Chew Tab 100 Each Bottle,9.08,5.0,2.72,7.85,38
NDC,00093306619,icatibant 30 mg/3 mL Solution Prefilled Syringe 3 mL Syringe,7324.9,4028.7,115.96,6336.04,63
NDC,00093312301,dicloxacillin 250 MG Cap 100 Each Bottle,9.05,4.98,2.72,7.83,38
NDC,00093312901,disopyramide 150 MG Cap 100 Each Bottle,13.74,7.56,4.12,11.89,38
NDC,00093314701,cephALEXin 500 MG Cap 100 Each Bottle,8.72,4.8,2.62,7.54,38
NDC,00093319601,cefadroxil 500 MG Cap 100 Each Bottle,8.59,4.73,2.58,7.43,38
NDC,00093319653,cefadroxil 500 MG Cap 50 Each Bottle,8.79,4.84,2.64,7.6,38
NDC,00093321201,clonazePAM 1 mg Tab 100 Each Bottle,10.11,5.57,3.03,8.75,38
NDC,00093321301,clonazePAM 2 mg Tab 100 Each Bottle,10.16,5.59,3.05,8.79,38
NDC,00093412773,penicillin V potassium 250 MG/5ML Recon Soln 100 mL Bottle,37.37,20.56,11.21,32.33,38
NDC,00093417773,cephALEXin 250 MG/5ML Recon Susp 100 mL Bottle,83.9,46.15,25.17,72.57,38
NDC,00093506001,hydrOXYzine HCl 10 MG Tab 100 Each Bottle,8.2,4.51,2.46,7.09,38
NDC,00093506005,hydrOXYzine HCl 10 MG Tab 500 Each Bottle,8.2,4.51,2.46,7.09,38
NDC,00093557156,erythromycin base 250 MG Tab 30 Each Bottle,23.86,13.13,7.16,20.64,38
NDC,00093590786,mesalamine 400 MG CAPSULE DELAYED RELEASE 180 Each Bottle,17.06,9.39,5.12,14.76,38
NDC,00093733401,mycophenolate mofetil 250 MG Cap 100 Each Bottle,8.93,4.92,0.13,7.72,48
NDC,00093763056,imatinib 400 MG Tab 30 Each Bottle,20.12,11.07,6.04,17.4,38
NDC,00093873901,mexiletine 150 MG Cap 100 Each Bottle,10.88,5.99,3.26,9.41,38
NDC,00093874001,mexiletine 200 MG Cap 100 Each Bottle,11.72,6.45,3.52,10.14,38
NDC,00093929119,clonazePAM 0.25 MG TABLET DISPERSIBLE 1 Each Blister,12.1,6.66,3.63,10.47,38
NDC,00093970101,carbidopa/levodopa 10-100 mg Tab 100 Each Bottle,8.73,4.81,2.62,7.55,38
NDC,00096070737,aluminum chloride 20 % Solution 37.5 mL Bottle,47.3,26.02,14.19,40.91,38
NDC,00115107001,dipyridamole 25 MG Tab 100 Each Bottle,9.65,5.31,2.9,8.35,38
NDC,00115351101,pyRIDostigmine 60 MG Tab 100 Each Bottle,9.45,5.2,2.84,8.17,38
NDC,00115443301,dantrolene 100 MG Cap 100 Each Bottle,11.92,6.56,3.58,10.31,38
NDC,00116200116,chlorhexidine 0.12 % Solution 473 mL Bottle,38.21,21.02,11.46,33.05,38
NDC,00116400515,lactulose 10 GM/15ML Solution 15 mL Cup,12.8,7.04,3.84,11.07,38
NDC,00116400515,lactulose 10 g/15 mL Solution 15 mL Cup,12.8,7.04,3.84,11.07,38
NDC,00121058104,haloperidol lactate 2 MG/ML Conc 120 mL Bottle,99.08,54.5,29.72,85.7,38
NDC,00121064616,amantadine 50 MG/5ML Solution 10 mL Oral Syringe,15.06,8.29,4.52,13.03,38
NDC,00121064616,amantadine 50 MG/5ML Solution 473 mL Bottle,96.97,53.34,29.09,83.88,38
NDC,00121064616,amantadine 50 MG/5ML Solution 5 mL Oral Syringe,8.94,4.92,2.68,7.73,38
NDC,00121065304,fluPHENAZine 5 MG/ML Conc 120 mL Bottle,948.4,521.62,284.52,820.37,38
NDC,00121076616,calcium carbonate 1250 MG/5ML Suspension 473 mL Bottle,40.78,22.43,12.23,35.27,38
NDC,00121082016,theophylline 80 MG/15ML Elixir 473 mL Bottle,139.12,76.52,41.74,120.34,38
NDC,00121115430,lactulose 10 GM/15ML Solution 30 mL Cup,14.53,8.0,4.36,12.57,38
NDC,00121115430,lactulose 20 g/30 mL Solution 30 mL Cup,14.53,8.0,4.36,12.57,38
NDC,00121127600,guaiFENesin/dextromethorphan 100-10 MG/5ML Syrup 10 mL Cup,14.4,7.92,4.32,12.46,38
NDC,00121131411,acetaminophen 325 MG/10.15ML Solution 10.15 mL Cup,12.18,6.7,3.65,10.54,38
NDC,00121148800,guaiFENesin 100 MG/5ML Liquid 10 mL Cup,11.25,6.19,3.38,9.73,38
NDC,00121154410,HYDROcodone/acetaminophen 5-217 mg/10 mL Solution 10 mL Cup,31.17,17.15,9.35,26.96,38
NDC,00121174405,guaiFENesin 100 MG/5ML Liquid 5 mL Cup,8.57,4.72,2.57,7.41,38
NDC,00121177505,guaiFENesin/codeine 100-10 MG/5ML Solution 5 mL Cup,17.59,9.68,5.28,15.22,38
NDC,00121187010,docusate sodium 150 MG/15ML Liquid 10 mL Cup,14.11,7.77,4.23,12.21,38
NDC,00121197121,acetaminophen 650 MG/20.3ML Solution 20.3 mL Cup,14.7,8.09,4.41,12.72,38
NDC,00121223200,guaiFENesin 100 MG/5ML Liquid 15 mL Cup,12.17,6.7,3.65,10.53,38
NDC,00121467505,valproic acid 250 MG/5ML Solution 5 mL Cup,12.52,6.89,3.76,10.83,38
NDC,00121477205,HYDROcodone/acetaminophen 2.5-108 mg/5 mL Solution 5 mL Cup,28.49,15.67,8.55,24.64,38
NDC,00131181067,Lacosamide 200 MG/20ML Solution 20 mL Vial,609.48,335.22,182.84,527.2,48
NDC,00131247735,lacosamide 50 MG Tab 60 Each Bottle,32.14,17.68,9.64,27.8,38
NDC,00131247835,lacosamide 100 MG Tab 60 Each Bottle,45.75,25.17,13.73,39.57,38
NDC,00131247935,lacosamide 150 MG Tab 60 Each Bottle,47.98,26.39,14.39,41.5,38
NDC,00131248035,lacosamide 200 MG Tab 60 Each Bottle,47.99,26.4,14.4,41.51,38
NDC,00143117101,captopril 12.5 MG Tab 100 Each Bottle,10.04,5.53,3.01,8.68,38
NDC,00143117101,captopril 3.125 mg quarter tablet Tab 0.25 tablet Package,7.76,4.27,2.33,6.71,38
NDC,00143117201,captopril 25 MG Tab 100 Each Bottle,10.26,5.65,3.08,8.87,38
NDC,00143124001,digoxin 125 MCG Tab 100 Each Bottle,8.99,4.95,2.7,7.78,38
NDC,00143124110,"digoxin 250 MCG Tab 1,000 Each Bottle",8.99,4.95,2.7,7.78,38
NDC,00143912801,gentamicin 40 mg/mL Solution 2 mL Vial,51.55,28.36,2.12,44.59,48
NDC,00143916101,vancomycin 500 mg Recon Soln 1 Each Vial,55.0,30.25,0.15,47.58,48
NDC,00143916201,vancomycin 1000 mg Recon Soln 1 Each Vial,67.0,36.85,0.15,57.96,48
NDC,00143927701,DOXOrubicin Recon Soln 1 Each Vial,1266.24,696.44,2.85,1095.3,48
NDC,00143928001,mitoMYcin (preservative-free) 0.4 mg/mL 1 mL Syringe,232.1,127.66,69.63,200.77,48
NDC,00143928001,mitoMYcin 40 MG Recon Soln 1 Each Vial,5713.0,3142.15,20.35,4941.75,63
NDC,00143929601,haloperidol decanoate 100 MG/ML Solution 5 mL Vial,1010.22,555.63,4.76,873.84,48
NDC,00143931810,norepinephrine 1 mg/mL Solution 4 mL Vial,113.7,62.54,34.11,98.35,38
NDC,00143937801,DAPTOmycin 500 mg Recon Soln 1 Each Vial,225.0,123.75,0.04,194.63,48
NDC,00143938001,midazolam (1 mg/mL) Solution 100 mL Flex Cont,170.0,93.5,0.14,147.05,48
NDC,00143950301,acetaZOLAMIDE Recon Soln 1 Each Vial,278.76,153.32,18.57,241.13,48
NDC,00143950601,etomidate 2 MG/ML Solution 10 mL Vial,68.54,37.7,20.56,59.29,38
NDC,00143950610,etomidate 2 MG/ML Solution 10 mL Vial,68.54,37.7,20.56,59.29,38
NDC,00143950810,ketamine 50 MG/ML Solution 10 mL Vial,84.0,46.2,25.2,72.66,38
NDC,00143955501,leucovorin 20 mg/mL Recon Soln 1 Each Vial,95.0,52.25,3.57,82.18,48
NDC,00143955501,leucovorin Recon Soln 1 Each Vial,95.0,52.25,3.57,82.18,48
NDC,00143956501,thiotepa 10 mg/ml Recon Soln 1 Each Vial,3400.0,1870.0,10.54,2941.0,63
NDC,00143959501,lidocaine (PF) 1 % Solution 5 mL Vial,43.45,23.9,13.04,37.58,38
NDC,00143970101,irinotecan 100 MG/5ML Solution 5 mL Vial,174.1,95.76,1.69,150.6,48
NDC,00143971010,milrinone 1 MG/ML Solution 10 mL Vial,68.75,37.82,1.13,59.47,48
NDC,00143972124,levoFLOXacin 500 MG/100ML Solution 100 mL Flex Cont,61.6,33.88,1.62,53.28,48
NDC,00143972224,levoFLOXacin 250 MG/50ML Solution 50 mL Flex Cont,61.0,33.55,1.62,52.77,48
NDC,00143974401,granisetron 1 MG/ML Solution 1 mL Vial,88.0,48.4,0.2,76.12,48
NDC,00143978401,flumazenil 0.5 MG/5ML Solution 5 mL Vial,70.5,38.78,21.15,60.98,38
NDC,00143978510,valproate 100 MG/ML Solution 5 mL Vial,132.35,72.8,39.71,114.48,38
NDC,00143978601,enalaprilat 1.25 MG/ML Solution 2 mL Vial,91.36,50.25,27.41,79.03,38
NDC,00143978610,enalaprilat 1.25 mg/mL Injection 2 mL Vial,91.37,50.26,27.41,79.04,38
NDC,00143978610,enalaprilat 1.25 mg/ml Injection 2 mL Vial,91.37,50.26,27.41,79.04,38
NDC,00143978710,enalaprilat 1.25 mg/mL Injection 1 mL Vial,99.33,54.64,29.8,85.92,38
NDC,00143983701,penicillin V potassium 250 MG Tab 100 Each Bottle,8.27,4.55,2.48,7.15,38
NDC,00143985101,methylPREDNISolone sod succ 1000 mg Recon Soln 1 Each Vial,266.34,146.49,0.21,230.38,63
NDC,00143985601,cefTRIAXone 2 g Recon Soln 1 Each Vial,47.5,26.13,0.39,41.09,48
NDC,00143985701,cefTRIAXone 1 g Recon Soln 1 Each Vial,46.0,25.3,0.39,39.79,48
NDC,00143987101,cladribine 10 MG/10ML Solution 10 mL Vial,1675.0,921.25,9.68,1448.88,63
NDC,00143987210,propranolol 1 MG/ML Solution 1 mL Vial,81.0,44.55,8.68,70.07,48
NDC,00143988701,amoxicillin 400 MG/5ML Recon Susp 100 mL Bottle,29.45,16.2,8.84,25.47,38
NDC,00143988701,amoxicillin 400 mg/5 mL Recon Susp 100 mL Bottle,64.0,35.2,19.2,55.36,38
NDC,00143992490,ceFAZolin 1 g Recon Soln 1 Each Vial,40.94,22.52,0.69,35.41,48
NDC,00143992490,ceFAZolin 1g Recon Soln 1 Each Vial,40.94,22.52,0.69,35.41,48
NDC,00143992490,ceFAZolin 2 g/100 ml Solution 2 g Bag,93.8,51.59,0.69,81.14,48
NDC,00143992490,ceFAZolin 2 g/20 ml Solution 2 g Syringe,57.1,31.41,0.69,49.39,48
NDC,00143992490,ceFAZolin 3 g/30 ml Solution 3 g Syringe,61.9,34.05,0.69,53.54,48
NDC,00143997790,cefuroxime 1.5 g Recon Soln 1 Each Vial,65.92,36.26,1.62,57.02,48
NDC,00143997922,cefuroxime 1 MG/ML Solution 1 Each Syringe,92.87,51.08,1.62,80.33,48
NDC,00143997922,cefuroxime 750 mg Recon Soln 1 Each Vial,46.92,25.81,1.62,40.59,48
NDC,00143998303,ceFAZolin 10 g Recon Soln 1 Each Vial,91.83,50.51,0.69,79.43,48
NDC,00168009960,ketoconazole 2 % Cream 60 g Tube,151.25,83.19,45.38,130.83,38
NDC,00168014630,hydrocortisone 2.5 % Ointment 28.35 g Tube,31.51,17.34,9.45,27.26,38
NDC,00168025815,clotrimazole/betamethasone 1-0.05 % Cream 15 g Tube,79.01,43.46,23.7,68.34,38
NDC,00168027740,clindamycin phosphate 2 % Cream 40 g Tube,353.91,194.66,106.17,306.13,38
NDC,00168035755,lidocaine/prilocaine 2.5-2.5 % Cream 5 g Tube,48.93,26.92,14.68,42.32,38
NDC,00169300301,insulin regular 100 units/mL Solution Pen-injector 3 mL Pen,72.12,39.67,21.64,62.38,38
NDC,00169720101,"coagulation factor VIIa recombinant 1 mg Recon Soln 1,000 mcg Vial",10984.0,6041.2,2.19,9665.92,63
NDC,00169720501,"Coagulation Factor VIIa Recomb 5 MG Recon Soln 5,000 mcg Vial",54820.0,30151.0,2.19,48241.6,63
NDC,00172392760,diazePAM 10 MG Tab 100 Each Bottle,10.23,5.63,3.07,8.85,38
NDC,00172731320,cycloSPORINE modified 100 MG/ML Solution 0.25 mL Syringe,10.54,5.8,1.89,13.97,48
NDC,00172731320,cycloSPORINE modified 100 MG/ML Solution 1 mL Syringe,21.15,11.64,1.89,18.29,48
NDC,00172731320,cycloSPORINE modified 100 MG/ML Solution 50 mL Bottle,714.4,392.92,1.89,617.96,48
NDC,00173085702,glycine diluent Solution 50 mL Vial,114.25,62.84,34.28,98.83,38
NDC,00173085914,"fluticasone furoate-vilanterol 100-25 mcg/act AEROSOL POWDER, BREATH ACTIVATED 28 Each Disp Pack",39.61,21.79,11.88,34.26,38
NDC,00173086906,"umeclidinium-vilanterol 62.5-25 mcg/act AEROSOL POWDER, BREATH ACTIVATED 7 Each Disp Pack",49.39,27.17,14.82,42.72,38
NDC,00173087306,"umeclidinium bromide 62.5 mcg/act AEROSOL POWDER, BREATH ACTIVATED 7 Each Disp Pack",57.52,31.64,17.26,49.75,38
NDC,00173087414,"fluticasone furoate 100 mcg/act AEROSOL POWDER, BREATH ACTIVATED 14 Each Disp Pack",44.32,24.38,13.3,38.34,38
NDC,00173087614,"fluticasone furoate 200 mcg/act AEROSOL POWDER, BREATH ACTIVATED 14 Each Disp Pack",52.56,28.91,15.77,45.46,38
NDC,00173088101,mepolizumab 100 MG Recon Soln 1 Each Vial,14845.16,8164.84,26.35,12841.06,63
NDC,00173088214,"fluticasone furoate-vilanterol 200-25 mcg/act AEROSOL POWDER, BREATH ACTIVATED 28 Each Disp Pack",39.61,21.79,11.88,34.26,38
NDC,00185012801,bumetanide 0.5 MG Tab 100 Each Bottle,9.49,5.22,2.85,8.21,38
NDC,00185075701,sulfADIAZINE 500 MG Tab 100 Each Bottle,19.11,10.52,5.73,16.53,38
NDC,00185505001,metOLazone 2.5 MG Tab 100 Each Bottle,8.76,4.82,2.63,7.58,38
NDC,00185560001,metOLazone 10 MG Tab 100 Each Bottle,9.7,5.34,2.91,8.39,38
NDC,00187001050,sodium benzoate/sodium phenylacetate 10-10 % Solution 50 mL Vial,191784.94,105481.72,57535.48,165893.97,76
NDC,00187074633,glucose 77.4 % Gel 31 g Tube,33.02,18.17,9.91,28.56,38
NDC,00187430305,amobarbital Recon Soln 1 Each Vial,5141.35,2827.75,9.72,4447.27,48
NDC,00187517245,tretinoin 0.01 % Gel 45 g Tube,177.5,97.63,53.25,153.54,38
NDC,00187560015,verteporfin Recon Soln 1 Each Vial,9247.43,5086.09,9.87,7999.03,63
NDC,00206885208,piperacillin/tazobactam Recon Soln 1 Each Vial,73.09,40.2,21.93,63.22,38
NDC,00206886102,piperacillin/tazobactam 3.375 g/50 mL Solution 50 mL Plas Cont,121.5,66.83,0.98,105.1,48
NDC,00206886202,piperacillin/tazobactam 4.5 g/100 mL Solution 100 mL Plas Cont,147.0,80.85,0.98,127.16,96
NDC,00223172001,sodium bicarbonate 325 MG Tab 100 Each Bottle,8.17,4.5,2.45,7.07,38
NDC,00223176001,sodium chloride 1 g Tab 100 Each Bottle,8.26,4.55,2.48,7.14,38
NDC,00225052547,saline Gel 14.1 g Tube,29.72,16.35,8.92,25.71,38
NDC,00228202910,ALPRAZolam 0.5 MG Tab 100 Each Bottle,10.12,5.57,3.04,8.75,38
NDC,00228203110,ALPRAZolam 1 MG Tab 100 Each Bottle,10.15,5.59,3.05,8.78,38
NDC,00228282011,hydroCHLOROthiazide 12.5 MG Tab 100 Each Bottle,8.92,4.91,2.68,7.72,38
NDC,00228287911,oxyCODONE 30 MG Tab 100 Each Bottle,11.6,6.38,3.48,10.03,38
NDC,00245010801,ferrous sulfate 325 (65 Fe) MG Tablet Delayed Response 100 Each Box,4.05,2.23,1.22,3.5,38
NDC,00245014430,amiodarone 100 MG Tab 30 Each Bottle,15.36,8.45,4.61,13.29,38
NDC,00245021111,midodrine 2.5 MG Tab 100 Each Bottle,8.79,4.84,2.64,7.6,38
NDC,00245021311,midodrine 10 MG Tab 100 Each Bottle,8.8,4.84,2.64,7.61,38
NDC,00254101196,sucralfate 1 GM/10ML Suspension 420 mL Bottle,588.73,323.81,176.62,509.25,38
NDC,00254202980,norgestimate/ethinyl estradiol 0.25-35 mg-mcg Tab 28 Each Disp Pack,9.33,5.14,2.8,8.07,38
NDC,00254302802,lubiprostone 8 MCG Cap 60 Each Bottle,10.0,5.5,3.0,8.65,38
NDC,00254302902,lubiprostone 24 MCG Cap 60 Each Bottle,10.0,5.5,3.0,8.65,38
NDC,00259160501,incobotulinumtoxinA 50 units Recon Soln 1 Each Vial,1462.2,804.21,4.73,1264.8,63
NDC,00259161001,incobotulinumtoxinA 100 units Recon Soln 1 Each Vial,2774.4,1525.92,4.73,2399.86,63
NDC,00259162001,incobotulinumtoxinA 200 units Recon Soln 1 Each Vial,5533.8,3043.59,4.73,4786.74,63
NDC,00264151032,D5W (excel) 5 % Solution 100 mL Flex Cont,47.5,26.13,14.25,41.09,38
NDC,00264194420,potassium chloride 2 MEQ/ML Solution 250 mL Flex Cont,137.5,75.63,0.09,118.94,48
NDC,00264751010,D5W (excel) 5 % Solution 500 mL Flex Cont,82.0,45.1,24.6,70.93,38
NDC,00264751020,D5W (excel) 5 % Solution 250 mL Flex Cont,56.25,30.94,16.88,48.66,38
NDC,00264780010,0.9% NaCl (excel) 0.9 % Solution 500 mL Flex Cont,77.38,42.56,23.21,66.93,38
NDC,00264780020,0.9% NaCl (excel) 0.9 % Solution 250 mL Flex Cont,70.44,38.75,21.13,60.93,38
NDC,00270009101,Cardiogen-82 Recon Soln 1 Each Package,300.0,165.0,90.0,264.0,48
NDC,00270044535,diatrizoate meglumine and diatrizoate sodium 66-10 % Solution 30 mL Bottle,89.63,49.3,0.19,77.53,48
NDC,00270055615,sincalide Recon Soln 1 Each Vial,719.5,395.73,98.22,917.8,48
NDC,00270709916,sulfur hexafluoride microsph 45 mcg/ml (after reconstitution) Recon Susp 1 Each Vial,502.35,276.3,16.04,434.53,48
NDC,00281032608,nitroglycerin 2 % Ointment 1 g Packet,14.27,7.85,4.28,12.34,38
NDC,00283056931,benzocaine 20 % Solution 30 mL Bottle,46.15,25.39,13.85,39.92,38
NDC,00310032130,meropenem Recon Soln 1 Each Vial,417.68,229.73,0.33,361.29,48
NDC,00310032520,meropenem 500 MG Recon Soln 1 Each Vial,216.34,118.99,0.33,187.13,48
NDC,00310072010,fulvestrant 250 MG/5ML Solution Prefilled Syringe 5 mL Syringe,4387.86,2413.33,5.72,3795.5,63
NDC,00310110501,sodium zirconium cyclosilicate 5 g Pack 1 Each Packet,73.93,40.67,22.18,63.95,38
NDC,00310110530,sodium zirconium cyclosilicate 5 g Pack 30 Each Box,73.92,40.66,22.18,63.94,38
NDC,00310111001,sodium zirconium cyclosilicate 10 g Pack 1 Each Packet,73.93,40.67,22.18,63.95,38
NDC,00310173030,benralizumab 30 MG/ML Solution Prefilled Syringe 1 mL Syringe,24567.61,13512.19,142.43,21250.98,63
NDC,00310304000,anifrolumab-fnia 300 MG/2ML Solution 2 mL Vial,22412.63,12326.95,15.26,19386.92,63
NDC,00310450012,durvalumab 120 MG/2.4ML Solution 2.4 mL Vial,4572.3,2514.77,72.02,3955.04,63
NDC,00310450525,tremelimumab-actl 25 mg/1.25mL Solution 1.25 mL Vial,14559.59,8007.78,118.86,12594.05,63
NDC,00310453530,tremelimumab-actl 300 mg/15mL Solution 15 mL Vial,166374.96,91506.23,118.86,143914.34,63
NDC,00310461150,durvalumab 500 MG/10ML Solution 10 mL Vial,18124.94,9968.72,72.02,15678.07,63
NDC,00316022530,miconazole 2 % Powder 85 g Bottle,39.34,21.64,11.8,34.03,38
NDC,00327000110,oxychlorosene Powder 2 g Box,81.66,44.92,24.5,70.64,38
NDC,00338000404,"sterile water Solution 1,000 mL Bottle",66.0,36.3,19.8,57.09,38
NDC,00338001304,"sterile water (preservative free) Solution 1,000 mL Flex Cont",137.5,75.63,41.25,118.94,38
NDC,00338001304,"sterile water Solution 1,000 mL Flex Cont",137.5,75.63,41.25,118.94,38
NDC,00338001304,"sterile water for injection (PF) Solution 1,000 mL Flex Cont",95.0,52.25,28.5,82.18,38
NDC,00338001306,"sterile water Solution 2,000 mL Flex Cont",100.5,55.28,30.15,86.93,38
NDC,00338001306,"sterile water for injection (PF) Solution 2,000 mL Flex Cont",67.0,36.85,20.1,57.96,38
NDC,00338001701,dextrose 5 % Solution 150 mL Flex Cont,64.6,35.53,19.38,55.88,38
NDC,00338001702,dextrose 5 % Solution 250 mL Flex Cont,59.75,32.87,17.93,51.68,76
NDC,00338001703,dextrose 5 % Solution 500 mL Flex Cont,86.63,47.65,25.99,74.93,76
NDC,00338001704,"dextrose 5 % Solution 1,000 mL Flex Cont",134.0,73.7,40.2,115.91,114
NDC,00338001741,dextrose 5 % Solution 50 mL Flex Cont,49.25,27.09,14.78,42.6,38
NDC,00338001748,dextrose 5 % Solution 100 mL Flex Cont,48.9,26.9,14.67,42.3,76
NDC,00338002304,"dextrose 10 % Solution 1,000 mL Flex Cont",162.0,89.1,48.6,140.13,114
NDC,00338004304,"0.45% NaCl 0.45 % Solution 1,000 mL Flex Cont",134.0,73.7,40.2,115.91,38
NDC,00338004304,"NaCl 0.45 % Solution 1,000 mL Flex Cont",134.0,73.7,40.2,115.91,38
NDC,00338004746,"NaCl 0.9 % Solution 2,000 mL Bottle",138.0,75.9,41.4,119.37,38
NDC,00338004747,"NaCl 0.9 % Solution 3,000 mL Flex Cont",192.0,105.6,57.6,166.08,38
NDC,00338004802,NaCl 0.9 % Solution 250 mL Plas Cont,72.75,40.02,21.83,62.93,38
NDC,00338004803,NaCl 0.9 % Solution 500 mL Plas Cont,70.5,38.78,21.15,60.98,38
NDC,00338004804,"NaCl 0.9 % Solution 1,000 mL Plas Cont",75.0,41.25,22.5,64.88,38
NDC,00338004902,NaCl 0.9 % Solution 250 mL Flex Cont,59.75,32.87,17.93,51.68,76
NDC,00338004903,NaCl 0.9 % Solution 500 mL Flex Cont,82.0,45.1,24.6,70.93,38
NDC,00338004904,"NaCl 0.9 % Solution 1,000 mL Flex Cont",120.0,66.0,36.0,103.8,38
NDC,00338004911,NaCl 0.9 % Solution 50 mL Flex Cont,50.3,27.67,15.09,43.51,38
NDC,00338004918,NaCl 0.9 % Solution 100 mL Flex Cont,50.3,27.67,15.09,43.51,38
NDC,00338004941,NaCl 0.9 % Solution 50 mL Flex Cont,47.85,26.32,14.36,41.39,38
NDC,00338004948,NaCl 0.9 % Solution 100 mL Flex Cont,51.0,28.05,15.3,44.12,76
NDC,00338005403,sodium chloride 3 % Solution 500 mL Flex Cont,123.065,67.69,0.08,121.97,86
NDC,00338006701,DOXOrubicin liposome 2 MG/ML Suspension 25 mL Vial,7603.0,4181.65,108.47,6576.6,63
NDC,00338007704,"dextrose 5 % and 0.2% NaCl 5-0.2 % Solution 1,000 mL Flex Cont",134.0,73.7,40.2,115.91,38
NDC,00338008001,DOXOrubicin liposome 2 MG/ML Suspension 10 mL Vial,3008.5,1654.68,108.47,2602.35,63
NDC,00338008503,dextrose 5% and NaCl 0.45% Solution 500 mL Flex Cont,113.0,62.15,33.9,97.75,38
NDC,00338008504,"dextrose 5 % and 0.45% NaCl 5-0.45 % Solution 1,000 mL Flex Cont",134.0,73.7,40.2,115.91,38
NDC,00338008504,"dextrose 5% and NaCl 0.45% Solution 1,000 mL Flex Cont",134.0,73.7,40.2,115.91,38
NDC,00338008904,"dextrose 5 % and 0.9% NaCl 5-0.9 % Solution 1,000 mL Flex Cont",134.0,73.7,40.2,115.91,38
NDC,00338011404,"lactated ringers (bottle) Solution 1,000 mL Plas Cont",111.0,61.05,33.3,96.02,38
NDC,00338011702,lactated ringers Solution 250 mL Flex Cont,61.5,33.83,18.45,53.2,76
NDC,00338011703,lactated ringers Solution 500 mL Flex Cont,86.63,47.65,25.99,74.93,114
NDC,00338011704,"lactated ringers Solution 1,000 mL Flex Cont",120.0,66.0,36.0,103.8,114
NDC,00338012504,"dextrose 5% in lactated ringers Solution 1,000 mL Flex Cont",117.25,64.49000000000001,30.15,115.91,76
NDC,00338022104,"PLASMA-LYTE A Solution 1,000 mL Flex Cont",245.125,134.82,60.68,249.12,76
NDC,00338034104,"cardioplegic Solution 1,000 mL Flex Cont",507.0,278.85,152.1,438.56,38
NDC,00338040903,lidocaine 2 g in D5W 500 mL 4-5 mg/ml-% Solution 500 mL Flex Cont,100.5,55.28,30.15,86.93,38
NDC,00338050348,gentamicin 80 mg/100 mL Solution 100 mL Flex Cont,58.0,31.9,17.4,50.17,38
NDC,00338050548,gentamicin 100 mg/100 mL Solution 100 mL Flex Cont,60.1,33.06,2.12,51.99,48
NDC,00338050748,gentamicin 120 mg/100 mL Solution 100 mL Flex Cont,59.4,32.67,2.12,51.38,48
NDC,00338051909,fat emulsion (INTRALIPID) 20 % Emulsion 250 mL Flex Cont,255.0,140.25,76.5,220.58,114
NDC,00338051913,fat emulsion (INTRALIPID) 20 % Emulsion 500 mL Flex Cont,227.5,125.13,68.25,196.79,38
NDC,00338055311,0.9% NaCl (mini-bag plus) Solution 50 mL Flex Cont,68.5,37.68,20.55,59.25,38
NDC,00338055318,0.9% NaCl (mini-bag plus) Solution 100 mL Flex Cont,68.8,37.84,20.64,59.51,38
NDC,00338064406,"amino acid (AMINOSYN II 10%) 10 % Solution 2,000 mL Plas Cont",351.0,193.05,105.3,303.62,38
NDC,00338064406,"amino acid (TRAVASOL 10%) 10 % Solution 2,000 mL Plas Cont",351.0,193.05,105.3,303.62,38
NDC,00338066904,"dextrose 5% and 0.45% NaCl with KCl 10 mEq/L 10-5-0.45 MEQ/L-%-% Solution 1,000 mL Flex Cont",190.0,104.5,57.0,164.35,38
NDC,00338067104,"dextrose 5% and 0.45% NaCl with KCl 20 mEq/L 20-5-0.45 MEQ/L-%-% Solution 1,000 mL Flex Cont",134.0,73.7,40.2,115.91,38
NDC,00338069104,"0.9% NaCl with KCl 20 mEq solution 1000 mL 20-0.9 MEQ/L-% Solution 1,000 mL Flex Cont",204.0,112.2,61.2,176.46,38
NDC,00338069504,"0.9% NaCl with KCl 40 mEq/L 40-0.9 MEQ/L-% Solution 1,000 mL Flex Cont",156.0,85.8,46.8,134.94,38
NDC,00338070341,potassium chloride 20 mEq in 50 mL 20 MEQ/50ML Solution 50 mL Plas Cont,56.6,31.13,0.09,48.96,48
NDC,00338070434,"0.45% NaCl with KCl 20 mEq solution 1000 mL 20-0.45 MEQ/L-% Solution 1,000 mL Flex Cont",148.0,81.4,44.4,128.02,38
NDC,00338070548,potassium chloride 20 mEq in 100 mL 20 MEQ/100ML Solution 100 mL Plas Cont,58.7,32.29,0.09,50.78,48
NDC,00338071906,"dextrose 70 % Solution 2,000 mL Plas Cont",330.0,181.5,99.0,285.45,38
NDC,00338071906,"dextrose 70% 70 % Solution 2,000 mL Plas Cont",150.0,82.5,45.0,129.75,38
NDC,00338080304,"dextrose 5% and 0.9% NaCl with KCl 20 mEq/L 20-5-0.9 MEQ/L-%-% Solution 1,000 mL Flex Cont",204.0,112.2,61.2,176.46,38
NDC,00338100702,DOPamine 1.6-5 MG/ML-% Solution 250 mL Plas Cont,91.25,50.19,0.67,78.93,48
NDC,00338101741,nafcillin 1 g/50 mL Solution 50 mL Plas Cont,105.0,57.75,31.5,90.83,38
NDC,00338101948,nafcillin 2 g/100 mL Solution 100 mL Flex Cont,142.0,78.1,0.24,122.83,48
NDC,00338102341,penicillin G potassium 2 million units/50 mL Solution 50 mL Plas Cont,71.75,39.47,0.65,62.06,48
NDC,00338102541,penicillin G potassium 3 million units/50 mL Solution 50 mL Plas Cont,73.75,40.57,0.65,63.79,48
NDC,00338104702,nitroglycerin 25 mg in D5W 250 mL 100 MCG/ML Solution 250 mL Glass Cont,122.5,67.38,1.21,105.96,48
NDC,00338104902,nitroglycerin 50 mg in D5W 250 mL 200-5 MCG/ML-% Solution 250 mL Glass Cont,132.5,72.88,1.21,114.61,48
NDC,00338105548,metroNIDAZOLE 500 mg in 100 mL Solution 100 mL Flex Cont,46.1,25.36,0.03,39.88,48
NDC,00338105548,metroNIDAZOLE Solution 1 mL Flex Cont,30.16,16.59,0.03,26.09,48
NDC,00338170940,magnesium sulfate in D5W 10 MG/ML Solution 100 mL Flex Cont,63.4,34.87,0.42,54.84,48
NDC,00338350341,ceFAZolin 1 g/50 mL Solution 50 mL Flex Cont,56.5,31.08,1.05,48.87,48
NDC,00338355248,vancomycin 1 GM/200ML Solution 200 mL Plas Cont,155.0,85.25,0.15,134.08,48
NDC,00338361250,clindamycin phosphate 600 mg/50 mL Solution 50 mL Flex Cont,73.5,40.43,1.83,63.58,48
NDC,00338381450,clindamycin phosphate in D5W 900 mg Solution 50 mL Flex Cont,85.25,46.89,1.83,73.74,48
NDC,00338604537,fluconazole 2 mg/mL Solution 200 mL Plas Cont,124.0,68.2,2.05,107.26,48
NDC,00338954304,NaCl 0.9 % Solution 500 mL Flex Cont,95.88,52.74,28.76,82.94,76
NDC,00338954306,"NaCl 0.9 % Solution 1,000 mL Flex Cont",148.0,81.4,44.4,128.02,114
NDC,00338978701,"dextrose 55 % Solution 3,000 mL Flex Cont",512.0,281.6,153.6,442.88,38
NDC,00378021801,atenolol 25 MG Tab 100 Each Bottle,8.21,4.52,2.46,7.1,38
NDC,00378022201,chlorTHALidone 12.5 mg half tablet Tab 0.5 tablet Packet,8.45,4.65,2.54,7.31,38
NDC,00378023101,atenolol 50 MG Tab 100 Each Bottle,8.23,4.53,2.47,7.12,38
NDC,00378023201,furosemide 80 MG Tab 100 Each Bottle,8.25,4.54,2.48,7.14,38
NDC,00378025701,haloperidol 1 MG Tab 100 Each Bottle,9.22,5.08,2.77,7.98,38
NDC,00378032701,haloperidol 5 MG Tab 100 Each Bottle,9.46,5.21,2.84,8.18,38
NDC,00378035101,haloperidol 0.5 MG Tab 100 Each Bottle,8.86,4.88,2.66,7.66,38
NDC,00378043501,buPROPion 50 mg half tablet Tab 0.5 tablet Package,8.0,4.4,2.4,6.92,38
NDC,00378075701,atenolol 100 MG Tab 100 Each Bottle,8.43,4.64,2.53,7.29,38
NDC,00378113401,ketorolac 10 MG Tab 100 Each Bottle,12.44,6.85,3.73,10.76,38
NDC,00378163132,formoterol 20 mcg/2 mL Nebu Soln 2 mL Packet,49.31,27.13,14.79,42.65,38
NDC,00378230201,prazosin 2 MG Cap 100 Each Bottle,9.38,5.16,2.81,8.11,38
NDC,00378233078,rufinamide 200 MG Tab 120 Each Bottle,16.21,8.92,4.86,14.02,38
NDC,00378312501,doxepin 25 MG Cap 100 Each Bottle,8.85,4.87,2.66,7.66,38
NDC,00378320501,prazosin 5 MG Cap 100 Each Bottle,10.93,6.02,3.28,9.45,38
NDC,00378352091,fosamprenavir calcium 700 MG Tab 60 Each Bottle,51.0,28.05,15.3,44.12,38
NDC,00378363501,cetirizine 5 MG Tab 100 Each Bottle,4.6,2.53,1.38,3.98,38
NDC,00378363701,cetirizine 10 MG Tab 100 Each Bottle,8.44,4.65,2.53,7.3,38
NDC,00378405091,nevirapine 200 MG Tab 60 Each Bottle,8.56,4.71,2.57,7.4,38
NDC,00378425001,doxepin 50 MG Cap 100 Each Bottle,9.65,5.31,2.9,8.35,38
NDC,00378427093,ambrisentan 5 MG Tab 30 Each Bottle,97.16,53.44,29.15,84.04,38
NDC,00378427193,ambrisentan 10 MG Tab 30 Each Bottle,97.16,53.44,29.15,84.04,38
NDC,00378427577,valACYclovir 500 MG Tab 90 Each Bottle,9.28,5.11,2.78,8.03,38
NDC,00378464216,estradiol 0.05 mg PATCH BIWEEKLY 1 Each Box,30.49,16.77,9.15,26.37,38
NDC,00378501101,felodipine 2.5 MG Tablet Extended Release 24 Hour 100 Each Bottle,10.26,5.65,3.08,8.87,38
NDC,00378606001,dilTIAZem HCl 60 mg CAPSULE SR 12 HR 100 Each Bottle,14.61,8.04,4.38,12.64,38
NDC,00378612001,dilTIAZem HCl 120 mg CAPSULE SR 12 HR 100 Each Bottle,18.34,10.09,5.5,15.86,38
NDC,00378617301,metOLazone 5 MG Tab 100 Each Bottle,13.15,7.24,3.95,11.37,38
NDC,00378641001,doxepin 100 MG Cap 100 Each Bottle,11.44,6.3,3.43,9.9,38
NDC,00378699252,albuterol 1.25 mg/3 mL Nebu Soln 3 mL Plas Cont,12.39,6.82,3.72,10.72,38
NDC,00378709693,bromocriptine 5 MG Cap 30 Each Bottle,26.11,14.37,7.83,22.59,38
NDC,00378728353,norethindrone/ethinyl estradiol/iron 1-20 mg-mcg Tab 28 Each Disp Pack,8.82,4.86,2.65,7.63,38
NDC,00378797031,ipratropium 0.02 % Solution 2.5 mL Vial,8.92,4.91,2.68,7.72,38
NDC,00378910293,nitroglycerin 0.1 mg/hour PATCH 24 HR 30 Each Box,8.83,4.86,2.65,7.64,38
NDC,00378910493,nitroglycerin 0.2 mg/hour PATCH 24 HR 30 Each Box,9.12,5.02,2.74,7.89,38
NDC,00378911916,fentaNYL 12 mcg/hr/patch PATCH 72 HR 1 Each Package,40.48,22.27,12.14,35.02,38
NDC,00378912316,fentaNYL 75 mcg/hr PATCH 72 HR 1 Each Package,48.04,26.43,14.41,41.55,38
NDC,00378963943,butorphanol 10 MG/ML Solution 2.5 mL Bottle,221.08,121.6,66.32,191.23,38
NDC,00386000803,pentafluoropropane/tetrafluoroethane Aerosol 116 mL Can,141.8,77.99,42.54,122.66,38
NDC,00386000804,pentafluoropropane/tetrafluoroethane Aerosol 30 mL Can,20.0,11.0,6.0,17.3,38
NDC,00395001916,acetone Solution 480 mL Bottle,70.4,38.72,21.12,60.9,38
NDC,00395030396,boric acid topical Powder 170 g Bottle,34.37,18.91,10.31,29.73,38
NDC,00395100392,gentian violet 1 % Solution 59 mL Bottle,44.37,24.41,13.31,38.38,38
NDC,00395103116,glycerin Liquid 473 mL Bottle,106.17,58.4,31.85,91.84,38
NDC,00395103196,glycerin Liquid 177 mL Bottle,38.02,20.92,11.41,32.89,38
NDC,00395121316,iodine/sodium iodide 2 % Tincture 473 mL Bottle,122.64,67.46,36.79,106.08,38
NDC,00395121391,iodine/sodium iodide 2 % Tincture 30 mL Bottle,32.18,17.7,9.65,27.84,38
NDC,00395150101,lactose hydrous Powder 454 g Bottle,187.63,103.2,56.29,162.3,38
NDC,00395199794,olive oil Oil 118 mL Bottle,49.14,27.03,14.74,42.51,38
NDC,00395224391,peppermint oil SPIRIT 30 mL Bottle,49.4,27.17,14.82,42.73,38
NDC,00395266216,cherry syrup Syrup 473 mL Bottle,69.98,38.49,20.99,60.53,38
NDC,00395277516,iodine strong 5 % Solution 473 mL Bottle,233.29,128.31,69.99,201.8,38
NDC,00406012423,HYDROcodone/acetaminophen 7.5-325 MG Tab 1 Each Blister,11.53,6.35,3.46,9.97,38
NDC,00406012462,HYDROcodone/acetaminophen 7.5-325 MG Tab 100 Each Box,11.52,6.34,3.46,9.96,38
NDC,00406012523,HYDROcodone/acetaminophen 10-325 MG Tab 1 Each Blister,11.55,6.36,3.47,9.99,38
NDC,00406048423,acetaminophen/codeine 300-30 mg Tab 1 Each Blister,11.26,6.2,3.38,9.74,38
NDC,00406052710,methadone 10 mg/1 mL Conc 1 mL Plas Cont,10.2,5.61,3.06,8.82,38
NDC,00406052710,"methadone 10 mg/mL Conc 1,000 mL Bottle",205.0,112.75,61.5,177.33,38
NDC,00406052710,methadone 100 mg/10 mL Conc 10 mL Plas Cont,11.95,6.58,3.59,10.34,38
NDC,00406055223,oxyCODONE 5 MG Tab 1 Each Blister,11.25,6.19,3.38,9.73,38
NDC,00406117001,naltrexone 50 MG Tab 100 Each Bottle,12.81,7.05,3.84,11.08,38
NDC,00406123601,diphenoxylate/atropine 2.5-0.025 MG Tab 100 Each Bottle,10.48,5.77,3.14,9.07,38
NDC,00406147301,methylphenidate HCl 20 MG Tab CR 100 Each Bottle,11.42,6.29,3.43,9.88,38
NDC,00406152055,cocaine hydrochloride Powder 25 g Bottle,7810.28,4295.66,2343.08,6755.89,38
NDC,00406575523,methadone 5 MG Tab 1 Each Blister,11.0,6.05,3.3,9.52,38
NDC,00406800312,morphine 20 MG/ML Solution 120 mL Bottle,161.2,88.66,48.36,139.44,38
NDC,00406838023,morphine sulfate 60 MG Tab CR 1 Each Blister,16.12,8.87,4.84,13.94,38
NDC,00406839023,morphine sulfate 100 MG Tab CR 1 Each Blister,20.49,11.27,6.15,17.72,38
NDC,00406851501,oxyCODONE 15 MG Tab 100 Each Bottle,10.8,5.94,3.24,9.34,38
NDC,00406855605,oxyCODONE 5 mg/5 mL Solution 5 mL Syringe,11.55,6.36,3.47,9.99,38
NDC,00406889101,amphetamine/dextroamphetamine 5 MG Tab 100 Each Bottle,11.14,6.13,3.34,9.64,38
NDC,00406895201,amphetamine/dextroamphetamine 10 MG CAPSULE SR 24 HR 100 Each Bottle,11.31,6.23,3.39,9.78,38
NDC,00406895401,amphetamine/dextroamphetamine 20 MG CAPSULE SR 24 HR 100 Each Bottle,11.31,6.23,3.39,9.78,38
NDC,00406895601,amphetamine/dextroamphetamine 30 MG CAPSULE SR 24 HR 100 Each Bottle,11.31,6.23,3.39,9.78,38
NDC,00406901276,fentaNYL 12 mcg/hr/patch PATCH 72 HR 5 Each Box,40.48,22.27,12.14,35.02,38
NDC,00406905076,fentaNYL 50 mcg/hr/patch PATCH 72 HR 5 Each Box,33.33,18.34,10.0,28.83,38
NDC,00406910076,fentaNYL 100 mcg/hr/patch PATCH 72 HR 5 Each Box,63.12,34.72,18.94,54.6,38
NDC,00406911276,fentaNYL 12 mcg/hr/patch PATCH 72 HR 5 Each Box,40.48,22.27,12.14,35.02,38
NDC,00406912576,fentaNYL 25 mcg/hr PATCH 72 HR 5 Each Box,23.97,13.19,7.19,20.73,38
NDC,00406915076,fentaNYL 50 mcg/hr/patch PATCH 72 HR 5 Each Box,33.33,18.34,10.0,28.83,38
NDC,00407141230,iohexol 240 mg/mL Solution 50 mL Bottle,142.2,78.21,0.35,123.0,48
NDC,00407141361,iohexol 300 mg/mL Solution 50 mL Bottle,167.23,91.98,0.13,144.65,48
NDC,00407141363,iohexol 300 mg/mL Solution 100 mL Bottle,322.8,177.54,0.13,279.22,48
NDC,00407141365,iohexol 300 mg/mL Solution 150 mL Bottle,468.58,257.72,0.13,405.32,48
NDC,00407141366,iohexol 300 mg/mL Solution 200 mL Bottle,579.0,318.45,0.13,500.84,48
NDC,00407141372,iohexol 300 mg/mL Solution 500 mL Bottle,1485.5,817.03,0.13,1284.96,48
NDC,00407141509,iohexol 9 mg/mL Solution 500 mL Bottle,40.0,22.0,12.0,34.6,38
NDC,00407270703,perflutren protein A microsphere Suspension 3 mL Vial,689.88,379.44,35.73,596.75,48
NDC,00409018101,gemcitabine 1 GM/26.3ML Solution 26.3 mL Vial,248.52,136.69,2.47,214.97,48
NDC,00409018201,Gemcitabine HCl 2 GM/52.6ML Solution 52.6 mL Vial,458.95,252.43,2.47,396.99,48
NDC,00409018301,gemcitabine 38 mg/mL Solution 5.26 mL Vial,73.86,40.63,2.47,63.89,48
NDC,00409020102,DOCEtaxel Solution 2 mL Vial,357.97,196.89,0.62,309.64,48
NDC,00409022201,meropenem 500 mg Recon Soln 1 Each Vial,44.65,24.56,0.33,38.62,48
NDC,00409080101,pentostatin 2 mg/mL Recon Soln 1 Each Vial,12710.5,6990.78,2346.15,17171.26,63
NDC,00409110901,atracurium 50 MG/5ML Solution 5 mL Vial,74.25,40.84,22.28,64.23,38
NDC,00409111210,busulfan 6 MG/ML Solution 10 mL Vial,1887.25,1037.99,0.88,1632.47,63
NDC,00409113403,morphine 50 MG/ML Solution 20 mL Vial,175.8,96.69,52.74,152.07,38
NDC,00409113502,morphine (preservative free) 25 mg/mL Solution 10 mL Vial,97.1,53.41,29.13,83.99,38
NDC,00409114112,sodium chloride 4 MEQ/ML Solution 100 mL Vial,120.1,66.06,36.03,103.89,38
NDC,00409115901,BUPivacaine (PF) 0.25 % Solution 10 mL Vial,42.78,23.53,0.01,37.0,48
NDC,00409115902,BUPivacaine 0.25 % (PF) 0.25 % Solution 30 mL Vial,43.23,23.78,12.97,37.39,38
NDC,00409116001,BUPivacaine 0.25 % Solution 50 mL Vial,51.63,28.4,0.01,44.66,48
NDC,00409116201,BUPivacaine (PF) 0.5 % Solution 10 mL Vial,45.78,25.18,0.01,39.6,48
NDC,00409116201,BUPivacaine 0.5 % (PF) 0.5 % Solution 10 mL Vial,45.78,25.18,13.73,39.6,38
NDC,00409116301,BUPivacaine 0.5 % Solution 50 mL Vial,47.13,25.93,0.01,40.77,48
NDC,00409116501,BUPivacaine (PF) 0.75 % Solution 10 mL Vial,47.05,25.88,0.01,40.7,48
NDC,00409116502,BUPivacaine (PF) 0.75 % Solution 30 mL Vial,61.0,33.55,0.01,52.77,48
NDC,00409117603,meperidine 25 MG/ML Solution 1 mL Syringe,80.4,44.22,5.98,105.91,48
NDC,00409117803,meperidine 50 MG/ML Solution 1 mL Syringe,95.5,52.53,5.98,105.91,48
NDC,00409120703,gentamicin 40 MG/ML Solution 2 mL Vial,52.09,28.65,2.12,45.06,86
NDC,00409120703,gentamicin neonatal 40 MG/ML Solution 2 mL Vial,52.09,28.65,2.12,45.06,48
NDC,00409120901,"lidocaine/EPINEPHrine (preservative free) 1.5%/1:200,000 Solution 5 mL Ampule",62.98,34.64,18.89,54.48,38
NDC,00409120910,"lidocaine/EPINEPHrine (preservative free) 1.5%/1:200,000 Solution 5 mL Ampule",62.94,34.62,18.88,54.44,38
NDC,00409127303,diazePAM 5 MG/ML Solution 2 mL Crtrdg-NDL,356.6,196.13,7.34,308.46,48
NDC,00409127332,diazePAM 5 MG/ML Solution 2 mL Crtrdg-NDL,356.62,196.15,7.34,308.48,48
NDC,00409128303,HYDROmorphone 1 MG/ML Solution 1 mL Crtrdg-NDL,59.94,32.97,0.08,51.85,48
NDC,00409131203,HYDROmorphone 2 MG/ML Solution 1 mL Crtrdg-NDL,73.81,40.6,0.08,63.85,48
NDC,00409131230,HYDROmorphone 2 MG/ML Solution 1 mL Crtrdg-NDL,73.76,40.57,22.13,63.8,38
NDC,00409132305,lidocaine 100 MG/5ML Solution Prefilled Syringe 5 mL Syringe,75.89,41.74,22.77,65.64,38
NDC,00409139121,meropenem 1000 mg Recon Soln 1 Each Vial,154.62,85.05,0.33,133.75,48
NDC,00409146371,nalbuphine 10 MG/ML Solution 1 mL Ampule,58.45,32.15,2.95,50.56,48
NDC,00409156010,BUPivacaine (PF) 0.5 % Solution 10 mL Vial,61.33,33.74,0.01,53.05,48
NDC,00409162601,butorphanol 2 MG/ML Solution 1 mL Vial,110.18,60.6,4.88,95.31,48
NDC,00409163110,calcium chloride 10 % Solution 10 mL Syringe,102.03,56.12,30.61,88.26,48
NDC,00409163401,vecuronium Recon Soln 1 Each Vial,107.03,58.87,32.11,92.58,38
NDC,00409166010,dexmedeTOMIDine 400 mcg/100 mL Solution 100 mL Glass Cont,270.0,148.5,81.0,233.55,38
NDC,00409166020,dexmedeTOMIDine 80 mcg/20 mL Solution 20 mL Vial,152.6,83.93,45.78,132.0,38
NDC,00409166055,dexmedeTOMIDine 200 mcg/50 mL Solution 50 mL Glass Cont,160.0,88.0,48.0,138.4,38
NDC,00409174929,"BUPivacaine/EPINEPHrine (PRESERVATIVE FREE) 0.5%/1:200,000 Solution 30 mL Vial",93.67,51.52,28.1,81.02,38
NDC,00409177815,metoprolol 5 MG/5ML Solution 5 mL Vial,40.4,22.22,0.65,34.95,48
NDC,00409188622,levETIRAcetam 500 MG/5ML Solution 5 mL Vial,54.18,29.8,0.05,46.87,48
NDC,00409189001,morphine 2 mg/mL Solution 1 mL Cartridge,57.69,31.73,17.31,49.9,38
NDC,00409189001,morphine sulfate 2 mg/mL Solution 1 mL Cartridge,57.69,31.73,3.93,49.9,48
NDC,00409189003,morphine sulfate 2 mg/mL Solution 1 mL Cartridge,57.69,31.73,3.93,49.9,48
NDC,00409189101,morphine 4 mg/mL Solution 1 mL Cartridge,55.3,30.42,16.59,47.83,38
NDC,00409189101,morphine sulfate 4 mg/mL Solution 1 mL Cartridge,55.3,30.42,3.93,47.83,48
NDC,00409189103,morphine sulfate 4 mg/mL Solution 1 mL Cartridge,55.35,30.45,3.93,47.88,48
NDC,00409189301,morphine 10 mg/mL Solution 1 mL Cartridge,60.02,33.02,18.01,51.92,38
NDC,00409189303,morphine sulfate 10 MG/ML Solution 1 mL Cartridge,60.03,33.02,3.93,51.93,48
NDC,00409196607,Saline Bacteriostatic 0.9 % Solution 30 mL Vial,42.33,23.29,12.7,36.62,38
NDC,00409196607,sodium chloride bacteriostatic 0.9 % Solution 30 mL Vial,42.33,23.29,12.7,36.62,38
NDC,00409198530,LORazepam 2 MG/ML Solution 1 mL Crtrdg-NDL,76.64,42.16,22.99,66.29,38
NDC,00409212201,enalaprilat 1.25 MG/ML Solution 1 mL Vial,43.44,23.9,13.03,37.58,38
NDC,00409226720,labetalol 5 MG/ML Solution 20 mL Vial,54.7,30.09,0.25,47.32,48
NDC,00409230504,midazolam PF 5 mg/5 mL Solution 5 mL Vial,58.24,32.04,0.12,50.38,48
NDC,00409230505,midazolam PF 5 mg/5 mL Solution 5 mL Vial,58.16,31.99,0.12,50.31,48
NDC,00409230516,midazolam PF 2 MG/2ML Solution 2 mL Vial,58.88,32.39,0.12,50.93,48
NDC,00409230801,midazolam 5 MG/1ML Solution 1 mL Vial,58.58,32.22,17.57,50.67,38
NDC,00409230801,midazolam PF 5 MG/ML Solution 1 mL Vial,58.58,32.22,0.12,50.67,48
NDC,00409233725,deferoxamine Recon Soln 1 Each Vial,259.35,142.65,7.68,224.34,48
NDC,00409233924,labetalol 5 MG/ML Solution 4 mL Cartridge,88.56,48.71,0.25,76.6,48
NDC,00409234402,DOBUTamine 12.5 MG/ML Solution 20 mL Vial,73.58,40.47,6.35,63.65,48
NDC,00409234632,DOBUTamine 1-5 MG/ML-% Solution 250 mL Flex Cont,306.0,168.3,6.35,264.69,48
NDC,00409255201,HYDROmorphone PF 1 MG/ML Solution 1 mL Ampule,60.14,33.08,0.08,52.02,48
NDC,00409317817,"lidocaine/EPINEPHrine 1%-1:100,000 Solution 30 mL Vial",93.71,51.55,28.11,81.06,38
NDC,00409318101,"lidocaine 1.5 % w/EPINEPHrine 1:200,000 (PF) 1.5%/1:200,000 Solution 30 mL Vial",140.32,77.18,42.1,121.38,38
NDC,00409318905,rocuronium 50 MG/5ML Solution 5 mL Vial,52.86,29.08,15.86,45.72,38
NDC,00409321312,diazePAM 5 MG/ML Solution 10 mL Vial,415.09,228.3,7.34,359.05,48
NDC,00409329451,potassium acetate 2 MEQ/ML Solution 50 mL Vial,92.8,51.04,27.84,80.27,38
NDC,00409329461,potassium acetate 2 MEQ/ML Solution 50 mL Vial,92.8,51.04,27.84,80.27,38
NDC,00409329906,sodium acetate 2 MEQ/ML Solution 100 mL Vial,86.6,47.63,25.98,74.91,38
NDC,00409330001,ciprofloxacin 400 mg/200 mL Solution 200 mL Flex Cont,67.0,36.85,0.71,57.96,48
NDC,00409330803,acetylcysteine 20 % Solution 30 mL Vial,83.41,45.88,25.02,72.15,38
NDC,00409336501,HYDROmorphone 2 MG/ML Solution 1 mL Vial,50.38,27.71,0.08,43.58,48
NDC,00409336511,HYDROmorphone 2 MG/ML Solution 1 mL Vial,50.41,27.73,0.08,43.6,48
NDC,00409338211,SUFentanil 50 MCG/ML Solution 1 mL Vial,151.2,83.16,45.36,130.79,38
NDC,00409350701,imipenem/cilastatin 500mg Recon Soln 1 Each Vial,92.97,51.14,6.18,80.42,48
NDC,00409357801,tobramycin sulfate 40 mg/mL Solution 2 mL Vial,47.38,26.06,1.69,40.98,48
NDC,00409361301,BUPivacaine 0.75% in dextrose 8.25% (intrathecal) 0.75-8.25 % Solution 2 mL Ampule,46.38,25.51,0.01,40.12,48
NDC,00409397703,Bacteriostatic Water(Benz Alc) Solution 30 mL Vial,68.89,37.89,20.67,59.59,38
NDC,00409403101,mannitol 25 % Solution 50 mL Vial,61.6,33.88,2.18,53.28,48
NDC,00409409001,zinc chloride 1 MG/ML Solution 10 mL Vial,173.99,95.7,52.2,150.5,38
NDC,00409409301,chromium chloride 40 MCG/10ML Solution 10 mL Vial,148.9,81.9,44.67,128.8,38
NDC,00409427601,OR lidocaine 10 MG/ML Solution 2 mL Syringe,30.09,16.55,9.03,26.03,38
NDC,00409427601,lidocaine 1 % Solution 5 mL Syringe,36.36,20.0,10.91,31.45,38
NDC,00409427616,lidocaine 1 % Solution 20 mL Vial,48.85,26.87,14.66,42.26,38
NDC,00409427902,lidocaine (PF) 1 % Solution 30 mL Vial,49.53,27.25,14.86,42.84,38
NDC,00409427902,lidocaine 1% (preservative free) 1 % (PF) Solution 30 mL Vial,49.53,27.25,14.86,42.84,38
NDC,00409428202,lidocaine 2% (PF) 2 % Solution 10 mL Ampule,75.61,41.59,22.68,65.4,38
NDC,00409428301,lidocaine PF 4 % Solution 5 mL Ampule,61.26,33.7,18.38,52.99,38
NDC,00409428311,lidocaine PF 4 % Solution 5 mL Ampule,61.23,33.68,18.37,52.96,38
NDC,00409433201,vancomycin (neonatal) Recon Soln 1 Each Vial,82.13,45.18,0.15,71.04,48
NDC,00409433201,vancomycin (preservative free) 50 mg/mL Solution 1 Each Vial,82.13,45.18,24.64,71.04,38
NDC,00409471302,lidocaine (PF) 1 % Solution 5 mL Ampule,43.68,24.03,13.1,37.78,38
NDC,00409477610,lidocaine 1.5 % Solution 20 mL Ampule,86.04,47.33,25.81,74.42,38
NDC,00409477723,ciprofloxacin 200 mg/100 mL Solution 100 mL Flex Cont,49.6,27.28,0.71,42.9,48
NDC,00409488717,sterile water for injection (PF) Solution 10 mL Vial,50.73,27.91,15.22,43.88,38
NDC,00409488724,sterile water for injection (PF) Solution 50 mL Vial,74.35,40.9,22.31,64.31,38
NDC,00409488802,sodium chloride (PF) 0.9 % Solution 10 mL Vial,7.29,4.01,2.19,6.31,38
NDC,00409488806,0.9% NaCl (preservative free) 0.9% Solution 50 mL Vial,51.63,28.4,15.49,44.66,38
NDC,00409488810,0.9% NaCl (preservative free) 0.9% Solution 10 mL Vial,37.52,20.64,11.26,32.45,38
NDC,00409490264,dextrose 50 % Solution 50 mL Syringe,139.28,76.61,41.78,120.48,38
NDC,00409490311,lidocaine 20 MG/ML Solution 5 mL Syringe,78.13,42.98,23.44,67.58,38
NDC,00409492120,EPINEPHrine 1 mg/10 mL Solution Prefilled Syringe 10 mL Syringe,61.68,33.93,3.6,53.35,48
NDC,00409508216,cefTAZidime 1g Nebu Soln 1 Each Vial,56.95,31.33,17.09,49.26,38
NDC,00409508216,cefTAZidime 1g Recon Soln 1 Each Vial,56.95,31.33,1.42,49.26,48
NDC,00409508216,cefTAZidime Recon Soln 1 Each Vial,56.95,31.33,17.09,49.26,38
NDC,00409508411,cefTAZidime 2 g Recon Soln 1 Each Vial,91.86,50.53,1.42,79.46,48
NDC,00409553434,sodium bicarbonate 0.5 mEq/mL Solution 10 mL Syringe,90.27,49.65,27.08,78.08,38
NDC,00409582001,DOPamine 40 MG/ML Solution 5 mL Vial,55.04,30.28,0.67,47.61,48
NDC,00409592201,aminophylline 25 MG/ML Solution 20 mL Vial,103.59,56.98,4.44,89.61,48
NDC,00409610210,furosemide Solution 10 mL Vial,62.5,34.38,18.75,54.06,38
NDC,00409610218,furosemide 10 MG/ML Solution 4 mL Vial,46.99,25.85,0.1,40.65,48
NDC,00409614309,"acetic acid 0.25 % Solution 1,000 mL Plas Cont",75.0,41.25,22.5,64.88,38
NDC,00409647644,erythromycin lactobionate 500 mg Recon Soln 1 Each Vial,522.21,287.22,53.35,506.59,48
NDC,00409648201,erythromycin Recon Soln 1 Each Vial,607.61,334.19,53.35,525.58,48
NDC,00409648201,erythromycin lactobionate 500 mg Recon Soln 1 Each Vial,607.61,334.19,53.35,525.58,48
NDC,00409650901,vancomycin 5000 mg Recon Soln 1 Each Vial,556.56,306.11,0.15,481.42,48
NDC,00409653311,vancomycin 1 g Recon Soln 1 Each Vial,125.82,69.21,0.15,108.83,48
NDC,00409653321,vancomycin 1 g Recon Soln 1 Each Vial,125.83,69.21,0.15,108.84,48
NDC,00409653349,vancomycin Recon Soln 1 Each Vial,124.26,68.35,37.28,107.48,38
NDC,00409662514,sodium bicarbonate 1 mEq/mL Solution 50 mL Vial,93.95,51.68,28.19,81.27,38
NDC,00409663724,sodium bicarbonate 1 mEq/mL Solution 50 mL Syringe,157.15,86.44,47.15,135.93,38
NDC,00409663734,sodium bicarbonate 1 mEq/mL Solution 50 mL Syringe,90.53,49.8,27.16,78.31,38
NDC,00409664802,dextrose 50 % Solution 50 mL Vial,61.4,33.77,18.42,53.11,76
NDC,00409665773,sodium chloride 2.5 MEQ/ML Solution 20 mL Vial,39.92,21.96,11.98,34.53,38
NDC,00409666075,sodium chloride 2.5 MEQ/ML Solution 40 mL Vial,71.76,39.47,21.53,62.07,38
NDC,00409710169,0.9% NaCl add-vantage Solution 100 mL Flex Cont,61.5,33.83,18.45,53.2,38
NDC,00409724803,hetastarch 6% in 0.9% NaCl 6-0.9 % Solution 500 mL Plas Cont,236.88,130.29,71.06,204.9,38
NDC,00409729511,potassium PHOSphate 3 mMol/mL Solution 15 mL Vial,116.14,63.88,34.84,100.46,38
NDC,00409729973,sodium acetate 2 MEQ/ML Solution 20 mL Vial,92.8,51.04,27.84,80.27,38
NDC,00409733201,cefTRIAXone Recon Soln 1 Each Vial,42.16,23.19,0.39,36.47,86
NDC,00409733211,cefTRIAXone Recon Soln 1 Each Vial,42.16,23.19,0.39,36.47,48
NDC,00409733349,cefTRIAXone 1 g Recon Soln 1 Each Vial,46.14,25.38,0.39,39.91,48
NDC,00409733513,cefTRIAXone 2 g Recon Soln 1 Each Vial,46.68,25.68,0.39,40.38,48
NDC,00409733604,cefTRIAXone 2 g Recon Soln 1 Each Vial,80.81,44.45,24.24,69.9,38
NDC,00409733701,cefTRIAXone Recon Soln 1 Each Vial,36.1,19.86,0.39,31.23,48
NDC,00409733811,cefTRIAXone 500 MG Recon Soln 1 Each Vial,37.72,20.75,0.39,32.63,48
NDC,00409739182,sodium phosphate 45 MMOLE/15ML Solution 15 mL Vial,256.29,140.96,76.89,221.69,38
NDC,00409741813,dextran 40 10% in dextrose 5% 10 % Solution 500 mL Flex Cont,981.0,539.55,44.24,848.57,48
NDC,00409741914,dextran 40 10% in 0.9% NaCl 10-0.9 % Solution 500 mL Flex Cont,365.13,200.83,44.24,315.84,48
NDC,00409751766,dextrose 50 % Solution 50 mL Syringe,148.05,81.43,44.42,128.06,38
NDC,00409771502,mannitol 20% 20 % Solution 250 mL Flex Cont,139.5,76.73,41.85,120.67,38
NDC,00409781124,metroNIDAZOLE 500 mg in 100 mL Solution 100 mL Flex Cont,43.3,23.82,0.03,37.45,48
NDC,00409796905,"cardioplegic Solution 1,000 mL Plas Cont",795.0,437.25,238.5,687.68,38
NDC,00409798302,NaCl 0.9 % Solution 250 mL Flex Cont,56.5,31.08,16.95,48.87,38
NDC,00409798503,0.45% NaCl 0.45 % Solution 500 mL Flex Cont,127.0,69.85,38.1,109.86,38
NDC,00409818301,potassium acetate 2 MEQ/ML Solution 20 mL Vial,62.8,34.54,18.84,54.32,38
NDC,00409909332,fentaNYL 0.05 MG/ML Solution 2 mL Ampule,53.22,29.28,15.97,46.04,38
NDC,00409909418,fentaNYL 0.05 MG/ML Solution 5 mL Vial,74.46,40.96,0.73,64.41,48
NDC,00409909418,fentaNYL 250 MCG/5ML Solution 5 mL Vial,74.46,40.96,0.73,64.41,48
NDC,00409909422,fentaNYL 0.05 MG/ML Solution 2 mL Vial,66.5,36.58,0.73,57.52,48
NDC,00409909422,fentaNYL 100 MCG/2ML Solution 2 mL Vial,66.5,36.58,0.73,57.52,48
NDC,00409909431,fentaNYL 1000 MCG/20ML Solution 20 mL Vial,124.8,68.64,0.73,107.95,48
NDC,00409909461,fentaNYL 0.05 MG/ML Solution 50 mL Vial,333.5,183.43,0.73,288.48,48
NDC,00409909461,fentaNYL 2500 MCG/50ML Solution 50 mL Vial,333.5,183.43,0.73,288.48,48
NDC,00409915731,phytonadione 1 MG/0.5ML Solution 0.5 mL Ampule,60.63,33.35,18.19,52.44,38
NDC,00409915801,phytonadione 10 MG/ML Solution 1 mL Ampule,308.8,169.84,1.9,267.11,48
NDC,00409956601,cefepime Recon Soln 1 Each Vial,67.63,37.2,1.06,58.5,48
NDC,00456045801,thyroid 30 MG Tab 100 Each Bottle,10.03,5.52,3.01,8.68,38
NDC,00456060010,ceftaroline 600 mg Recon Soln 1 Each Vial,1405.28,772.91,3.39,1215.57,63
NDC,00456120130,linaCLOtide 145 MCG Cap 30 Each Bottle,57.12,31.42,17.14,49.41,38
NDC,00456120230,linaCLOtide 290 MCG Cap 30 Each Bottle,57.12,31.42,17.14,49.41,38
NDC,00456120330,linaCLOtide 72 MCG Cap 30 Each Bottle,57.12,31.42,17.14,49.41,38
NDC,00456155060,milnacipran 50 MG Tab 60 Each Bottle,29.03,15.97,8.71,25.11,38
NDC,00456270010,cefTAZidime-avibactam 2.5 (2-0.5) g Recon Soln 1 Each Vial,2257.97,1241.89,86.48,1953.14,63
NDC,00469042099,isavuconazonium sulfate 372 MG Recon Soln 1 Each Vial,1984.16,1091.29,0.86,1716.3,63
NDC,00469052002,Isavuconazonium Sulfate 186 MG Cap 14 Each Box,282.8,155.54,84.84,244.62,38
NDC,00469142590,gilteritinib 40 MG Tab 90 Each Bottle,777.78,427.78,233.33,672.78,38
NDC,00469260130,mirabegron 25 MG Tablet Extended Release 24 Hour 30 Each Bottle,47.43,26.09,14.23,41.03,38
NDC,00469301601,tacrolimus Solution 1 mL Ampule,1392.15,765.69,218.66,1770.05,63
NDC,00469305130,amphotericin B liposome 4 mg/mL Solution 1 Each Vial,1733.87,953.63,20.59,1499.8,63
NDC,00469305130,amphotericin B liposome 50 MG Recon Susp 1 Each Vial,1733.87,953.63,20.59,1499.8,63
NDC,00469342510,zolbetuximab-clzb 100 MG Recon Soln 1 Each Vial,8655.0,4760.25,33.71,7486.58,63
NDC,00472038015,betamethasone dipropionate 0.05 % Cream 15 g Tube,133.4,73.37,40.02,115.39,38
NDC,00472038115,betamethasone dipropionate 0.05 % Ointment 15 g Tube,157.5,86.63,47.25,136.24,38
NDC,00472173803,miconazole nitrate 200 MG Suppos 3 Each Box,48.98,26.94,14.69,42.37,38
NDC,00480372056,pyrimethamine 25 MG Tab 30 Each Bottle,620.6,341.33,186.18,536.82,38
NDC,00487590199,racepinephrine 2.25 % Nebu Soln 1 Each Plas Cont,13.0,7.15,3.9,11.25,38
NDC,00487900360,sodium chloride 3 % Nebu Soln 4 mL Plas Cont,32.66,17.97,9.8,28.25,38
NDC,00487950101,albuterol (2.5 mg/3mL) 0.083% Nebu Soln 3 mL Plas Cont,8.99,4.95,2.7,7.78,38
NDC,00487960101,budesonide 0.25 MG/2ML Suspension 2 mL Plas Cont,30.72,16.9,9.22,26.57,38
NDC,00487980101,ipratropium 0.02 % Solution 2.5 mL Plas Cont,9.19,5.06,2.76,7.95,38
NDC,00487990130,albuterol 0.5 % Nebu Soln 1 Each Box,9.65,5.31,2.9,8.35,38
NDC,00517042001,estradiol valerate 20 mg/mL Oil 5 mL Vial,765.98,421.29,6.82,662.57,48
NDC,00517065001,ferric carboxymaltose 750 MG/15ML Solution 15 mL Vial,7967.01,4381.86,0.95,6891.46,63
NDC,00517074020,methylergonovine 0.2 MG/ML Solution 1 mL Vial,202.68,111.48,18.74,175.32,48
NDC,00517100401,atropine 0.4 MG/ML Solution 1 mL Vial,93.0,51.15,0.1,80.45,48
NDC,00517101025,atropine 1 MG/ML Solution 1 mL Vial,101.64,55.91,0.1,87.92,48
NDC,00517234001,iron sucrose 20 MG/ML Solution 5 mL Vial,393.36,216.35,0.2,340.26,48
NDC,00517234001,iron sucrose 300mg/250 mL Solution 250 mL Bag,1111.0,611.05,0.2,961.02,48
NDC,00517250210,caffeine/sodium benzoate 125-125 MG/ML Solution 2 mL Vial,234.06,128.74,70.22,202.46,38
NDC,00517271025,calcium chloride 1.4 mEq/ML Solution 10 mL Vial,47.5,26.13,14.25,41.09,48
NDC,00517271025,calcium chloride 10 % Solution 10 mL Vial,47.5,26.13,14.25,41.09,48
NDC,00517400225,papaverine 30 MG/ML Solution 2 mL Vial,263.46,144.91,79.04,227.89,38
NDC,00517430001,nab-PACLitaxel 100 MG Recon Susp 1 Each Vial,7400.37,4070.21,10.54,6401.32,126
NDC,00517481025,nitroglycerin 5 MG/ML Solution 10 mL Vial,121.08,66.6,1.21,104.73,48
NDC,00517656005,Selenious Acid 60 MCG/ML Solution 10 mL Vial,944.43,519.44,283.33,816.93,38
NDC,00517912025,aminocaproic acid 250 MG/ML Solution 20 mL Vial,93.88,51.64,7.5,81.21,48
NDC,00517930501,trace minerals Solution 1 mL Vial,176.88,97.29,53.06,153.0,38
NDC,00517930525,trace minerals Solution 1 mL Vial,176.88,97.29,53.06,153.0,38
NDC,00517970201,droPERidol 2.5 MG/ML Solution 2 mL Vial,89.1,49.01,10.47,77.07,48
NDC,00517970225,droPERidol 2.5 MG/ML Solution 0.25 mL Syringe,40.63,22.35,10.47,36.18,48
NDC,00527130101,primidone 50 MG Tab 100 Each Bottle,8.53,4.7,2.56,7.38,38
NDC,00527131101,terbutaline 5 MG Tab 100 Each Bottle,20.36,11.2,6.11,17.61,38
NDC,00527139201,danazol 50 MG Cap 100 Each Bottle,14.61,8.04,4.38,12.64,38
NDC,00527139401,loxapine 5 MG Cap 100 Each Bottle,8.64,4.76,2.59,7.47,38
NDC,00527139501,loxapine 10 MG Cap 100 Each Bottle,9.16,5.04,2.75,7.92,38
NDC,00527155201,butalbital/aspirin/caffeine 50-325-40 MG Cap 100 Each Bottle,11.3,6.22,3.39,9.77,38
NDC,00527197174,cocaine 4 % Solution 4 mL Bottle,449.0,246.95,134.7,388.39,48
NDC,00527213335,posaconazole 100 MG Tablet Delayed Response 60 Each Bottle,19.5,10.73,5.85,16.87,38
NDC,00536009185,aluminum hydroxide 320 MG/5ML Suspension 473 mL Bottle,43.18,23.75,12.95,37.35,38
NDC,00536116134,dextromethorphan/guiafenesin 30-600 mg TABLET SR 12 HR 20 Each Box,4.84,2.67,1.45,4.19,38
NDC,00536120215,lidocaine 4 % Patch 5 Each Box,10.76,5.92,3.23,9.31,38
NDC,00536124801,senna/docusate 8.6-50 mg Tab 100 Each Bottle,4.1,2.26,1.23,3.55,38
NDC,00536125240,ketotifen fumarate 0.035 % Solution 5 mL Bottle,57.1,31.41,17.13,49.39,38
NDC,00536125391,sodium chloride (hypertonic) 5 % Ointment 3.5 g Tube,55.9,30.75,16.77,48.35,38
NDC,00536125494,sodium chloride (hypertonic) 5 % Solution 15 mL Bottle,35.33,19.44,10.6,30.56,38
NDC,00536126812,camphor/menthol 0.5-0.5 % Lotion 222 mL Bottle,39.43,21.69,11.83,34.11,38
NDC,00536128636,bismuth subsalicylate 262 MG/15ML Suspension 237 mL Bottle,17.86,9.83,5.36,15.45,38
NDC,00536128806,phenylephrine/mineral oil/petrolatum 0.25-14-74.9 % Ointment 57 g Tube,28.58,15.72,8.57,24.72,38
NDC,00536140894,polyvinyl alcohol 1.4 % Solution 15 mL Bottle,35.17,19.35,10.55,30.42,38
NDC,00536252525,capsaicin 0.025 % Cream 60 g Tube,44.36,24.4,13.31,38.37,38
NDC,00536344308,multivitamin with iron 18 MG Chew Tab 60 Each Bottle,4.27,2.35,1.28,3.69,38
NDC,00536430605,polycarbophil 625 MG Tab 500 Each Bottle,4.24,2.34,1.27,3.67,38
NDC,00548560700,enoxaparin 150 mg/mL Solution Prefilled Syringe 1 mL Syringe,166.25,91.44,0.48,143.81,48
NDC,00548570100,medroxyPROGESTERone 150 MG/ML Suspension Prefilled Syringe 1 mL Syringe,182.5,100.38,0.43,157.86,48
NDC,00548590000,cosyntropin Recon Soln 1 Each Vial,590.53,324.8,28.71,510.81,48
NDC,00555003302,chlordiazePOXIDE 10 mg capsule Cap 100 Each Bottle,10.37,5.71,3.11,8.97,38
NDC,00555006602,isoniazid 100 MG Tab 100 Each Bottle,8.39,4.62,2.52,7.26,38
NDC,00555007102,isoniazid 300 MG Tab 100 Each Bottle,8.82,4.86,2.65,7.63,38
NDC,00555015802,chlordiazePOXIDE 5 mg capsule Cap 100 Each Bottle,10.48,5.77,3.14,9.07,38
NDC,00555015902,chlordiazePOXIDE 25 mg capsule Cap 100 Each Bottle,10.42,5.74,3.13,9.01,38
NDC,00555060602,megestrol 20 MG Tab 100 Each Bottle,9.19,5.06,2.76,7.95,38
NDC,00555060702,megestrol 40 MG Tab 100 Each Bottle,9.09,5.0,2.73,7.86,38
NDC,00555087302,medroxyPROGESTERone 5 MG Tab 100 Each Bottle,8.71,4.8,2.61,7.53,38
NDC,00555095202,dextroamphetamine 5 MG Tab 100 Each Bottle,12.15,6.69,3.65,10.51,38
NDC,00555097102,amphetamine/dextroamphetamine 5 MG Tab 100 Each Bottle,11.95,6.58,3.59,10.34,38
NDC,00555900867,norethindrone/ethinyl estradiol 0.5-35 mg-mcg Tab 28 Each Disp Pack,9.33,5.14,2.8,8.07,38
NDC,00555900942,norethindrone/ethinyl estradiol 1-35 mg-mcg Tab 21 Each Disp Pack,9.84,5.42,2.95,8.51,38
NDC,00562780500,Rho (D) immune globulin 300 mcg (1500 units) Solution Prefilled Syringe 1 Each Syringe,679.2,373.56,71.57,587.51,48
NDC,00574006915,glucose 40 % Gel 15 g Tube,9.67,5.32,2.9,8.36,38
NDC,00574010601,bromocriptine 2.5 MG Tab 100 Each Bottle,16.01,8.81,4.8,13.85,38
NDC,00574011501,flavoxATE 100 MG Tab 100 Each Bottle,10.32,5.68,3.1,8.93,38
NDC,00574014560,trospium 20 MG Tab 60 Each Bottle,9.38,5.16,2.81,8.11,38
NDC,00574029201,aMILoride 5 MG Tab 100 Each Bottle,8.74,4.81,2.62,7.56,38
NDC,00574030316,ORA-Plus Liquid 473 mL Bottle,82.75,45.52,24.83,71.58,38
NDC,00574030416,ORA-SWEET Syrup 473 mL Bottle,17.5,9.63,5.25,15.14,38
NDC,00574050801,ferrous gluconate 324 (38 Fe) MG Tab 100 Each Bottle,4.22,2.33,1.27,3.65,38
NDC,00574052176,activated charcoal AQ 50 g Liquid 240 mL Tube,70.57,38.82,21.17,61.04,38
NDC,00574060115,podophyllum resin 25 % Solution 15 mL Bottle,333.48,183.42,100.04,288.46,38
NDC,00574200416,sodium polystyrene 15 g Powder 454 g Jar,457.46,251.61,137.24,395.7,38
NDC,00574200815,nystatin 100000 UNIT/GM Powder 15 g Bottle,87.88,48.34,26.36,76.02,38
NDC,00574402235,bacitracin 500 UNIT/GM Ointment 3.5 g Tube,366.26,201.45,109.88,316.81,38
NDC,00574703412,aspirin 300 MG Suppos 12 Each Box,7.08,3.9,2.12,6.12,38
NDC,00574704001,belladonna/opium 16.2-60 MG Suppos 1 Each Box,61.52,33.84,18.46,53.21,38
NDC,00574704512,belladonna/opium 16.2-30 MG Suppos 12 Each Box,52.03,28.62,15.61,45.01,38
NDC,00574705012,bisacodyl 10 MG Suppos 12 Each Box,4.24,2.34,1.27,3.67,38
NDC,00574705050,bisacodyl 10 MG Suppos 50 Each Box,3.92,2.16,1.18,3.39,38
NDC,00574711612,morphine 30 MG Suppos 12 Each Box,24.75,13.62,7.43,21.41,38
NDC,00574722612,prochlorperazine 25 MG Suppos 12 Each Box,29.53,16.25,8.86,25.54,38
NDC,00591034301,verapamil 80 MG Tab 100 Each Bottle,8.17,4.5,2.45,7.07,38
NDC,00591040401,verapamil 40 MG Tab 100 Each Bottle,8.51,4.69,2.55,7.36,38
NDC,00591058301,propafenone 225 MG Tab 100 Each Bottle,8.52,4.69,2.56,7.37,38
NDC,00591079401,dicyclomine 10 MG Cap 100 Each Bottle,8.66,4.77,2.6,7.49,38
NDC,00591224522,mesalamine 1.2 g Tablet Delayed Response 120 Each Bottle,20.34,11.19,6.1,17.59,38
NDC,00591321730,testosterone 50 MG/5GM (1%) Gel 5 g Package,35.23,19.38,10.57,30.47,38
NDC,00591350954,cloNIDine 0.2 mg/24hr/patch PATCH WEEKLY 1 Each Box,112.07,61.64,33.62,96.94,38
NDC,00591351004,cloNIDine 0.3 mg/24hr/patch PATCH WEEKLY 4 Each Box,153.54,84.45,46.06,132.81,38
NDC,00591354060,buPROPion HCl 100 MG TABLET SR 12 HR 60 Each Bottle,8.82,4.86,2.65,7.63,38
NDC,00591354125,buPROPion HCl 150 MG TABLET SR 12 HR 250 Each Bottle,8.89,4.89,2.67,7.69,38
NDC,00591410201,perphenazine 4 MG Tab 100 Each Bottle,8.86,4.88,0.56,7.66,48
NDC,00591412879,testosterone cypionate 200 MG/ML Solution 10 mL Vial,577.77,317.78,0.03,499.77,48
NDC,00591533501,trihexyphenidyl 2 MG Tab 100 Each Bottle,8.5,4.68,2.55,7.35,38
NDC,00591533701,trihexyphenidyl 5 MG Tab 100 Each Bottle,9.0,4.95,2.7,7.79,38
NDC,00591534701,probenecid 500 MG Tab 100 Each Bottle,8.78,4.83,2.63,7.59,38
NDC,00597003510,spesolimab-sbzo 450 MG/7.5ML Solution 7.5 mL Vial,117203.77,64462.08,52.75,101381.26,63
NDC,00597015237,empagliflozin 10 mg Tab 30 Each Box,62.65,34.46,18.8,54.19,38
NDC,00597015337,empagliflozin 25 mg Tab 30 Each Box,62.65,34.46,18.8,54.19,38
NDC,00597019705,idaruCIZUmab 2.5 GM/50ML Solution 50 mL Vial,10725.04,5898.78,3217.51,9277.16,48
NDC,00597036082,dabigatran 150 MG Cap 60 Each Box,16.92,9.31,5.08,14.64,38
NDC,00603243321,benztropine 0.5 MG Tab 100 Each Bottle,8.46,4.66,2.54,7.32,38
NDC,00603243421,benztropine 1 MG Tab 100 Each Bottle,8.53,4.7,2.56,7.38,38
NDC,00603258221,carisoprodol 350 MG Tab 100 Each Bottle,10.24,5.64,3.07,8.86,38
NDC,00603516621,PHENobarbital 32.4 MG Tab 100 Each Bottle,11.22,6.18,3.37,9.71,38
NDC,00603516821,PHENobarbital 97.2 MG Tab 100 Each Bottle,12.14,6.68,3.64,10.5,38
NDC,00603548321,propranolol 20 MG Tab 100 Each Bottle,8.66,4.77,2.6,7.49,38
NDC,00641036721,dexAMETHasone 10 MG/ML Solution 1 mL Vial,41.44,22.8,0.1,35.85,48
NDC,00641036725,dexAMETHasone 10 MG/ML Solution 1 mL Vial,41.43,22.79,0.1,35.84,48
NDC,00641037625,diphenhydrAMINE 50 MG/ML Solution 1 mL Vial,39.38,21.66,0.62,34.06,48
NDC,00641040012,heparin 5000 UNIT/ML Solution 1 mL Vial,44.23,24.33,0.17,38.26,48
NDC,00641049325,phenytoin 50 MG/ML Solution 2 mL Vial,41.12,22.62,0.41,35.57,96
NDC,00641092825,promethazine 25 MG/ML Solution 1 mL Vial,44.78,24.63,3.06,38.73,48
NDC,00641139735,chlorproMAZINE 25 MG/ML Solution 1 mL Ampule,188.33,103.59,26.17,182.72,48
NDC,00641141031,digoxin 0.25 MG/ML Solution 2 mL Ampule,63.5,34.93,7.58,54.93,48
NDC,00641234139,HYDROmorphone 2 MG/ML Solution 20 mL Vial,234.4,128.92,0.08,202.76,48
NDC,00641234141,HYDROmorphone 2 MG/ML Solution 20 mL Vial,234.4,128.92,0.08,202.76,48
NDC,00641255545,phenytoin 50 MG/ML Solution 5 mL Vial,45.96,25.28,0.41,39.76,48
NDC,00641600101,LORazepam 2 MG/ML Solution 1 mL Vial,54.7,30.09,1.16,47.32,48
NDC,00641600801,bumetanide 0.25 MG/ML Solution 4 mL Vial,47.65,26.21,0.37,41.22,63
NDC,00641601310,dilTIAZem 25 MG/5ML Solution 5 mL Vial,50.65,27.86,0.2,43.81,48
NDC,00641601510,dilTIAZem 125 MG/25ML Solution 25 mL Vial,88.7,48.79,0.2,76.73,48
NDC,00641601910,morphine (PF) 1 MG/ML Solution 10 mL Ampule,309.6,170.28,9.92,267.8,48
NDC,00641602605,fentaNYL 0.05 MG/ML Solution 20 mL Ampule,105.0,57.75,0.73,90.83,48
NDC,00641602901,fentaNYL 1000 MCG/20ML Solution 20 mL Vial,130.0,71.5,0.73,112.45,48
NDC,00641605325,meperidine 50 MG/ML Solution 1 mL Vial,64.35,35.4,5.98,105.91,48
NDC,00641605401,meperidine 100 MG/ML Solution 1 mL Vial,67.7,37.24,5.98,105.91,48
NDC,00641606010,midazolam 50 MG/10ML Solution 10 mL Vial,94.27,51.85,0.12,81.54,48
NDC,00641610301,methocarbamol 1000 MG/10ML Solution 10 mL Vial,183.0,100.65,5.63,158.3,48
NDC,00641612701,morphine 10 MG/ML Solution 1 mL Vial,63.15,34.74,3.93,54.62,48
NDC,00641614901,neostigmine 10 MG/10ML Solution 10 mL Vial,88.0,48.4,26.4,76.12,38
NDC,00641615101,HYDROmorphone PF 2 MG/ML Solution 1 mL Vial,69.0,37.95,0.08,59.69,48
NDC,00641616701,amikacin sulfate 500 mg/2 mL Solution 2 mL Vial,81.0,44.55,0.46,70.07,48
NDC,00641616710,amikacin sulfate 500 MG/2ML Solution 2 mL Vial,81.0,44.55,0.46,70.07,48
NDC,00641617401,octreotide 50 MCG/ML Solution 1 mL Vial,58.75,32.32,17.63,50.82,38
NDC,00703001801,HYDROmorphone 500 MG/50ML Solution 50 mL Vial,734.5,403.98,0.08,635.34,48
NDC,00703066601,treprostinil 1 mg/mL Solution 20 mL Vial,6547.16,3600.94,48.04,5663.29,63
NDC,00703069601,treprostinil 10 mg/mL Solution 20 mL Vial,50815.47,27948.51,48.04,43955.38,63
NDC,00703291403,vecuronium Recon Soln 1 Each Vial,69.1,38.01,20.73,59.77,38
NDC,00703342711,ifosfamide 50 mg/mL Solution 20 mL Vial,202.68,111.48,21.52,175.32,48
NDC,00703342911,ifosfamide 50 mg/mL Solution 60 mL Vial,535.34,294.44,21.52,463.07,48
NDC,00703398501,oxaliplatin 50 MG/10ML Solution 10 mL Vial,265.0,145.75,0.06,229.23,96
NDC,00703398501,oxaliplatin 5000 mcg/mL Solution 10 mL Vial,265.0,145.75,0.06,229.23,48
NDC,00703424401,CARBOplatin Solution 5 mL Vial,68.78,37.83,20.63,59.49,38
NDC,00703450201,metoclopramide 5 MG/ML Solution 2 mL Vial,50.14,27.58,0.88,43.37,48
NDC,00703463601,streptozocin 100 mg/mL Recon Soln 1 Each Vial,1671.38,919.26,359.82,1445.74,48
NDC,00703514001,leucovorin 20 mg /mL Recon Soln 1 Each Vial,124.0,68.2,3.57,107.26,48
NDC,00703565601,Etoposide 500 MG/25ML Solution 25 mL Vial,208.6,114.73,0.85,180.44,48
NDC,00703565701,Etoposide 1 GM/50ML Solution 50 mL Vial,387.2,212.96,0.85,334.93,48
NDC,00703951403,sulfamethoxazole/trimethoprim 16 MG/ML Solution 10 mL Vial,101.51,55.84,0.25,87.81,48
NDC,00713050324,hydrocortisone 25 MG Suppos 24 Each Box,35.49,19.52,10.65,30.7,38
NDC,00713052612,promethazine 25 MG Suppos 12 Each Box,32.32,17.78,9.7,27.96,38
NDC,00713053606,promethazine 12.5 MG Suppos 1 Each Box,32.32,17.78,9.7,27.96,38
NDC,00713065615,clobetasol propionate 0.05 % Ointment 15 g Tube,104.0,57.2,31.2,89.96,38
NDC,00713067815,nystatin 100000 UNIT/GM Cream 15 g Tube,65.47,36.01,19.64,56.63,38
NDC,00713068215,gentamicin 0.1 % Ointment 15 g Tube,158.23,87.03,47.47,136.87,38
NDC,00781148601,amitriptyline 10 MG Tab 100 Each Bottle,8.47,4.66,2.54,7.33,38
NDC,00781148701,amitriptyline 25 MG Tab 100 Each Bottle,8.94,4.92,2.68,7.73,38
NDC,00781148801,amitriptyline 50 MG Tab 100 Each Bottle,8.72,4.8,2.62,7.54,38
NDC,00781149001,amitriptyline 100 MG Tab 100 Each Bottle,10.43,5.74,3.13,9.02,38
NDC,00781163501,isosorbide dinitrate 5 MG Tab 100 Each Bottle,9.36,5.15,2.81,8.1,38
NDC,00781187431,amoxicillin/clavulanate 250-125 mg Tab 30 Each Bottle,16.97,9.34,5.09,14.68,38
NDC,00781196260,clarithromycin 500 MG Tab 60 Each Bottle,9.93,5.47,2.98,8.59,38
NDC,00781232206,aprepitant 80 MG Cap 6 Each Box,396.22,217.93,2.46,342.73,48
NDC,00781232306,aprepitant 125 MG Cap 1 Each Blister,616.3,338.97,2.46,533.1,48
NDC,00781305670,isoniazid 100 MG/ML Solution 10 mL Vial,1726.04,949.33,517.81,1493.02,38
NDC,00781311095,piperacillin/tazobactam 2.25 (2-0.25) g Recon Soln 1 Each Vial,50.76,27.92,0.98,43.91,48
NDC,00781312485,nafcillin Recon Soln 1 Each Vial,95.92,52.76,28.78,82.97,38
NDC,00781312646,nafcillin Recon Soln 1 Each Vial,614.51,337.99,0.24,531.55,48
NDC,00781315095,cisatracurium 10 MG/5ML Solution 5 mL Vial,74.0,40.7,22.2,64.01,38
NDC,00781315295,cisatracurium 20 MG/10ML Solution 10 mL Vial,95.0,52.25,28.5,82.18,38
NDC,00781315401,ferumoxytol 510 MG/17ML Solution 17 mL Vial,4004.35,2202.4,0.32,3463.76,63
NDC,00781323394,cycloPHOSphamide 20 mg/mL Recon Soln 1 Each Vial,1346.89,740.79,0.48,1165.06,63
NDC,00781331275,palonosetron 0.25 MG/5ML Solution 5 mL Vial,225.0,123.75,0.51,194.63,48
NDC,00781331495,argatroban 50 mg/50 mL Solution 50 mL Vial,1203.0,661.65,0.69,1040.6,63
NDC,00781340485,ampicillin 1 g Recon Soln 1 Each Vial,73.3,40.32,0.61,63.4,48
NDC,00781340485,ampicillin Recon Soln 1 Each Vial,73.3,40.32,21.99,63.4,38
NDC,00781340778,ampicillin Recon Soln 1 Each Vial,51.4,28.27,0.61,44.46,48
NDC,00781340880,ampicillin 2 g Recon Soln 1 Each Vial,107.1,58.91,0.61,92.64,48
NDC,00781341195,succinylcholine 20 MG/ML Solution 10 mL Vial,144.67,79.57,1.35,125.14,48
NDC,00781348170,tigecycline 50 mg Recon Soln 1 Each Vial,312.0,171.6,0.54,269.88,48
NDC,00781532501,bromocriptine 2.5 MG Tab 100 Each Bottle,19.5,10.73,5.85,16.87,38
NDC,00781557801,entacapone 200 MG Tab 100 Each Bottle,16.48,9.07,4.94,14.26,38
NDC,00781615395,penicillin G sodium 5000000 Units Recon Soln 1 Each Vial,291.47,160.31,87.44,252.12,38
NDC,00781730431,rivastigmine 4.6 mg/24hr/patch PATCH 24 HR 30 Each Box,42.5,23.38,12.75,36.76,38
NDC,00781730931,rivastigmine 9.5 mg/24hr/patch PATCH 24 HR 30 Each Box,42.5,23.38,12.75,36.76,38
NDC,00832022600,morphine sulfate 20 MG CAPSULE SR 24 HR 100 Each Bottle,17.78,9.78,5.33,15.38,38
NDC,00832022700,morphine sulfate 30 MG CAPSULE SR 24 HR 100 Each Bottle,18.56,10.21,5.57,16.05,38
NDC,00832023300,morphine sulfate 100 MG CAPSULE SR 24 HR 100 Each Bottle,25.71,14.15,7.71,22.24,38
NDC,00832031011,valproic acid 250 MG Cap 100 Each Bottle,9.45,5.2,2.84,8.17,38
NDC,00832051100,bethanechol 10 MG Tab 100 Each Bottle,9.05,4.98,2.72,7.83,38
NDC,00832051200,bethanechol 25 MG Tab 100 Each Bottle,9.51,5.24,2.85,8.23,38
NDC,00832058011,cloBAZam 10 MG Tab 100 Each Bottle,11.65,6.41,3.5,10.08,38
NDC,00832059530,exemestane 25 MG Tab 30 Each Bottle,17.0,9.35,5.1,14.71,38
NDC,00832105411,baclofen 2.5 mg half tablet Tab 0.5 tablet Package,8.25,4.54,2.48,7.14,38
NDC,00832105511,baclofen 20 MG Tab 100 Each Bottle,8.76,4.82,2.63,7.58,38
NDC,00832121101,warfarin 1 mg Tab 100 Each Box,9.22,5.08,2.77,7.98,38
NDC,00832121401,warfarin 3 mg Tab 100 Each Box,9.31,5.13,2.79,8.05,38
NDC,00832121501,warfarin 4 mg Tab 100 Each Box,9.31,5.13,2.79,8.05,38
NDC,00832121701,warfarin 6 mg Tab 100 Each Box,8.68,4.78,2.6,7.51,38
NDC,00832121801,warfarin 7.5 mg Tab 100 Each Box,8.74,4.81,2.62,7.56,38
NDC,00832121901,warfarin 10 mg Tab 100 Each Box,8.82,4.86,2.65,7.63,38
NDC,00832125030,ramelteon 8 MG Tab 30 Each Bottle,11.25,6.19,3.38,9.73,38
NDC,00832532411,potassium chloride crys 10 MEQ Tab CR 100 Each Bottle,9.57,5.27,2.87,8.28,38
NDC,00832607311,methIMAzole 10 MG Tab 100 Each Bottle,8.73,4.81,2.62,7.55,38
NDC,00884629730,phenol 89 % SWAB 30 Each Package,12.23,6.73,3.67,10.58,38
NDC,00904027060,vitamin E 100 units Cap 100 Each Bottle,4.08,2.25,1.22,3.53,38
NDC,00904027472,vitamin E 400 units Cap 300 Each Bottle,4.18,2.3,1.25,3.62,38
NDC,00904027746,vitamin E 1000 units Cap 30 Each Bottle,4.56,2.51,1.37,3.94,38
NDC,00904052361,ascorbic acid 500 mg Tab 100 Each Box,8.11,4.47,2.43,7.02,38
NDC,00904053061,multivitamin Tab 100 Each Box,4.14,2.28,1.24,3.58,38
NDC,00904078816,magnesium hydroxide 400 MG/5ML Suspension 473 mL Bottle,18.9,10.4,5.67,16.35,38
NDC,00904198516,acetaminophen 160 MG/5ML Liquid 473 mL Bottle,16.77,9.23,5.03,14.51,38
NDC,00904198880,"acetaminophen 500 MG Tab 1,000 Each Bottle",4.04,2.23,1.21,3.49,38
NDC,00904208560,vitamin A 10000 units Cap 100 Each Bottle,8.14,4.48,2.44,7.04,38
NDC,00904227260,niacin 500 MG Tab 100 Each Bottle,4.12,2.27,1.24,3.56,38
NDC,00904253321,calamine 8-8 % Lotion 177 mL Bottle,24.96,13.73,7.49,21.59,38
NDC,00904386575,sodium chloride 0.65 % Solution 44 mL Bottle,23.23,12.78,6.97,20.09,38
NDC,00904434260,niacin 500 MG Tab CR 100 Each Bottle,8.09,4.45,2.43,7.0,38
NDC,00904531360,prenatal multivitamin 27-0.8 MG Tab 100 Each Bottle,8.11,4.47,2.43,7.02,38
NDC,00904539561,iron polysaccharides 150 MG Cap 100 Each Box,8.42,4.64,2.53,7.28,38
NDC,00904544861,pentoxifylline 400 MG Tab CR 100 Each Box,9.02,4.97,2.71,7.8,38
NDC,00904552952,famotidine 10 MG Tab 60 Each Bottle,8.24,4.54,2.47,7.13,38
NDC,00904561646,co-enzyme Q-10 50 MG Cap 30 Each Bottle,8.67,4.77,2.6,7.5,38
NDC,00904572514,aluminum & magnesium hydroxide/simethicone 400-400-40 MG/5ML Suspension 355 mL Bottle,32.43,17.84,9.73,28.05,38
NDC,00904578017,famotidine 20 MG Tab 25 Each Box,8.57,4.72,2.57,7.41,38
NDC,00904582360,cholecalciferol 400 units Tab 100 Each Bottle,8.05,4.43,2.42,6.96,38
NDC,00904582360,vitamin D3 400 units Tab 100 Each Bottle,8.05,4.43,2.42,6.96,38
NDC,00904585561,ibuprofen 800 MG Tab 100 Each Box,8.25,4.54,2.48,7.14,38
NDC,00904598426,ammonium lactate 12 % Lotion 226 g Bottle,66.6,36.63,19.98,57.61,38
NDC,00904600861,LORazepam 1 MG Tab 100 Each Box,10.23,5.63,3.07,8.85,38
NDC,00904600961,LORazepam 2 MG Tab 100 Each Box,10.27,5.65,3.08,8.88,38
NDC,00904617261,carBAMazepine 200 MG Tab 100 Each Box,9.69,5.33,2.91,8.38,38
NDC,00904630521,phenol throat 1.4 % Liquid 177 mL Bottle,28.67,15.77,8.6,24.8,38
NDC,00904640761,bisacodyl 5 MG Tablet Delayed Response 100 Each Box,4.12,2.27,1.24,3.56,38
NDC,00904641292,calcium carbonate 500 MG Chew Tab 150 Each Bottle,4.07,2.24,1.22,3.52,38
NDC,00904642661,escitalopram 10 MG Tab 100 Each Box,8.5,4.68,2.55,7.35,38
NDC,00904643604,temazepam 7.5 mg Cap 30 Each Box,16.36,9.0,4.91,14.15,38
NDC,00904644961,isosorbide mononitrate 30 MG Tablet Extended Release 24 Hour 100 Each Box,9.25,5.09,2.78,8.0,38
NDC,00904648838,white petrolatum/mineral oil Ointment 3.5 g Tube,38.87,21.38,11.66,33.62,38
NDC,00904655761,morphine sulfate 15 MG Tab CR 100 Each Box,11.4,6.27,3.42,9.86,38
NDC,00904662735,carbamide peroxide 6.5 % Solution 15 mL Bottle,26.62,14.65,7.99,23.03,38
NDC,00904664524,acetaminophen 160 MG Chew Tab 24 Each Box,4.37,2.41,1.31,3.78,38
NDC,00904672559,senna 8.6 MG Tab 100 Each Bottle,4.08,2.25,1.22,3.53,38
NDC,00904672760,pseudoephedrine 30 MG Tab 100 Each Bottle,8.09,4.45,2.43,7.0,38
NDC,00904672852,pseudoephedrine 60 MG Tab 100 Each Bottle,4.21,2.32,1.26,3.64,38
NDC,00904673061,acetaminophen 500 MG Tab 100 Each Box,4.17,2.3,1.25,3.61,38
NDC,00904676520,cetirizine 1 MG/ML Solution 118 mL Bottle,25.77,14.18,7.73,22.29,38
NDC,00904677361,acetaminophen 325 MG Tab 100 Each Box,4.24,2.34,1.27,3.67,38
NDC,00904678370,aspirin 81 MG Tablet Delayed Response 250 Each Bottle,4.05,2.23,1.22,3.5,38
NDC,00904679480,"aspirin 81 MG Chew Tab 1,000 Each Bottle",4.04,2.23,1.21,3.49,38
NDC,00904682960,witch hazel/glycerin Pads 100 Each Box,20.14,11.08,6.04,17.42,38
NDC,00904683620,loperamide 1 MG/7.5ML Solution 120 mL Bottle,20.2,11.11,6.06,17.47,38
NDC,00904686061,divalproex 250 MG Tablet Delayed Response 100 Each Box,8.66,4.77,2.6,7.49,38
NDC,00904686161,divalproex 500 MG Tablet Delayed Response 100 Each Box,8.64,4.76,2.59,7.47,38
NDC,00904701416,acetaminophen 160 MG/5ML Solution 473 mL Bottle,23.16,12.74,6.95,20.03,38
NDC,00904701416,acetaminophen 650 MG/20.3ML Solution 20.3 mL Cup,12.42,6.84,3.73,10.74,38
NDC,00904704161,allopurinol 100 MG Tab 100 Each Box,9.09,5.0,2.73,7.86,38
NDC,00904714461,droNABinol 2.5 MG Cap 100 Each Box,26.84,14.77,1.58,23.22,48
NDC,00904717761,furosemide 20 MG Tab 100 Each Box,8.24,4.54,2.47,7.13,38
NDC,00904723761,diphenhydrAMINE 25 MG Cap 100 Each Box,8.14,4.48,2.44,7.04,38
NDC,00904724361,ciprofloxacin 500 MG Tab 100 Each Box,9.02,4.97,2.71,7.8,38
NDC,00904730561,carvedilol 3.125 MG Tab 100 Each Box,8.3,4.57,2.49,7.18,38
NDC,00904730861,carvedilol 25 MG Tab 100 Each Box,8.3,4.57,2.49,7.18,38
NDC,00904775216,therapeutic hand/body Lotion 473 mL Bottle,33.24,18.29,9.97,28.75,38
NDC,00904791461,ibuprofen 200 MG Tab 100 Each Box,4.3,2.37,1.29,3.72,38
NDC,00942064104,"anticoagulant citrate dextrose formula A Solution 1,000 mL Plas Cont",137.5,75.63,41.25,118.94,38
NDC,00944049505,albumin human 5 % Solution 250 mL Flex Cont,246.0,135.3,45.57,358.29,53
NDC,00944265707,immune globulin 10 % Recon Soln 5 g Vial,23910.1,13150.56,69.92,20682.24,63
NDC,00944265707,immune globulin 5 % Recon Soln 5 g Vial,23910.1,13150.56,69.92,20682.24,63
NDC,00944265908,immune globulin 10 % Recon Soln 10 g Vial,9570.04,5263.53,69.92,8278.08,63
NDC,00944265908,immune globulin 5 % Recon Soln 10 g Vial,9570.04,5263.53,69.92,8278.08,63
NDC,00944270004,immune globulin 10% 5 g/50 mL Solution 50 mL Vial,4729.47,2601.21,39.9,4090.99,63
NDC,00944270004,immune globulin 10% Solution 50 mL Vial,4729.47,2601.21,39.9,4090.99,63
NDC,00944270005,immune globulin 10% 10 g/100 mL Solution 100 mL Glass Cont,9443.94,5194.17,39.9,8169.01,63
NDC,00944270005,immune globulin 10% Solution 100 mL Glass Cont,9443.94,5194.17,39.9,8169.01,63
NDC,00944270006,immune globulin 10% 20 g/200 mL Solution 200 mL Glass Cont,14677.24,8072.49,39.9,12695.81,63
NDC,00944270006,immune globulin 10% Solution 200 mL Glass Cont,14677.24,8072.49,39.9,12695.81,63
NDC,00944270007,immune globulin 10% 30 g/300 mL Solution 300 mL Glass Cont,22010.86,12105.98,39.9,19039.39,63
NDC,00944270007,immune globulin 10% Solution 300 mL Glass Cont,22010.86,12105.98,39.9,19039.39,63
NDC,00944288401,"alpha-1-proteinase inhibitor (human) 1000 MG/50ML Solution 1,000 mg Vial",3579.0,1968.45,2.85,3095.84,63
NDC,00944302602,coagulation factor IX recombinant 250 units Recon Soln 1 Each Vial,32.22,17.73,1.42,28.35,48
NDC,00944303002,coagulation Factor IX recombinant 1000 units Recon Soln 1 Each Vial,32.22,17.73,1.42,28.35,48
NDC,00944303202,coagulation Factor IX recombinant 2000 units Recon Soln 1 Each Vial,32.22,17.73,1.42,28.35,48
NDC,00944305102,antihemophilic factor 10 units/mL Recon Soln 1 Each Vial,32.64,17.96,1.32,28.72,63
NDC,00944500101,antihemophilic factor rpFVIII 500 units Recon Soln 1 Each Vial,36.51,20.09,2.77,32.13,63
NDC,00944500105,antihemophilic factor rpFVIII 500 units Recon Soln 1 Each Vial,36.51,20.09,2.77,32.13,63
NDC,00944500110,antihemophilic factor rpFVIII 500 units Recon Soln 1 Each Vial,45.12,24.82,2.77,39.71,63
NDC,00944755102,Von Willebrand Factor (Recomb) 650 units Recon Soln 1 Each Vial,32.72,18.0,1.58,28.79,63
NDC,00944755302,Von Willebrand Factor (Recomb) 1300 units Recon Soln 1 Each Vial,32.72,18.0,1.58,28.79,63
NDC,00955172720,oxaliplatin 100 MG/20ML Solution 20 mL Vial,500.0,275.0,0.06,432.5,48
NDC,00990771502,mannitol 20% 20 % Solution 250 mL Flex Cont,139.5,76.73,41.85,120.67,38
NDC,00990771503,mannitol 20% 20 % Solution 500 mL Flex Cont,220.75,121.42,66.23,190.95,76
NDC,00990793519,dextrose 20 % Solution 500 mL Flex Cont,253.0,139.15,75.9,218.85,38
NDC,00990798361,NaCl 0.9 % Solution 150 mL Flex Cont,56.5,31.08,16.95,48.87,38
NDC,00998020615,pilocarpine 4 % Solution 15 mL Bottle,339.09,186.5,101.73,293.31,38
NDC,05446125601,oxymetazoline with lidocaine 0.05%-4% Solution 1 mL Syringe,29.37,16.16,8.81,25.41,38
NDC,07006612330,cocoa butter Misc 28.3 g Tube,26.93,14.82,8.08,23.29,38
NDC,08065183055,sodium hyaluronate 10 mg/mL Solution 0.55 mL Syringe,1024.31,563.38,307.29,886.03,38
NDC,08065183150,sodium hyaluron/sodium chondroitin 0.55-0.5 ML Kit 1 Each Syringe,1432.42,787.84,429.73,1239.04,38
NDC,08065183905,sodium chondroitin/sodium hyaluronate 20-15 MG/0.5ML Solution Prefilled Syringe 0.5 mL Syringe,1085.66,597.12,325.7,939.1,38
NDC,08290301029,syringe (disposable) 10 ML Misc 850 Each Box,0.18,0.1,0.05,0.16,38
NDC,08290306547,0.9% NaCl 0.9 % Solution 10 mL Syringe,6.17,3.4,1.85,5.34,38
NDC,08544508321,sodium hyaluronate 23 mg/mL Solution Prefilled Syringe 0.6 mL Syringe,638.7,351.29,191.61,552.48,38
NDC,08544508541,sodium hyaluronate 14 mg/mL Solution Prefilled Syringe 0.85 mL Syringe,805.02,442.77,241.51,696.34,38
NDC,08544636981,sodium hyaluronate 10 mg/mL Solution 0.85 mL Syringe,785.9,432.25,235.77,679.8,38
NDC,09900986000,acetylcysteine 10% 10% Solution 15 mL Bottle,1825.0,1003.75,547.5,1578.63,38
NDC,09997127016,ibuprofen 100 MG/5ML Suspension 40 mL Cup,16.84,9.27,5.05,14.57,38
NDC,09998003101,hydrocortisone 2.5 mg half tablet Tab 0.5 tablet Package,8.57,4.72,2.57,7.41,38
NDC,09998006708,phenytoin 125 MG/5ML Suspension 6 mL Oral Syringe,10.28,5.66,3.08,8.89,38
NDC,09998008216,acyclovir 200 MG/5ML Suspension 10 mL Oral Syringe,29.59,16.28,8.88,25.6,38
NDC,09998127016,ibuprofen 100 MG/5ML Suspension 30 mL Cup,14.63,8.05,4.39,12.65,38
NDC,09998137858,lactulose 10 GM/15ML Solution 45 mL Cup,19.43,10.69,5.83,16.81,38
NDC,09998147340,acetaminophen 500 mg/15.6 mL Solution 15.6 mL Oral Syringe,4.49,2.47,1.35,3.88,38
NDC,09999-0834-03,warfarin 3.75 mg half tablet Tab 0.5 tablet Package,9.65,5.31,2.9,8.35,38
NDC,09999-2127-50,cloNIDine 0.05 mg half tablet Tab 0.5 tablet Package,8.07,4.44,2.42,6.98,38
NDC,09999-9210-00,fluorouracil 10 mg/2 mL Solution 1 Each Syringe,30.35,16.7,9.11,26.25,38
NDC,09999-9210-04,mitoMYcin 0.02% Solution 5 mL Bottle,486.06,267.34,145.82,420.44,38
NDC,09999001829,predniSONE 20 MG Tab 24 tablet Pack,24.24,13.34,0.01,20.97,48
NDC,09999002301,dilTIAZem 15 mg half tablet Tab 0.5 tablet Package,8.5,4.68,2.55,7.35,38
NDC,09999003451,tiZANidine 1 mg Tab 0.5 tablet Package,8.95,4.93,2.69,7.74,38
NDC,09999004601,cortisone 12.5 mg half tablet Tab 0.5 tablet Package,7.76,4.27,2.33,6.71,38
NDC,09999004904,"0.9% NaCl 5 L Solution 5,000 mL Bag",153.75,84.57,46.13,132.99,38
NDC,09999005230,carBAMazepine 50 mg half tablet Chew Tab 0.5 tablet Package,7.79,4.29,2.34,6.74,38
NDC,09999006708,phenytoin 125 MG/5ML Suspension 5 mL Oral Syringe,9.9,5.45,2.97,8.56,38
NDC,09999006801,clonazePAM 0.25 mg half tablet Tab 0.5 tablet Package,10.83,5.96,3.25,9.37,38
NDC,09999007003,gentamicin 14.4 mg/30 mL Solution 30 mL Syringe,501.9,276.05,2.12,434.14,48
NDC,09999008216,acyclovir 200 MG/5ML Suspension 5 mL Oral Syringe,18.3,10.07,5.49,15.83,38
NDC,09999016000,metroNIDAZOLE Solution 10 mg Syringe,30.24,16.64,9.07,26.16,38
NDC,09999016056,ANTIBIOTIC LOCK THERAPY 1 Each Syringe,55.0,30.25,16.5,47.58,38
NDC,09999017105,sotalol 40 mg half tablet Tab 0.5 tablet Package,8.46,4.66,2.54,7.32,38
NDC,09999017675,warfarin 1.25 mg half tablet Tab 0.5 tablet Package,13.66,7.52,4.1,11.82,38
NDC,09999022110,glimepiride 0.5 mg half tablet Tab 0.5 tablet Package,10.99,6.05,3.3,9.51,38
NDC,09999024256,digoxin 62.5 mcg half tablet Tab 0.5 tablet Package,8.64,4.76,2.59,7.47,38
NDC,09999027539,QUEtiapine 12.5 mg half tablet Tab 0.5 tablet Package,13.66,7.52,4.1,11.82,38
NDC,09999032705,entacapone 100 mg half tablet Tab 0.5 tablet Package,16.41,9.03,4.92,14.19,38
NDC,09999043101,felbamate 300 mg half tablet Tab 0.5 tablet Package,53.76,29.57,16.13,46.5,38
NDC,09999054410,docusate sodium 150 MG/15ML Liquid 5 mL Oral Syringe,9.83,5.41,2.95,8.5,38
NDC,09999057616,metoclopramide 5 mg/5 mL Solution 5 mL Oral Syringe,9.02,4.97,2.71,7.8,38
NDC,09999058201,propafenone 75 mg half tablet Tab 0.5 tablet Package,9.51,5.24,2.85,8.23,38
NDC,09999064000,salsalate 500 MG Tab 1 mg Package,25.01,13.76,7.5,21.63,38
NDC,09999064255,lamoTRIgine 100 mg/6 mL Suspension 6 mL Bottle,41.27,22.7,12.38,35.7,38
NDC,09999065705,busPIRone 2.5 mg half tablet Tab 0.5 tablet Package,8.08,4.45,2.42,6.99,38
NDC,09999066200,lamiVUDine 50 mg half tablet Tab 0.5 tablet Package,27.95,15.38,8.39,24.18,38
NDC,09999067005,gemfibrozil 300 mg half tablet Tab 0.5 tablet Package,8.83,4.86,2.65,7.64,38
NDC,09999069000,bupivacaine 0.25% HYDROmorphone 10 mcg/mL in 0.9% NaCL 100 mL 100 mL Cartridge,177.0,97.35,53.1,153.11,38
NDC,09999077101,bisoprolol fumarate 2.5 mg half tablet Tab 0.5 tablet Package,8.33,4.59,2.5,7.21,38
NDC,09999077201,verapamil 60 mg Tab 0.5 tablet Package,8.21,4.52,2.46,7.1,38
NDC,09999083102,warfarin 0.5 mg half tablet Tab 0.5 tablet Package,9.03,4.97,2.71,7.81,38
NDC,09999088001,benzocaine-menthol Lozenge 8 Each Package,8.29,4.56,2.49,7.17,38
NDC,09999092000,phenol 6 % Solution 30 mL Vial,435.0,239.25,130.5,376.28,38
NDC,09999092502,warfarin 1.5 mg half tablet Tab 0.5 tablet Package,9.11,5.02,2.73,7.88,38
NDC,09999094000,barium sulfate Powder 6 g Bottle,259.34,142.64,77.8,224.33,38
NDC,09999096002,coenzyme Q-10 60 MG/ML Suspension 1 mL Oral Syringe,8.89,4.89,2.67,7.69,38
NDC,09999097009,small pill box - 7 day strip Misc 1 Each Box,43.45,23.9,13.04,37.58,38
NDC,09999098000,sulphan blue 1 % Solution 5 mL Vial,180.0,99.0,54.0,155.7,38
NDC,09999099702,fludrocortisone 50 mcg half tablet Tab 0.5 tablet Package,8.65,4.76,2.6,7.48,38
NDC,09999104000,doxycycline monohydrate 100 mg Cap 14 Each Bottle,9.52,5.24,2.86,8.23,38
NDC,09999107810,atenolol 12.5 mg half tablet Tab 0.5 tablet Package,8.06,4.44,2.42,6.97,38
NDC,09999112001,emtricitabine/tenofovir DF 200/300 mg Tab 5 Each Bottle,741.91,408.06,222.57,641.75,38
NDC,09999112009,dolutegravir 50 mg Tab 5 Each Bottle,935.06,514.29,280.52,808.83,38
NDC,09999113289,cyproheptadine 2 mg half tablet Tab 0.5 tablet Package,8.7,4.79,2.61,7.53,38
NDC,09999116019,metroNIDAZOLE 500 mg Tab 14 Each Bottle,9.6,5.28,2.88,8.3,38
NDC,09999117110,captopril 6.25 mg half tablet Tab 0.5 tablet Package,8.52,4.69,2.56,7.37,38
NDC,09999120125,colchicine 0.3 mg half tablet Tab 0.5 tablet Package,7.92,4.36,2.38,6.85,38
NDC,09999121038,tretinoin 5 MG/ML Emulsion 10 mL Oral Syringe,510.23,280.63,153.07,441.35,38
NDC,09999123216,lidocaine/diphenhydrAMINE/alum & mag-simethicone 30 mL Solution 30 mL Cup,23.44,12.9,7.03,20.28,38
NDC,09999127016,ibuprofen 100 MG/5ML Suspension 20 mL Oral Syringe,12.42,6.84,3.73,10.74,38
NDC,09999129005,methocarbamol 250 mg half tablet Tab 0.5 tablet Package,8.24,4.54,2.47,7.13,38
NDC,09999130101,primidone 25 mg half tablet Tab 0.5 tablet Package,8.26,4.55,2.48,7.14,38
NDC,09999138000,norepinephrine 4mg in NaCl 0.9 % 250 mL 16 mcg/mL Solution 250 mL Bag,83.74,46.06,25.12,72.44,38
NDC,09999138010,norepinephrine 16mg in NaCl 0.9 % 250 mL 64 mcg/mL Solution 250 mL Bag,247.0,135.85,74.1,213.66,38
NDC,09999145134,miSOPROStol 25 mcg quarter tablet in gelcap Tab 0.25 tablet,10.14,5.58,3.04,8.77,38
NDC,09999146001,simethicone 40 mg Tab 1 Each Package,8.27,4.55,2.48,7.15,38
NDC,09999146003,"docusate sodium 100 MG Cap 1,000 Each Bottle",8.04,4.43,2.41,6.95,38
NDC,09999147000,loperamide 2 MG Cap 100 Each Bottle,9.21,5.07,2.76,7.97,38
NDC,09999148710,amitriptyline 12.5 mg half tablet Tab 0.5 tablet Package,8.89,4.89,2.67,7.69,38
NDC,09999152002,"metoclopramide 10 MG Tab 1,000 Each Bottle",8.22,4.53,2.47,7.11,38
NDC,09999156210,hydroxychloroquine 100 mg half tablet Tab 0.5 tablet Package,18.76,10.32,5.63,16.23,38
NDC,09999160000,progesterone micronized Cap 1 Each,31.0,17.05,9.3,26.82,38
NDC,09999164000,aspirin Cap 1 mg Package,8.23,4.53,2.47,7.12,38
NDC,09999164005,"acetaminophen 325 MG Tab 1,000 Each Bottle",4.02,2.22,1.21,3.48,38
NDC,09999164006,acetaminophen 500 MG Tab 500 Each Bottle,4.04,2.23,1.21,3.49,38
NDC,09999164007,aspirin 81 MG Chew Tab 36 Each Bottle,4.1,2.26,1.23,3.55,38
NDC,09999164012,aspirin 0.0006 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
NDC,09999164013,aspirin 0.0012 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
NDC,09999164014,aspirin 0.0025 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
NDC,09999164015,aspirin 0.005 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
NDC,09999164016,aspirin 0.01 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
NDC,09999164017,aspirin 0.02 mg Cap 1 capsule Packet,89.56,49.26,26.87,77.47,38
NDC,09999164018,aspirin 0.04 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
NDC,09999164019,aspirin 0.08 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
NDC,09999164020,aspirin 0.15 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
NDC,09999164021,aspirin 0.16 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
NDC,09999164022,aspirin 0.3 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
NDC,09999164023,aspirin 0.6 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
NDC,09999164024,aspirin 1.2 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
NDC,09999164025,aspirin 1.25 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
NDC,09999164026,aspirin 10 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
NDC,09999164027,aspirin 10.1 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
NDC,09999164028,aspirin 165 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
NDC,09999164029,aspirin 2.4 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
NDC,09999164030,aspirin 2.5 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
NDC,09999164031,aspirin 20.25 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
NDC,09999164032,aspirin 40 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
NDC,09999164033,aspirin 40.5 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
NDC,09999164034,aspirin 5 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
NDC,09999164035,aspirin 80 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
NDC,09999164041,aspirin 20 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
NDC,09999164043,aspirin 10 mg/mL Suspension 81 mL Bottle,13.0,7.15,3.9,11.25,38
NDC,09999166000,ibuprofen 200 MG Tab 100 Each Bottle,4.08,2.25,1.22,3.53,38
NDC,09999166001,ibuprofen 400 MG Tab 100 Each Bottle,8.26,4.55,2.48,7.14,38
NDC,09999166002,ibuprofen 600 MG Tab 100 Each Bottle,8.36,4.6,2.51,7.23,38
NDC,09999166003,ibuprofen 800 MG Tab 100 Each Bottle,8.51,4.69,2.55,7.36,38
NDC,09999179000,potassium chloride crys 20 MEQ Tab CR 100 Each Bottle,8.51,4.69,2.55,7.36,38
NDC,09999180689,LORazepam 0.25 mg half tablet Tab 0.5 tablet Package,10.72,5.9,3.22,9.27,38
NDC,09999183001,promethazine 12.5 mg half tablet Tab 1 Each Package,8.23,4.53,0.24,7.12,48
NDC,09999194000,potassium perchlorate 200 mg Cap 1 capsule Package,9.94,5.47,2.98,8.75,38
NDC,09999214605,spironolactone 12.5 mg half tablet Tab 0.5 tablet Package,8.26,4.55,2.48,7.14,38
NDC,09999221000,ruxolitinib 5 mg half tablet Tab 0.5 tablet Package,1413.0,777.15,423.9,1222.25,38
NDC,09999228000,methIMAzole 2.5 mg half tablet Tab 0.5 tablet Packet,8.4,4.62,2.52,7.27,38
NDC,09999233000,metoprolol succinate XL 12.5 mg half tablet Tablet Extended Release 24 Hour 0.5 tablet Packet,8.79,4.84,2.64,7.6,38
NDC,09999236005,losartan 12.5 mg half tablet Tab 0.5 tablet Packet,10.23,5.63,3.07,8.85,38
NDC,09999254001,oxyBUTYnin 2.5 mg half tablet Tab 0.5 tablet Packet,8.8,4.84,2.64,7.61,38
NDC,09999257006,LORazepam (1 mg/mL) Injection 100 mL Bag,271.2,149.16,81.36,234.59,38
NDC,09999258004,traZODone 25 mg half tablet Tab 0.5 tablet Packet,8.41,4.63,2.52,7.27,38
NDC,09999265000,HYDROmorphone 1 mg half tablet Tab 0.5 tablet Packet,10.59,5.83,3.18,9.16,38
NDC,09999265001,traMADol 25 mg half tablet Tab 0.5 tablet Packet,8.18,4.5,2.45,7.08,38
NDC,09999265002,morphine 7.5 mg half tablet Tab 0.5 tablet Package,10.23,5.63,3.07,8.85,38
NDC,09999265004,hydrocodone/acetaminophen 2.5-162.5 (half-tablet) Tab 0.5 tablet Package,10.4,5.72,3.12,9.0,38
NDC,09999265006,buprenorphine 0.5 mg quarter tablet SL Tab 0.25 tablet Package,7.4,4.07,2.22,6.4,38
NDC,09999265007,buprenorphine 1 mg half tablet SL Tab 0.5 tablet Package,7.8,4.29,2.34,6.75,38
NDC,09999272006,cloBAZam 5 mg half tablet Tab 0.5 tablet Package,13.66,7.52,4.1,11.82,38
NDC,09999290880,furosemide 10 mg half tablet Tab 0.5 tablet Package,8.06,4.44,2.42,6.97,38
NDC,09999319101,pyRIDostigmine 30 mg half tablet Tab 0.5 tablet Package,8.8,4.84,2.64,7.61,38
NDC,09999325601,cyclobenzaprine  2.5 mg half tablet Tab 0.5 tablet Package,8.56,4.71,2.57,7.4,38
NDC,09999355347,methadone 50 mg/5 mL Conc 5 mL Plas Cont,10.85,5.97,3.26,9.39,38
NDC,09999356699,midazolam 10 mg/5 mL Syrup 5 mL Oral Syringe,20.57,11.32,6.17,17.79,38
NDC,09999364970,glipiZIDE 2.5 mg half tablet Tab 0.5 tablet Package,9.16,5.04,2.75,7.92,38
NDC,09999365000,traMADol 12.5 mg quarter tablet Tab 0.25 tablet Packet,7.59,4.18,2.28,6.57,38
NDC,09999375760,lisinopril 1.25 mg half tablet Tab 0.5 tablet Package,8.12,4.47,2.44,7.02,38
NDC,09999400148,levETIRAcetam 100 MG/ML Solution 2.5 mL Oral Syringe,21.64,11.91,6.49,18.72,38
NDC,09999400149,levETIRAcetam 100 MG/ML Solution 5 mL Oral Syringe,36.28,19.96,10.88,31.38,38
NDC,09999400150,levETIRAcetam 100 MG/ML Solution 7.5 mL Oral Syringe,50.92,28.01,15.28,44.05,38
NDC,09999401000,amoxicillin/clavulanate 875:125 Suspension 400 mg Oral Syringe,31.76,17.47,9.53,27.47,38
NDC,09999401001,amoxicillin 400 mg/5 mL Recon Susp 250 mg Oral Syringe,26.5,14.58,7.95,22.92,38
NDC,09999403000,clarithromycin Suspension 125 mg Oral Syringe,656.88,361.29,197.06,568.2,38
NDC,09999403001,azithromycin Suspension 250 mg Oral Syringe,71.7,39.44,21.51,62.02,38
NDC,09999404709,carBAMazepine 100 MG/5ML Suspension 40 mL Cup,28.72,15.8,8.62,24.84,38
NDC,09999405000,moxifloxacin Suspension 1 mg Package,25.52,14.04,7.66,22.07,38
NDC,09999405001,levoFLOXacin Suspension 1 mg Package,25.32,13.93,7.6,21.9,38
NDC,09999409001,rifabutin 20 mg/mL Suspension 15 mL Oral Syringe,258.46,142.16,77.54,223.57,38
NDC,09999409004,rifAMPin 25 MG/ML Suspension 120 mL Bottle,107.0,58.85,32.1,92.56,38
NDC,09999411000,amphotericin B 1 mg/mL 1 mg/mL Solution 1 mL Oral Syringe,9.31,5.13,2.79,8.05,38
NDC,09999411001,amphotericin B 50 MCG/5 ML Solution 5 mL Oral Syringe,8.07,4.44,2.42,6.98,38
NDC,09999411007,flucytosine 50 mg/mL Suspension 100 mL Bottle,9265.0,5095.75,2779.5,8014.23,38
NDC,09999413001,hydroxychloroquine 25 mg/mL Liquid 480 mL Bottle,351.73,193.46,105.52,304.25,38
NDC,0999941302,hydroxychloroquine 25 mg/mL Liquid 8 mL Oral Syringe,13.73,7.56,4.12,11.88,38
NDC,09999414508,levOCARNitine 1 GM/10ML Solution 3.3 mL Oral Syringe,11.42,6.29,3.43,9.88,38
NDC,09999416001,atovaquone 750 MG/5ML Suspension 5 mL Oral Syringe,76.88,42.29,23.06,66.5,38
NDC,09999419068,sildenafil 10 mg half tablet Tab 0.5 tablet Package,69.86,38.43,20.96,60.43,38
NDC,09999421009,hydroxyurea 100 mg/mL Suspension 500 mL Bottle,364.66,200.57,109.4,315.43,38
NDC,09999423416,hydrocodone/homatropine 5-1.5 mg/5 mL Solution 5 mL Plas Cont,11.76,6.47,3.53,10.17,38
NDC,09999425960,indapamide 1.25 mg half tablet Tab 0.5 tablet Package,11.98,6.59,3.59,10.36,38
NDC,09999427000,glucose 40 % Gel 1 mL Oral Syringe,8.11,4.47,2.43,7.02,38
NDC,09999433000,atenolol Solution 25 mg Oral Syringe,25.15,13.84,7.55,21.75,38
NDC,09999433001,metoprolol tartrate Solution 1 Each Syringe,8.03,4.42,2.41,6.95,38
NDC,09999434119,levothyroxine 12.5 mcg half tablet Tab 0.5 tablet Package,7.81,4.3,2.34,6.76,38
NDC,09999436000,hydrALAZINE Solution 1 mcg Oral Syringe,8.0,4.4,2.4,6.92,38
NDC,09999436470,labetalol 50 mg half tablet Tab 0.5 tablet Package,8.66,4.77,2.6,7.49,38
NDC,09999436660,labetalol 150 mg half tablet Tab 0.5 tablet Package,8.12,4.47,2.44,7.02,38
NDC,09999437000,bumetanide Solution 1 mg Package,4.75,2.62,1.43,4.11,38
NDC,09999440000,bosentan 6.25 mg/mL Suspension 5 mL Oral Syringe,160.71,88.4,48.21,139.01,38
NDC,09999440001,bosentan 6.25 mg/mL Suspension 10 mL Oral Syringe,609.61,335.29,182.88,527.31,38
NDC,09999440002,bosentan 6.25 mg/mL Suspension 20 mL Oral Syringe,315.42,173.49,94.63,272.84,38
NDC,09999441000,diphenhydrAMINE 12.5 MG/5ML Liquid 5 mL Oral Syringe,4.11,2.27,1.23,3.56,38
NDC,09999443009,hydrocodone/chlorpheniramine 10-8 MG/5ML Suspension Extended Release 5 mL Plas Cont,17.91,9.86,5.37,15.49,38
NDC,09999443010,hydrocodone/chlorpheniramine 10-8 MG/5ML Suspension Extended Release 2.5 mL Plas Cont,12.82,7.06,3.85,11.09,38
NDC,09999446005,magnesium hydroxide 400 MG/5ML Suspension 30 mL Cup,5.62,3.1,1.69,4.86,38
NDC,09999447009,loperamide 1 MG/7.5ML Solution 7.5 mL Oral Syringe,4.95,2.73,1.49,4.28,38
NDC,09999448000,aluminum & magnesium hydroxide/simethicone 200-200-20 mg/ 5 ml Suspension 30 mL Cup,6.7,3.69,2.01,5.8,38
NDC,09999452004,ursodiol 50 MG/ML Suspension 6 mL Oral Syringe,22.48,12.37,6.74,19.45,38
NDC,09999452005,ursodiol 50 MG/ML Suspension 480 mL Bottle,1245.4,684.97,373.62,1077.27,38
NDC,09999452006,ursodiol 60 MG/ML Suspension 120 mL Bottle,316.6,174.13,94.98,273.86,38
NDC,09999452007,ursodiol 60 MG/ML Suspension 5 mL Oral Syringe,19.9,10.95,5.97,17.21,38
NDC,09999460003,midazolam 5 mg/2.5 mL Syrup 2.5 mL Oral Syringe,14.79,8.14,4.44,12.79,38
NDC,09999464005,acetaminophen 40 mg/1.25 mL Solution 1.25 mL Oral Syringe,8.03,4.42,2.41,6.95,38
NDC,09999465007,LORazepam 1 mg/mL Solution 20 mL Bottle,33.67,18.52,10.1,29.12,38
NDC,09999465028,morphine 0.04 mg/0.1 mL Solution 0.1 mL Oral Syringe,9.41,5.18,2.82,8.14,38
NDC,09999465029,morphine 0.06 mg/0.15 mL Solution 0.15 mL Oral Syringe,9.61,5.29,2.88,8.31,38
NDC,09999465030,morphine 0.08 mg/0.2 mL Solution 0.2 mL Oral Syringe,9.82,5.41,2.95,8.49,38
NDC,09999465031,morphine 0.1 mg/0.25 mL Solution 0.25 mL Oral Syringe,10.02,5.52,3.01,8.67,38
NDC,09999465032,morphine 0.12 mg/0.3 mL Solution 0.3 mL Oral Syringe,10.23,5.63,3.07,8.85,38
NDC,09999465033,morphine 0.15 mg/0.375 mL Solution 0.375 mL Oral Syringe,10.53,5.8,3.16,9.11,38
NDC,09999465034,morphine 0.2 mg/0.5 mL Solution 0.5 mL Oral Syringe,11.04,6.08,3.31,9.55,38
NDC,09999465035,morphine 0.25 mg/0.625 mL Solution 0.625 mL Oral Syringe,11.55,6.36,3.47,9.99,38
NDC,09999465036,morphine 0.3 mg/0.75 mL Solution 0.75 mL Oral Syringe,12.06,6.64,3.62,10.43,38
NDC,09999465040,morphine 10 mg/0.5 mL Solution 0.5 mL Plas Cont,10.49,5.77,3.15,9.07,38
NDC,09999465041,morphine 20 mg/1 mL Solution 1 mL Plas Cont,10.98,6.04,3.29,9.5,38
NDC,09999465042,morphine 30 mg/1.5 mL Solution 1.5 mL Plas Cont,11.47,6.31,3.44,9.92,38
NDC,09999465043,morphine 5 MG/0.25ML Solution 0.25 mL Plas Cont,10.25,5.64,3.08,8.87,38
NDC,09999465044,morphine 15 mg/7.5 mL Solution 7.5 mL Plas Cont,12.38,6.81,3.71,10.71,38
NDC,09999465045,morphine 2.5 mg/1.25 mL Solution 1.25 mL Plas Cont,10.4,5.72,3.12,9.0,38
NDC,09999465046,morphine 5 mg/2.5 mL Solution 2.5 mL Plas Cont,10.79,5.94,3.24,9.33,38
NDC,09999465047,oxyCODONE 20 MG/ML Conc 0.5 mL Plas Cont,10.53,5.8,3.16,9.11,38
NDC,09999465050,oxyCODONE 20 mg/1 mL Conc 1 mL Plas Cont,12.06,6.64,3.62,10.43,38
NDC,09999465051,oxyCODONE 30 mg/1.5 mL Conc 1.5 mL Plas Cont,13.59,7.48,4.08,11.76,38
NDC,09999465053,oxyCODONE 5 mg/0.25 mL Conc 0.25 mL Plas Cont,8.09,4.45,2.43,7.0,38
NDC,09999465054,oxyCODONE 2.5 mg/2.5 mL Solution 2.5 mL Plas Cont,10.46,5.76,3.14,9.05,38
NDC,09999470000,ketamine 10 mg/mL *STOCK SUPPLY* Solution 25 mL Bottle,96.31,52.98,28.89,83.31,38
NDC,09999472000,phenytoin 125 MG/5ML Suspension 4 mL Oral Syringe,9.33,5.14,2.8,8.07,38
NDC,09999472001,carBAMazepine 100 MG/5ML Suspension 10 mL Cup,13.18,7.25,3.95,11.4,38
NDC,09999472002,valproic acid 250 MG/5ML Solution 5 mL Oral Syringe,8.43,4.64,2.53,7.29,38
NDC,09999472003,valproic acid 250 MG/5ML Solution 10 mL Oral Syringe,8.86,4.88,2.66,7.66,38
NDC,09999472005,gabapentin 250 MG/5ML Solution 2 mL Oral Syringe,9.31,5.13,2.79,8.05,38
NDC,09999475001,baclofen 5 MG/ML Suspension 50 mL Bottle,50.5,27.78,15.15,43.68,38
NDC,09999477005,phytonadione 1 MG/ML Solution 50 mL Bottle,1535.69,844.63,460.71,1328.37,38
NDC,09999477006,phytonadione 2.5 mg/0.25 mL Solution 0.25 mL Oral Syringe,34.38,18.91,10.31,29.74,38
NDC,09999482001,ferrous sulfate 220 (44 Fe) MG/5ML Solution 7.4 mL Oral Syringe,8.37,4.61,2.51,7.24,38
NDC,09999485000,clopidogrel Solution 1 Each Oral Syringe,23.4,12.87,7.02,20.24,38
NDC,09999485001,pentoxifylline 20 mg/mL Suspension 200 mL Bottle,76.64,42.16,22.99,66.29,38
NDC,09999493000,naltrexone 1 mg/mL Suspension 50 mL Bottle,12.95,7.13,3.89,11.2,38
NDC,09999496050,sertraline 12.5 mg half tablet Tab 0.5 tablet Package,14.24,7.84,4.27,12.32,38
NDC,09999499015,tacrolimus 1 mg/mL Suspension 480 mL Bottle,3275.8,1801.69,982.74,2833.57,38
NDC,09999499016,tacrolimus 1 mg/mL Suspension 1 mL Oral Syringe,13.81,7.6,4.14,11.95,38
NDC,09999499017,tacrolimus 1 mg/mL Suspension 0.5 mL Oral Syringe,13.81,7.6,4.14,11.95,38
NDC,09999499021,sucralfate/diphenhydrAMINE/alum & mag-simethicone Suspension 30 mL Bottle,108.46,59.66,32.54,93.82,38
NDC,09999507701,loratadine 5 mg half tablet Tab 0.5 tablet Package,8.19,4.51,2.46,7.08,38
NDC,09999513503,linezolid 300 mg half tablet Tab 0.5 tablet Package,413.16,227.24,123.95,357.38,38
NDC,09999516000,vancomycin 500mg Recon Soln 1 Each Vial,82.13,45.18,24.64,71.04,38
NDC,09999521610,folic acid 0.5 mg half tablet Tab 0.5 tablet Package,8.26,4.55,2.48,7.14,38
NDC,09999533501,trihexyphenidyl 1 mg half tablet Tab 0.5 tablet Package,8.5,4.68,2.55,7.35,38
NDC,09999545209,sennosides 8.8 MG/5ML Syrup 5 mL Oral Syringe,9.25,5.09,2.78,8.0,38
NDC,09999546003,"lactulose 200 g/1000 mL Enema 1,000 mL Bottle",75.65,41.61,22.7,65.44,38
NDC,09999554405,allopurinol 150 mg half tablet Tab 0.5 tablet Package,8.71,4.8,2.61,7.53,38
NDC,09999573551,nicotine polacrilex 4 MG Gum 10 Each Box,20.82,11.46,6.25,18.01,38
NDC,09999596100,glycerin (rectal) Liquid 1 mL Syringe,4.22,2.33,1.27,3.65,38
NDC,09999640000,treprostinil 0.6 MG/ML Solution 4 Each Pack,2249.94,1237.47,674.98,1946.2,38
NDC,09999643001,acetylcysteine 20 % Solution 2 mL Syringe,16.45,9.05,4.94,14.23,38
NDC,09999650949,vancomycin (oral) 50 MG/ML Recon Soln 2.5 mL Oral Syringe,11.16,6.14,3.35,9.65,38
NDC,09999670000,Sevoflurane Solution 1 Each Package,20.35,11.2,6.11,17.6,38
NDC,09999670001,Desflurane Solution 1 Each Package,7.7,4.24,2.31,6.66,38
NDC,09999670002,Isoflurane Solution 1 Each Package,23.85,13.12,7.16,20.63,38
NDC,09999700002,dexAMETHasone 0.33% and lidocaine 0.1% in ultrasound Gel 250 mL Jar,109.81,60.4,32.94,94.99,38
NDC,09999700004,lidocaine 2% zinc oxide 12% in A&D ointment Ointment 30 g Jar,40.12,22.07,12.04,34.7,38
NDC,09999700012,lidocaine 2% zinc oxide 12% in A&D ointment Ointment 270 g Jar,161.08,88.6,48.32,139.33,38
NDC,09999706819,levothyroxine 62.5 mcg Tab 0.5 tablet Package,11.97,6.59,3.59,10.35,38
NDC,09999717105,traMADol 25 mg half tablet Tab 0.5 tablet Package,8.18,4.5,2.45,7.08,38
NDC,09999732000,nitroglycerin 0.3 % Ointment 30 g Jar,38.68,21.28,11.6,33.46,38
NDC,09999742002,oxymetazoline with lidocaine 0.05%-4% Solution 2 mL Syringe,33.75,18.57,10.13,29.19,38
NDC,09999744000,EPINEPHrine 1 MG/ML Solution 20 mL Syringe,80.4,44.22,24.12,69.55,38
NDC,09999788001,povidone iodine 0.5% Solution 450 mL Bottle,639.03,351.47,191.71,552.76,38
NDC,09999790002,cocaine 10 % Solution 10 mL Bottle,1330.0,731.5,399.0,1150.45,38
NDC,09999792100,phenol 88 % Liquid 2 mL Vial,37.5,20.63,11.25,32.44,38
NDC,0999979300,calcium gluconate 2.5% 2.5 % Gel 25 g Tube,114.5,62.98,34.35,99.04,38
NDC,09999800006,NxStage RFP400 CRRT solution Solution 1 Each Bag,475.54,261.55,142.66,411.34,38
NDC,09999800007,NxStage RFP401 CRRT solution Solution 1 Each Bag,460.0,253.0,138.0,397.9,38
NDC,09999800008,NxStage RFP453 CRRT solution Solution 1 Each Bag,460.0,253.0,138.0,397.9,38
NDC,09999800124,NxStage RFP402 CRRT solution Solution 1 Each Bag,460.0,253.0,138.0,397.9,38
NDC,09999800234,fentaNYL/vecuronium/atropine 25-250-25 mcg/mL Injection 2 mL Syringe,202.4,111.32,60.72,175.08,38
NDC,09999800937,NxStage RFP454 CRRT solution Solution 1 Each Bag,475.54,261.55,142.66,411.34,38
NDC,09999801000,penicillin G potassium 3 million units 3 Solution 3 Million Units Bag,120.45,66.25,36.14,104.19,38
NDC,09999801005,nafcillin 2 g/20mL Solution 1 Each Syringe,167.28,92.01,50.18,144.7,38
NDC,09999801013,penicillin G potassium 4 million units/100 mL Solution 100 mL Bag,97.0,53.35,0.65,83.91,48
NDC,09999802005,ceFAZolin 3 g/50 mL Solution 1 Each Flex Cont,71.98,39.59,0.69,62.26,48
NDC,09999802007,cefTAZidime 2.25 mg/0.05 mL Solution 0.5 mL Syringe,58.75,32.32,17.63,50.82,38
NDC,09999807000,gentamicin 80 mg in NS 30 ml ophthalmic soak syringe 30 mL Syringe,314.88,173.19,94.46,272.37,38
NDC,09999807003,gentamicin (preservative free) neonatal 2 mg/mL Solution 30 mL Vial,570.3,313.67,171.09,493.31,38
NDC,09999808425,azaTHIOprine 25 mg half tablet Tab 0.5 tablet Package,8.65,4.76,1.02,14.45,48
NDC,09999811001,amphotericin 5 mcg/0.05 mL Solution 1 Each Syringe,30.04,16.53,9.01,25.98,38
NDC,09999812001,foscarnet 24 mg/mL Solution 250 mL Glass Cont,808.0,444.4,16.08,698.92,63
NDC,09999816002,vancomycin 1250 mg Solution 250 mL Flex Cont,120.0,66.0,36.0,103.8,38
NDC,09999816003,vancomycin 1500 mg Solution 250 mL Flex Cont,135.04,74.28,40.51,116.81,38
NDC,09999816004,vancomycin 1750 mg Solution 250 mL Flex Cont,136.88,75.29,41.06,118.4,38
NDC,09999816005,vancomycin 2000 MG/250ML Solution 250 mL Flex Cont,136.88,75.29,41.06,118.4,38
NDC,09999816006,sulfamethoxazole-trimethoprim Solution 160 mg Vial,63.08,34.7,18.92,54.56,38
NDC,09999816007,vancomycin 1 mg/0.05 mL Solution 0.5 mL Syringe,97.36,53.55,29.21,84.22,38
NDC,09999816008,vancomycin 1500 mg Solution 500 mL Flex Cont,135.04,74.28,40.51,116.81,38
NDC,09999816009,vancomycin 1750 mg Solution 500 mL Flex Cont,136.88,75.29,41.06,118.4,38
NDC,09999816010,vancomycin 2000 mg Solution 500 mL Flex Cont,136.88,75.29,41.06,118.4,38
NDC,09999816011,vancomycin 500mg/10mL Solution 1 Each Syringe,81.28,44.71,24.38,70.31,38
NDC,09999816015,vancomycin 1250 mg Solution 250 mL Flex Cont,120.0,66.0,36.0,103.8,38
NDC,09999816016,vancomycin 750-0.9 MG/250ML-% Solution 250 mL Flex Cont,127.25,69.99,0.15,110.07,48
NDC,09999816017,vancomycin 750-5 MG/250ML-% Solution 250 mL Flex Cont,127.25,69.99,0.15,110.07,48
NDC,09999821199,bleomycin 1 mg/mL Solution 0.5 mL Syringe,263.64,145.01,17.95,228.05,48
NDC,09999821318,idecabtagene vicleucel 460000000 CELLS Suspension 1 Each Bag,2286275.0,1257451.25,453609.05,3653508.04,63
NDC,09999821375,ciltacabtagene autoleucel 100000000 CELLS Suspension 1 Each Bag,2394750.0,1317112.5,473361.93,3735307.1,63
NDC,09999821440,aldesleukin 500000 units/0.1 mL Solution 0.1 mL Syringe,623.0,342.65,186.9,5619.34,63
NDC,09999821456,pembrolizumab 200 mg 200 mg Solution 58 mL Bag,51852.78,28519.03,49.46,44852.65,63
NDC,09999821457,pembrolizumab 400 mg 400 mg Solution 66 mL Bag,119237.3,65580.52,49.46,103140.26,63
NDC,09999821503,nivolumab Solution 124 mL Flex Cont,37387.48,20563.12,27.74,32340.17,63
NDC,09999821504,nivolumab Solution 148 mL Flex Cont,89147.25,49030.99,27.74,77112.37,63
NDC,09999821586,pembrolizumab 200 mg 200 mg Solution 58 mL Bag,51852.78,28519.03,49.46,44852.65,63
NDC,09999821587,pembrolizumab 400 mg 400 mg Solution 66 mL Bag,119237.3,65580.52,49.46,103140.26,63
NDC,09999822003,dexAMETHasone 12 mg Solution 50 mL Bag,63.68,35.03,0.1,55.08,48
NDC,09999822011,dexAMETHasone 20 mg Solution 50 mL Bag,56.5,31.08,0.1,48.87,48
NDC,09999827007,insulin REGULAR 100 units/100 mL Solution 100 mL Bag,106.45,58.55,31.94,92.08,38
NDC,09999827008,insulin regular 1 unit/mL Solution 5 mL Syringe,76.0,41.8,22.8,65.74,38
NDC,09999829002,oxytocin 30 units in 0.9% NaCl 500 mL Solution 500 mL Flex Cont,134.0,73.7,40.2,115.91,38
NDC,09999830000,vasopressin 20 units in 0.9% NaCl 100 mL infusion 0.2 units/mL Kit 100 mL Pack,16127.5,8870.13,4838.25,13950.29,38
NDC,09999830008,vasopressin 20 units in 0.9% NaCl 100 mL 0.2 units/mL Solution 100 mL Bag,457.37,251.56,1.4,395.63,48
NDC,09999832000,nitroglycerin 0.1 mg/mL Solution 10 mL Syringe,36.56,20.11,10.97,31.62,38
NDC,09999832001,nitroglycerin 0.1 mg/mL Solution 1 mL Syringe,30.02,16.52,9.01,25.97,38
NDC,09999832002,nitroglycerin 0.01 mg/mL Solution 10 mL Syringe,30.22,16.63,9.07,26.14,38
NDC,09999832004,nitroglycerin 0.2 mg/mL Solution 0.5 mL Syringe,30.36,16.7,9.11,26.26,38
NDC,09999832005,nitroglycerin 0.2 mg/mL Solution 5 mL Syringe,33.6,18.48,10.08,29.06,38
NDC,09999834000,niCARdipine 25 mg in 0.9% NaCl 250 mL infusion 100 mcg/mL Kit 250 mL Bag,236.79,130.24,71.04,204.82,38
NDC,09999835000,amiodarone 150 mg in D5W 100 mL infusion 1.5 mg/mL Kit 100 mL Bag,380.63,209.35,114.19,329.24,38
NDC,09999837002,bumetanide 0.2 mg/mL Solution 50 mL Bag,120.0,66.0,0.37,103.8,63
NDC,09999838001,EPINEPHrine 0.3 MG/0.3ML Injection 0.3 mL,35.04,19.28,10.51,30.31,38
NDC,09999838002,EPINEPHrine 0.15 MG/0.15 ML Injection 0.15 mL,32.52,17.89,9.76,28.13,38
NDC,09999838003,phenylephrine 20 mg in NS 250 mL infusion 80 mcg/mL Kit 20 mg Bag,97.7,53.74,29.31,84.51,38
NDC,09999838005,phenylephrine 0.1 mg/mL Solution 5 mL Syringe,57.55,31.66,17.27,49.78,38
NDC,09999844002,EPINEPHrine 50 mcg/mL Injection 2 mL Syringe,108.8,59.84,32.64,94.11,38
NDC,09999849002,atropine 0.4 MG/ML Solution 3 mL Syringe,61.86,34.03,0.1,53.51,48
NDC,09999849003,atropine 0.4 MG/ML Solution 1 mL Syringe,81.0,44.55,0.1,70.07,48
NDC,09999850001,ondansetron 16 mg Solution 50 mL Bag,60.36,33.2,0.08,52.21,48
NDC,09999855324,methadone 2.5 mg half tablet Tab 0.5 tablet Package,10.39,5.72,3.12,8.99,38
NDC,09999856024,BUPivacaine 0.5% w/fentanyl 5 mcg/ml Solution 30 mL Syringe,64.71,35.6,19.41,55.97,38
NDC,09999860003,dexmedetomidine HCl in NaCl 4 mcg/mL Solution Prefilled Syringe 5 mL Syringe,71.41,39.28,21.42,61.77,38
NDC,09999864002,cloNIDine 100 MCG/ML Solution 1 mL Syringe,43.75,24.07,13.13,119.27,48
NDC,09999865007,methadone 2 mg/mL Solution 30 mL,497.22,273.48,149.17,430.1,38
NDC,09999865009,morphine 10 mg/mL Solution 30 mL Syringe,309.8,170.39,92.94,267.98,38
NDC,09999865015,HYDROmorphone 5 mg/mL Solution 30 mL Syringe,418.0,229.9,125.4,361.57,38
NDC,09999865016,morphine 1 mg/mL Solution 30 mL Syringe,99.8,54.89,29.94,86.33,38
NDC,09999865017,morphine 5 mg/mL Solution 30 mL Syringe,119.3,65.62,35.79,103.19,38
NDC,09999865018,remifentanil Recon Soln 0.25 Each Syringe,499.25,274.59,149.78,431.85,38
NDC,09999865023,BUPivacaine 0.5% w/fentanyl 10 mcg/ml Solution 30 mL Syringe,64.71,35.6,19.41,55.97,38
NDC,09999865025,BUPivacaine 0.25% w/fentanyl 5 mcg/ml Solution 30 mL Syringe,64.71,35.6,19.41,55.97,38
NDC,09999865026,BUPivacaine 0.5% w/fentanyl 5 mcg/ml Solution 30 mL Syringe,64.71,35.6,19.41,55.97,38
NDC,09999865027,BUPivacaine 0.125 % w/fentanyl 1 mcg/ml Solution 30 mL Syringe,64.71,35.6,19.41,55.97,38
NDC,09999865032,remifentanil Recon Soln 1 Each Syringe,188.4,103.62,56.52,162.97,38
NDC,09999865043,SUFentanil 5 mcg/mL Solution 50 mL Bag,4602.0,2531.1,1380.6,3980.73,38
NDC,09999865060,fentaNYL 50 mcg/mL Solution 30 mL Syringe,235.0,129.25,70.5,203.28,38
NDC,09999865076,BUPivacaine 0.1 % fentaNYL 2 mcg/mL in 0.9 % NaCL 0.5-0.1-0.9 MG/250ML-% Solution 250 mL Bag,291.0,160.05,87.3,251.72,38
NDC,09999865081,remifentanil 100 mcg/mL Solution 30 mL Syringe,1427.0,784.85,428.1,1234.36,38
NDC,09999865724,oxyCODONE 2.5 mg half tablet Tab 0.5 tablet Package,10.57,5.82,3.17,9.14,38
NDC,09999869002,ROPivacaine 0.2 % Solution 100 mL Cartridge,571.96,314.58,0.05,494.75,48
NDC,09999869003,BUPivacaine 0.125 % Solution 200 mL Bag,78.76,43.32,0.01,68.13,48
NDC,09999869009,"ROPivacaine 0.5% w/EPINEPHrine 1:400,000 Solution 30 mL Vial",145.97,80.29,43.79,126.26,38
NDC,09999869012,"lidocaine 2% w/EPINEPHrine 1:400,000 (PF) Solution 10 mL Vial",75.61,41.59,22.68,65.4,38
NDC,09999869013,"ROPivacaine 0.2 % /EPINEPHrine 1:400,000 0.5%/1:400,000 Solution 20 mL Vial",92.76,51.02,27.83,80.24,38
NDC,09999869015,"BUPivacaine 0.25% w/EPINEPHrine 1:400,000 Solution 30 mL Vial",43.23,23.78,12.97,37.39,38
NDC,09999869016,"BUPivacaine 0.5% w/EPINEPHrine 1:400,000 (PF) Solution 30 mL Vial",45.03,24.77,13.51,38.95,38
NDC,09999869017,BUPivacaine 0.125% Solution 30 mL Syringe,43.23,23.78,12.97,37.39,38
NDC,09999869021,"ROPivacaine 1% w/EPINEPHrine 1:400,000 Solution 20 mL Vial",167.55,92.16,50.27,144.93,38
NDC,09999869022,"lidocaine MPF 2% & sodium bicarb 1 mEq/mL & EPINEPHrine 1:200,000 Solution 10 mL Syringe",73.51,40.44,22.05,63.59,38
NDC,09999869023,"mepivacine 1.5% w/EPINEPHrine 1:400,000 Solution 30 mL Syringe",64.48,35.47,19.34,55.78,38
NDC,09999869028,lidocaine 1 % Solution 30 mL Vial,49.53,27.25,14.86,42.84,38
NDC,09999869034,BUPivacaine 0.125% Solution 10 mL Syringe,34.48,18.97,10.34,29.83,38
NDC,09999869036,BUPivacaine 0.125 % Solution 500 mL Bag,129.41,71.18,38.82,111.94,38
NDC,09999869037,BUPivacaine 0.125 % Solution 700 mL Bag,163.17,89.75,48.95,141.14,38
NDC,09999869046,"lidocaine 1% - EPINEPHrine 1:100,000 buffered in sod bicarbonate injection 1 %-1:100000 Solution Prefilled Syringe 10 mL Syringe",49.75,27.37,14.93,43.03,38
NDC,09999869047,lidocaine 1% buffered with 8.4% sod bicarbonate 1-8.4 % Solution Prefilled Syringe 10 mL Syringe,42.25,23.24,12.68,36.55,38
NDC,09999870002,methohexital 10 mg/mL Solution 10 mL Syringe,165.02,90.77,49.51,142.74,38
NDC,09999870006,ketamine 100 mg in NaCl 0.9 % 50 mL 100 MG/50 ML Solution 50 mL,115.0,63.25,34.5,99.48,38
NDC,09999872000,fosphenytoin 1000 mg PE/120 mL Kit 120 mL,131.37,72.26,39.41,113.64,38
NDC,09999873925,predniSONE 0.5 mg half tablet Tab 0.5 tablet Package,8.74,4.81,2.62,7.56,38
NDC,09999876001,neostigmine 1 MG/ML Solution 5 mL Syringe,301.2,165.66,90.36,260.54,38
NDC,09999879011,sodium acetate Solution 100 mL Vial,239.0,131.45,71.7,206.74,38
NDC,09999879012,"NaCl 0.9 % Solution 1,000 mL Flex Cont",120.0,66.0,36.0,103.8,38
NDC,09999879019,potassium chloride 40 MEQ/20 ML Solution 20 mL Syringe,37.68,20.73,11.3,32.59,38
NDC,09999879023,sodium bicarbonate 1 mEq/mL Solution 1 mL Syringe,31.56,17.36,9.47,27.3,76
NDC,09999879024,NaCl 0.9 % Solution 100 mL Flex Cont,50.3,27.67,15.09,43.51,38
NDC,09999879027,calcium gluconate 2 g/100 mL Solution 2 g Flex Cont,104.45,57.45,31.34,90.35,38
NDC,09999879040,sodium PHOSphate 15 mmol 15 mmol/250 mL Solution 250 mL Flex Cont,108.01,59.41,32.4,93.43,38
NDC,09999879041,sodium PHOSphate 20 mmol 20 mmol/250 mL Solution 250 mL Flex Cont,123.97,68.19,37.19,107.23,38
NDC,09999879042,sodium PHOSphate 25 mmol 25 mmol/250 mL Solution 250 mL Flex Cont,139.87,76.93,41.96,120.99,38
NDC,09999879044,sodium PHOSphate 25 mmol 25 mmol/250 mL Solution 250 mL Bag,139.87,76.93,41.96,120.99,38
NDC,09999879047,potassium PHOSphate 15 mmol in D5W 250 mL Solution 250 mL Flex Cont,113.75,62.57,34.13,98.39,38
NDC,09999879060,NaCl 0.9 % Solution 250 mL Flex Cont,59.75,32.87,17.93,51.68,38
NDC,09999880003,dextrose 5 % Solution 10 mL Syringe,30.16,16.59,9.05,26.09,38
NDC,09999880004,arginine 10 % Solution 15 g Bag,327.0,179.85,98.1,282.86,38
NDC,09999880009,"arginine/lysine 5 % Solution 1,000 mL Flex Cont",1315.0,723.25,394.5,1137.48,38
NDC,09999880010,D5W 0.05 Solution 100 mL Flex Cont,48.9,26.9,14.67,42.3,38
NDC,09999880011,D5W 0.05 Solution 250 mL Flex Cont,56.5,31.08,16.95,48.87,38
NDC,09999880012,dextrose 50 % Solution 50 mL Syringe,82.4,45.32,24.72,71.28,38
NDC,09999882000,iron sucrose Solution 100 mg,425.64,234.11,127.69,368.18,38
NDC,09999883002,heparin 1000 units/mL Solution 1 mL Syringe,31.9,17.55,9.57,27.59,38
NDC,09999883003,heparin DIALYSIS 1000 unit/ml Solution 8 mL Syringe,65.71,36.15,19.71,56.84,38
NDC,09999883009,heparin 5000 UNIT/ML Solution 1.5 mL Syringe,68.68,37.78,0.17,59.41,48
NDC,09999883012,"heparin 5,000 units in NS 1000 mL 5 units/mL Solution 1,000 mL Bag",160.04,88.03,48.01,138.43,38
NDC,09999883013,sodium citrate 4 % Solution 3 mL Syringe,30.26,16.65,9.08,26.17,38
NDC,09999883017,"heparin 5,000 units (10 units/mL) in NaCl 0.9% 500 mL 10 units/mL Solution 500 mL Flex Cont",95.88,52.74,28.76,82.94,38
NDC,09999883018,"heparin 10,000 units (20 units/mL) in NaCl 0.9% 500 mL 20 units/mL Solution 500 mL Flex Cont",95.88,52.74,28.76,82.94,38
NDC,09999883027,"heparin 5,000 units (10 units/mL) in NaCl 0.9% 500 mL 10 units/mL Solution 500 mL Flex Cont",95.88,52.74,28.76,82.94,38
NDC,09999885003,alteplase 0.5 mg/2 mL Solution 0.01 Each Syringe,18490.76,10169.92,78.54,15994.51,63
NDC,09999885026,alteplase 2 MG/2 ML Solution 2 mg Syringe,965.44,531.0,78.54,835.11,63
NDC,09999885027,alteplase 12.5 mcg/0.1 mL Solution 1 Each Syringe,341.1,187.61,102.33,295.05,38
NDC,09999886001,fluorescein 10 % Solution 0.2 mL Syringe,46.6,25.63,13.98,40.31,38
NDC,09999894002,adenosine diagnostic 3 MG/ML Solution 40 mL Vial,2366.59,1301.63,0.28,2047.1,48
NDC,09999894007,technetium Tc-99m bicisate Kit 25 millicurie,4301.11,2365.62,683.8,3784.98,63
NDC,09999894021,sodium iodide I-123 Cap 0.99 millicurie,236.0,129.8,70.8,207.68,48
NDC,09999894025,sodium iodide I-131 Cap 1 millicurie,144.95,79.73,23.13,127.56,63
NDC,09999894027,iodinated I-125 albumin Kit 5 microcurie(s),2031.1,1117.11,609.33,1787.37,48
NDC,09999894028,technetium Tc-99m tilmanocept Kit 0.5 millicurie,1508.5,829.68,452.55,1327.48,48
NDC,09999894030,technetium Tc-99m pentetate Kit 25 millicurie,296.29,162.96,88.89,260.74,48
NDC,09999894036,sodium chromate Cr-51 Kit 250 millicurie,1436.95,790.33,431.09,1264.52,48
NDC,09999894037,sodium fluorine F-18 Kit 30 millicurie,632.62,347.95,189.79,556.71,48
NDC,09999894038,ammonia N-13 Kit 40 millicurie,1286.8,707.74,386.04,1132.38,48
NDC,09999894039,technetium Tc-99m pertechnetate Kit 1 millicurie,20.35,11.2,6.11,17.91,48
NDC,09999894053,sodium iodide I-123 Cap 1 millicurie,236.0,129.8,70.8,207.68,48
NDC,09999898001,sterile water for injection (PF) Solution 2.2 mL Syringe,36.14,19.88,10.84,31.26,38
NDC,09999899000,"belzer-mps Solution 1,000 mL Flex Cont",3326.0,1829.3,997.8,2876.99,38
NDC,09999899002,antithymocyte globulin (horse) (ATG) skin test Solution 0.2 mL Syringe,1108.24,609.54,332.47,958.63,38
NDC,09999899913,tacrolimus Solution 100 mL Vial,2607.0,1433.85,218.66,2255.06,63
NDC,09999899914,tacrolimus Solution 50 mL Vial,1311.0,721.05,218.66,1770.05,63
NDC,09999902001,ceFAZolin Solution 0.5 mL Syringe,41.43,22.79,12.43,35.84,38
NDC,09999902002,cefTAZidime 5 % Solution 10 mL Bottle,148.55,81.71,44.57,128.5,38
NDC,099999063302,lamoTRIgine 12.5 mg half tablet Tab 0.5 tablet Package,35.0,19.25,10.5,30.28,38
NDC,09999911000,voriconazole 25 mcg/0.1 mL Solution 1 Each Syringe,376.8,207.24,113.04,325.93,38
NDC,09999911001,voriconazole 50 mcg/0.05 mL Solution 1 Each Syringe,281.1,154.61,84.33,243.15,38
NDC,09999911003,voriconazole 50 mcg/0.1 ml Solution 1 Each Syringe,376.8,207.24,113.04,325.93,38
NDC,09999912100,ganciclovir 2 mg/0.05 ml Injection 1 Each Syringe,368.4,202.62,110.52,318.67,38
NDC,09999912101,ganciclovir 3 mg/0.1 ml Injection 1 Each Syringe,368.4,202.62,110.52,318.67,38
NDC,09999912102,foscarnet 2.4 mg/0.1 mL Solution 0.1 mL Syringe,45.36,24.95,13.61,105.17,63
NDC,09999913901,pyridoXINE 25 mg half tablet Tab 0.5 tablet Package,8.04,4.43,2.41,6.95,38
NDC,09999916001,ceFAZolin 5 % Solution 15 mL Bottle,31.27,17.2,9.38,27.05,38
NDC,09999916003,vancomycin 2.5% Solution 10 mL Bottle,99.7,54.84,29.91,86.24,38
NDC,09999916005,vancomycin Solution 1 Each Syringe,82.13,45.18,24.64,71.04,38
NDC,09999916007,ceFAZolin Solution 1 Each Syringe,41.43,22.79,12.43,35.84,38
NDC,09999921006,fluorouracil 1.25 mg/0.5 mL Solution 1 Each Syringe,30.35,16.7,1.91,26.25,48
NDC,09999921007,methotrexate 400mcg/0.1 mL Solution 0.1 mL Syringe,30.94,17.02,9.28,26.76,38
NDC,09999921008,riTUXimab-pvvr 1 mg/0.1 mL Solution 0.5 mL Syringe,198.45,109.15,20.26,178.88,63
NDC,09999922204,isosorbide mononitrate CR 15 mg half tablet Tablet Extended Release 24 Hour 0.5 tablet Package,8.94,4.92,2.68,7.73,38
NDC,09999925101,theophylline CR (24-hour) 200 mg Tablet Extended Release 24 Hour 0.5 tablet Package,11.55,6.36,3.47,9.99,38
NDC,09999946701,propranolol 5 mg half tablet Tab 0.5 tablet Package,8.45,4.65,2.54,7.31,38
NDC,09999968000,glycerin 99.5% (sterile) Solution 10 mL Vial,405.0,222.75,121.5,350.33,38
NDC,09999968001,glycerin 99% (sterile) Solution 10 mL Vial,470.4,258.72,141.12,406.9,38
NDC,09999986001,acetylcysteine 5% 5% Solution 15 mL Bottle,160.6,88.33,48.18,138.92,38
NDC,09999986003,amphotericin B 0.3% Solution 5 mL Bottle,151.36,83.25,45.41,130.93,38
NDC,09999986007,gentamicin 1.4 % Solution 7 mL Bottle,125.98,69.29,37.79,108.97,38
NDC,09999986008,gentamicin 1.5 % Solution 10 mL Bottle,97.51,53.64,29.25,84.35,38
NDC,09999986010,fluorescein 2 % Solution 2 mL Bottle,38.92,21.41,11.68,33.67,38
NDC,09999986011,cycloSPORINE 0.05 % Emulsion 1 Each Ampule,35.05,19.28,10.52,30.32,38
NDC,09999986013,ketorolac 0.5 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
NDC,09999986015,brimonidine 0.15 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
NDC,09999986016,cyclopentolate 1 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
NDC,09999986017,dorzolamide 2 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
NDC,09999986018,homatropine 5 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
NDC,09999986019,moxifloxacin 0.5 % Solution 1 mL Package,25.0,13.75,7.5,21.63,38
NDC,09999986020,phenylephrine 2.5 % Solution 1 mL Package,25.0,13.75,7.5,21.63,38
NDC,09999986021,timolol 0.25 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
NDC,09999986022,timolol 0.5 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
NDC,09999986023,trimethoprim/polymyxin B 10000-0.1 UNIT/ML-% Solution 1 mL Package,10.0,5.5,3.0,8.65,38
NDC,09999986024,tropicamide 1 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
NDC,09999986025,pilocarpine 2 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
NDC,09999986026,pilocarpine 4 % Solution 1 mL Package,25.0,13.75,7.5,21.63,38
NDC,09999986027,latanoprost 0.005 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
NDC,09999986028,fluorescein 2 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
NDC,09999986031,cycloSPORINE 0.1 % Solution 5 mL Bottle,4525.0,2488.75,1357.5,3914.13,38
NDC,09999986032,acetylcysteine 10% 10% Solution 5 mL Bottle,4525.0,2488.75,1357.5,3914.13,38
NDC,09999986033,cycloSPORINE 0.1 % Solution 15 mL Bottle,1825.0,1003.75,547.5,1578.63,38
NDC,09999986034,tacrolimus 0.02 % Solution 5 mL Bottle,4525.0,2488.75,1357.5,3914.13,38
NDC,09999986035,tacrolimus 0.02 % Solution 15 mL Bottle,1825.0,1003.75,547.5,1578.63,38
NDC,09999986048,fluorescein 2 % Solution 0.2 mL Syringe,52.84,29.07,15.85,45.71,38
NDC,09999986060,acetylcysteine 10% 10% Solution 15 mL Bottle,1675.0,921.25,502.5,1448.88,38
NDC,09999986064,amphotericin B 0.15% Solution 10 mL Bottle,287.2,157.96,86.16,248.43,38
NDC,09999996002,edetate 2% Solution 10 mL,486.25,267.44,145.88,420.61,38
NDC,10006070012,pyridoXINE 50 MG Tab 100 Each Bottle,8.06,4.44,2.42,6.97,38
NDC,10006070020,niacin 250 MG Cap CR 100 Each Bottle,8.29,4.56,2.49,7.17,38
NDC,10006070028,magnesium oxide 200 mg half tablet Tab 0.5 tablet Package,4.16,2.29,1.25,3.6,38
NDC,10019007587,"esmolol in sodium chloride 2,000 mg/100 mL Solution 100 mL Flex Cont",1773.65,975.51,0.18,1534.21,48
NDC,10019036040,Isoflurane Solution 100 mL Bottle,104.0,57.2,31.2,89.96,38
NDC,10019064134,Desflurane Solution 240 mL Bottle,160.32,88.18,48.1,138.68,38
NDC,10019095301,mesna 100 MG/ML Solution 10 mL Vial,147.5,81.13,1.35,127.59,48
NDC,10019095501,cycloPHOSphamide 20 mg/ml Recon Soln 1 Each Vial,1751.38,963.26,525.41,1514.94,48
NDC,10019095616,cycloPHOSphamide 20 mg/ml Recon Soln 1 Each Vial,2236.56,1230.11,0.48,1934.62,63
NDC,10019095701,cycloPHOSphamide 20 mg/ml Recon Soln 1 Each Vial,6617.5,3639.63,0.48,5724.14,63
NDC,10119000252,eye irrigating Solution 118 mL Bottle,20.0,11.0,6.0,17.3,38
NDC,10122016002,pegunigalsidase alfa-iwxj 20 mg/10 mL Solution 10 mL Vial,18610.54,10235.8,194.72,16098.12,63
NDC,10122051001,poractant alfa 120 MG/1.5ML Suspension 1.5 mL Vial,3249.39,1787.17,974.82,2810.72,38
NDC,10122051001,poractant alfa 80 MG/ML Suspension 1.5 mL Vial,3249.39,1787.17,974.82,2810.72,38
NDC,10122051003,poractant alfa 240 MG/3ML Suspension 3 mL Vial,6392.83,3516.06,1917.85,5529.8,38
NDC,10122051003,poractant alfa 80 MG/ML Suspension 3 mL Vial,6392.83,3516.06,1917.85,5529.8,38
NDC,10122061001,clevidipine 25 MG/50ML Emulsion 50 mL Vial,367.6,202.18,110.28,317.97,38
NDC,10122062001,cangrelor 200 mcg/mL Injection 250 mL Bag,3808.39,2094.62,16.16,3294.26,63
NDC,10122062010,cangrelor 50 MG Recon Soln 1 Each Vial,5421.47,2981.81,16.16,4689.57,63
NDC,10135070104,menthol-zinc oxide 0.44-20.6 % Ointment 113 g Tube,31.47,17.31,9.44,27.22,38
NDC,10223020103,butamben/tetracaine/benzocaine 2-2-14 % Aerosol 20 g Bottle,385.35,211.95,115.61,333.33,38
NDC,10223020104,butamben/tetracaine/benzocaine 2-2-14 % Aerosol 5 g Bottle,180.15,99.09,54.05,155.83,38
NDC,10361079301,sod bicarbonate/citric acid/simethicone 2.21-1.53-0.04 g Pack 50 Each Box,12.77,7.03,3.83,11.05,38
NDC,10370083009,dilTIAZem 180 MG CAPSULE SR 24 HR 90 Each Bottle,9.81,5.4,2.94,8.49,38
NDC,10454071010,rimabotulinumtoxinB 2500 UNIT/0.5ML Solution 0.5 mL Vial,1729.72,951.35,11.57,1496.21,63
NDC,10454071110,rimabotulinumtoxinB 5000 UNIT/ML Solution 1 mL Vial,3444.43,1894.44,11.57,2979.43,63
NDC,10454071210,rimabotulinumtoxinB 10000 UNIT/2ML Solution 2 mL Vial,6873.86,3780.63,11.57,5945.89,63
NDC,10481011208,monsels ferric subsulfate Solution 8 mL Bottle,71.04,39.08,21.31,61.45,38
NDC,10511300102,hexaminolevulinate 100 mg Recon Soln 1 Each Vial,5494.4,3021.92,1648.32,9614.23,48
NDC,10572010001,"polyethylene glycol/electrolytes Recon Soln 4,000 mL Bottle",104.0,57.2,31.2,89.96,38
NDC,10599000301,mometasone furoate 1350 MCG Implant 1 Each Box,3543.44,1948.9,9.75,3065.08,63
NDC,10702007501,methylphenidate HCl 10 MG Tab CR 100 Each Bottle,11.25,6.19,3.38,9.73,38
NDC,10702010101,methylphenidate 10 MG Tab 100 Each Bottle,10.55,5.81,3.17,9.13,38
NDC,10702025301,butalbital/acetaminophen/caffeine 50-325-40 mg Tab 100 Each Bottle,10.47,5.76,3.14,9.06,38
NDC,11509004460,pyrithione zinc 1 % Shampoo 118 mL Bottle,28.64,15.76,8.59,24.77,38
NDC,11701006723,miconazole 2 % Ointment 57 g Tube,45.74,25.16,13.72,39.57,38
NDC,11980002205,sulfacetamide/prednisoLONE 10-0.2 % Suspension 5 mL Bottle,536.3,294.97,160.89,463.9,38
NDC,11980017405,prednisoLONE acetate 0.12 % Suspension 5 mL Bottle,536.3,294.97,160.89,463.9,38
NDC,11994012106,gallium citrate Ga-67 2 MCI/ML Solution 1 millicurie,98.37,54.11,29.51,86.57,48
NDC,11994012711,xenon Xe-133 gas 10 MCI Gas 10 millicurie,219.75,120.87,65.93,193.38,48
NDC,11994042726,thallous chloride Tl-201 2 MCI/ML Solution 1 millicurie,264.21,145.32,79.26,232.5,48
NDC,12547017162,diphenhydrAMINE/zinc acetate Cream 28.3 g Tube,32.58,17.92,9.77,28.18,38
NDC,12870000101,silver nitrate/potassium nitrate 75-25 % Misc 1 Each Package,9.27,5.1,2.78,8.02,38
NDC,13107003501,dextroamphetamine 5 MG Tab 100 Each Bottle,11.08,6.1,3.32,9.58,38
NDC,13517010716,PHENobarbital 20 mg/5 mL Elixir 10 mL Oral Syringe,13.65,7.51,4.1,11.81,38
NDC,13517010716,PHENobarbital 20 mg/5 mL Elixir 473 mL Bottle,182.65,100.46,54.8,157.99,38
NDC,13517011301,PHENobarbital 97.2 MG Tab 100 Each Bottle,12.13,6.68,3.64,10.49,38
NDC,13533013101,tetanus/diphtheria toxoids (Td) 2-2 LF/0.5ML Suspension 0.5 mL Vial,108.75,59.82,28.75,245.5,38
NDC,13533031801,Rabies Immune Globulin 300 UNIT/ML Solution 1 mL Vial,3689.7,2029.34,240.72,3191.59,53
NDC,13533031805,Rabies Immune Globulin 1500 UNIT/5ML Solution 5 mL Vial,14300.37,7865.21,240.72,12369.82,53
NDC,13533060320,antithrombin III human 500 units Recon Soln 1 Each Vial,41.89,23.04,3.4,36.23,63
NDC,13533061325,plasma protein fraction 5 % Solution 250 mL Vial,333.0,183.15,99.9,288.05,38
NDC,13533061802,rabies immune globulin 300 UNIT/2ML Solution 2 mL Vial,3635.38,1999.46,240.72,3144.6,53
NDC,13533063402,tetanus immune globulin 250 UNIT/ML Solution Prefilled Syringe 1 mL Syringe,3520.52,1936.29,491.18,3895.09,63
NDC,13533063603,hepatitis B immune globulin 110 UNIT/0.5ML Solution Prefilled Syringe 0.5 mL Syringe,545.7,300.14,163.71,472.03,38
NDC,13533068520,albumin human 5 % Solution 50 mL Vial,183.0,100.65,45.57,358.29,53
NDC,13533070501,"alpha-1-proteinase inhibitor (human) 1000 MG Solution 1,000 mg Vial",3201.0,1760.55,2.6,2768.87,63
NDC,13533080020,immune globulin 10 % Solution 50 mL Vial,3957.0,2176.35,42.08,3422.81,63
NDC,13533080020,immune globulin 10% 5 g/50 mL Solution 50 mL Vial,3957.0,2176.35,42.08,3422.81,63
NDC,13533080024,immune globulin 10 % Solution 200 mL Vial,12274.0,6750.7,42.08,10617.01,63
NDC,13533080024,immune globulin 10% 20 g/200 mL Solution 200 mL Vial,12274.0,6750.7,42.08,10617.01,63
NDC,13533080040,immune globulin 10% 40 g/400 mL Solution 400 mL Vial,24538.0,13495.9,42.08,21225.37,63
NDC,13533080071,immune globulin 10 % Solution 100 mL Vial,7899.0,4344.45,42.08,6832.64,63
NDC,13533080071,immune globulin 10% 10 g/100 mL Solution 100 mL Vial,7899.0,4344.45,42.08,6832.64,63
NDC,13668000901,citalopram 10 MG Tab 100 Each Bottle,8.19,4.51,2.46,7.08,38
NDC,13668000901,citalopram 5 mg half tablet Tab 0.5 tablet Package,8.09,4.45,2.43,7.0,38
NDC,13668001001,citalopram 20 MG Tab 100 Each Bottle,8.17,4.5,2.45,7.07,38
NDC,13668001101,citalopram 40 MG Tab 100 Each Bottle,8.19,4.51,2.46,7.08,38
NDC,13668009190,pramipexole 0.125 MG Tab 90 Each Bottle,8.49,4.67,2.55,7.34,38
NDC,13668009290,pramipexole 0.25 MG Tab 90 Each Bottle,8.49,4.67,2.55,7.34,38
NDC,13668009390,pramipexole 0.5 MG Tab 90 Each Bottle,8.49,4.67,2.55,7.34,38
NDC,13668009490,pramipexole 1 MG Tab 90 Each Bottle,8.49,4.67,2.55,7.34,38
NDC,13668010290,donepezil 5 MG Tab 90 Each Bottle,8.5,4.68,2.55,7.35,38
NDC,13668013201,felodipine 2.5 MG Tablet Extended Release 24 Hour 100 Each Bottle,9.25,5.09,2.78,8.0,38
NDC,13668045301,anagrelide 0.5 MG Cap 100 Each Bottle,9.5,5.23,2.85,8.22,38
NDC,13668046201,anagrelide 1 MG Cap 100 Each Bottle,12.37,6.81,3.71,10.7,38
NDC,14789011605,erythromycin lactobionate 500 mg Recon Soln 1 Each Vial,1095.0,602.25,53.35,947.18,48
NDC,15054004301,irinotecan liposome 43 MG/10ML Injection 10 mL Vial,12829.7,7056.34,55.13,11097.69,63
NDC,15054050001,abobotulinumtoxinA 500 units Recon Soln 1 Each Vial,4769.7,2623.34,7.6,4125.79,63
NDC,15054053006,abobotulinumtoxinA 300 units Recon Soln 1 Each Vial,2868.9,1577.9,7.6,2481.6,63
NDC,15054106004,lanreotide acetate 60 MG/0.2ML Solution 0.2 mL Syringe,25579.6,14068.78,34.05,22126.35,63
NDC,15054109004,lanreotide acetate 90 MG/0.3ML Solution 0.3 mL Syringe,34063.6,18734.98,34.05,29465.01,63
NDC,15054112004,lanreotide acetate 120 MG/0.5ML Solution 0.5 mL Syringe,40170.4,22093.72,34.05,34747.4,63
NDC,16477073801,hyoscyamine sulfate 0.375 MG TABLET SR 12 HR 100 Each Bottle,8.99,4.95,2.7,7.78,38
NDC,16571067101,PHENobarbital 16.2 MG Tab 100 Each Bottle,10.23,5.63,3.07,8.85,38
NDC,16571067301,PHENobarbital 32.4 MG Tab 100 Each Bottle,10.38,5.71,3.11,8.98,38
NDC,16571072360,mafenide 85 MG/GM Cream 56.7 g Tube,250.32,137.68,75.1,216.53,38
NDC,16571074309,glycopyrrolate 1 MG Tab 90 Each Bottle,8.44,4.65,2.53,7.3,38
NDC,16571075809,nateglinide 60 MG Tab 90 Each Bottle,9.65,5.31,2.9,8.35,38
NDC,16571081320,calcium acetate 667 MG Cap 200 Each Bottle,8.83,4.86,2.65,7.64,38
NDC,16714077501,felbamate 600 MG/5ML Suspension 237 mL Bottle,1542.05,848.13,462.62,1333.87,38
NDC,16714085001,clomiPRAMINE 50 MG Cap 30 Each Bottle,30.92,17.01,9.28,26.75,38
NDC,16729010811,mitoMYcin 20 MG Recon Soln 1 Each Vial,2868.91,1577.91,20.35,2481.61,63
NDC,16729011431,etoposide 100 MG/5ML Solution 5 mL Vial,78.41,43.13,0.85,67.82,48
NDC,16729013600,clonazePAM 0.5 mg Tab 100 Each Bottle,10.07,5.54,3.02,8.71,38
NDC,16729021301,doxazosin 4 MG Tab 100 Each Bottle,8.87,4.88,2.66,7.67,38
NDC,16729026765,DOCEtaxel 160 MG/8ML Conc 8 mL Vial,892.92,491.11,0.62,772.38,48
NDC,16729027567,bivalirudin Recon Soln 1 Each Vial,444.51,244.49,0.14,384.5,48
NDC,16729027730,methotrexate (preservative free) 50 MG/2ML Solution 2 mL Vial,49.88,27.44,2.89,43.15,48
NDC,16729027735,methotrexate (preservative free) 1 GM/40ML Solution 40 mL Vial,204.09,112.25,61.23,176.54,48
NDC,16729029805,ondansetron 40 MG/20ML Solution 20 mL Vial,63.5,34.93,0.08,54.93,48
NDC,16729043630,fulvestrant 250 MG/5ML Solution Prefilled Syringe 5 mL Syringe,793.75,436.57,5.72,686.59,63
NDC,16729044410,buPROPion HCl 300 MG Tablet Extended Release 24 Hour 30 Each Bottle,8.53,4.7,2.56,7.38,38
NDC,16864068003,benzocaine-menthol 20-0.5 % Aerosol 85 g Can,40.23,22.13,12.07,34.8,38
NDC,17156002101,indium In-111 oxyquinoline associated WBCs Kit 1 millicurie,5950.78,3272.93,1031.39,5236.69,63
NDC,17156002305,technetium Tc-99m exametazime Kit 25 millicurie,4810.6,2645.83,802.34,4233.33,63
NDC,17156002630,technetium Tc-99m tetrofosmin Kit 33 millicurie,483.81,266.1,145.14,425.75,48
NDC,17156021001,ioflupane I-123 185 MBQ/2.5ML Solution 5 millicurie,4166.14,2291.38,1249.84,3666.2,63
NDC,17156023501,iobenguane I-123 10 MCI/5ML Solution 15 millicurie,10867.0,5976.85,1781.43,9562.96,63
NDC,17156025108,indium In-111 pentetate disodium Solution 0.5 millicurie,2845.9,1565.25,715.29,2504.39,63
NDC,17156052501,technetium Tc-99m dimercaptosuccinic acid Kit 10 millicurie,2578.75,1418.32,773.63,2269.3,48
NDC,17204043440,magnesium plus protein (amino acid chelate) 133 MG Tab 100 Each Bottle,8.2,4.51,2.46,7.09,38
NDC,17238050105,fluorescein-benoxinate Solution 5 mL Bottle,42.93,23.62,12.88,37.13,38
NDC,17238090011,fluorescein 1 MG Strip 100 Each Box,20.74,11.41,6.22,17.94,38
NDC,17433987603,docusate sodium 283 mg Enema 5 mL Tube,14.15,7.79,4.25,12.24,38
NDC,17433987703,benzocaine/docusate sodium 20-283 MG Enema 5 mL Box,14.15,7.79,4.25,12.24,38
NDC,17478005005,SUFentanil 250 MCG/5ML Solution 5 mL Ampule,180.0,99.0,54.0,155.7,38
NDC,17478006235,white petrolatum/mineral oil Ointment 3.5 g Tube,44.46,24.46,13.34,38.46,38
NDC,17478006412,hypromellose 2.5 % Solution 15 mL Bottle,87.78,48.28,26.33,75.93,38
NDC,17478007031,erythromycin 5 MG/GM Ointment 1 g Tube,28.07,15.44,8.42,24.28,38
NDC,17478010112,tropicamide 0.5 % Solution 15 mL Bottle,47.98,26.39,14.39,41.5,38
NDC,17478020605,phenylephrine 10 % Solution 5 mL Bottle,160.0,88.0,48.0,138.4,38
NDC,17478025310,fluorescein 10 % Solution 5 mL Vial,447.0,245.85,134.1,386.66,38
NDC,17478040303,fluorescein 0.6 MG Strip 300 Each Box,20.42,11.24,6.13,17.66,38
NDC,17478050401,methylene blue 1 % Solution 1 mL Vial,136.34,74.99,7.64,117.93,63
NDC,17478054005,HYDROmorphone 50 MG/5ML Solution 5 mL Ampule,88.9,48.9,0.08,76.9,48
NDC,17478062235,sodium chloride (hypertonic) 5 % Ointment 3.5 g Tube,56.64,31.16,16.99,48.99,38
NDC,17478071110,lidocaine 2 % Gel 5 mL Tube,44.5,24.48,13.35,38.49,38
NDC,17478071130,lidocaine 2 % Gel 30 mL Tube,362.59,199.43,108.78,313.64,38
NDC,17856021108,acetaminophen 160 MG/5ML Solution 31.25 mL Cup,11.88,6.54,3.56,10.28,38
NDC,17856198602,acetaminophen 160 MG/5ML Solution 15.6 mL Cup,9.9,5.45,2.97,8.56,38
NDC,17856198602,acetaminophen 500 mg/15.6 mL Solution 15.6 mL Cup,9.9,5.45,2.97,8.56,38
NDC,18582001132,hypochlorous acid 0.024 % Solution 500 mL Bottle,119.96,65.98,35.99,103.77,38
NDC,18657011701,hyaluronidase human 150 units/mL Solution 1 mL Vial,349.8,192.39,0.32,302.58,48
NDC,20451087121,lanolin Cream 0.3 oz Box,20.23,11.13,6.07,17.5,38
NDC,20555000100,ascorbic acid 250 MG Tab 100 Each Bottle,4.07,2.24,1.22,3.52,38
NDC,20555003601,melatonin 3 MG Tab 100 Each Box,8.47,4.66,2.54,7.33,38
NDC,21922001605,clobetasol propionate 0.05 % Cream 30 g Tube,54.97,30.24,16.49,47.55,38
NDC,21922002107,permethrin 5 % Cream 60 g Tube,125.0,68.75,37.5,108.13,38
NDC,21922003923,metroNIDAZOLE 0.75% Gel 70 g Tube,90.07,49.54,27.02,77.91,38
NDC,21922006304,triamcinolone acetonide 0.1 % Ointment 15 g Tube,27.72,15.25,8.32,23.98,38
NDC,21922006330,triamcinolone acetonide 0.1 % Ointment 454 g Jar,107.4,59.07,32.22,92.9,38
NDC,23155021631,cidofovir 75 MG/ML Solution 5 mL Vial,4011.0,2206.05,258.53,3573.32,63
NDC,23155025831,adenosine diagnostic 3 MG/ML Solution 20 mL Vial,405.0,222.75,0.28,350.33,48
NDC,23155029031,amikacin sulfate 500 MG/2ML Solution 2 mL Vial,77.5,42.63,0.46,67.04,48
NDC,23155048601,verapamil 120 MG Tab 100 Each Bottle,9.53,5.25,2.86,8.24,38
NDC,23155051211,niMODipine 30 MG Cap 1 Each Blister,10.6,5.83,3.18,9.17,38
NDC,23155064941,carmustine 3.3 mg/mL Recon Soln 1 Each Vial,2455.0,1350.25,219.22,2123.58,63
NDC,23155078531,amikacin 25 mg/mL Solution 2 mL Vial,63.61,34.99,0.46,55.02,48
NDC,24200005316,"sodium bicarbonate 100 mEq/L in dextrose 5 % Solution 1,000 mL Bag",273.3,150.32,81.99,236.4,38
NDC,24200022845,morphine (PF) 1 MG/ML Solution 1 mL Syringe,44.82,24.66,9.92,72.83,48
NDC,24200029364,HYDROmorphone 1 mg/mL Solution Prefilled Syringe 30 mL Syringe,202.4,111.32,60.72,175.08,38
NDC,24200031964,morphine 10 mg/mL Solution 30 mL Syringe,309.8,170.39,92.94,267.98,38
NDC,24200038890,BUPivacaine 0.125 % Solution 100 mL Bag,72.5,39.88,21.75,62.71,38
NDC,24200069798,sodium chloride 4 mEq/mL Solution 30 mL Bag,60.88,33.49,18.26,52.66,38
NDC,24201020105,sodium tetradecyl sulfate 3 % Solution 2 mL Vial,477.0,262.35,143.1,412.61,38
NDC,24201040002,calcitonin (salmon) 200 UNIT/ML Solution 2 mL Vial,4335.0,2384.25,484.97,3749.78,63
NDC,24208000202,hyaluronidase 200 UNIT/ML Solution 1.2 mL Vial,667.46,367.11,0.32,577.35,48
NDC,24208029525,tobramycin/dexamethasone 0.3-0.1 % Suspension 2.5 mL Bottle,179.35,98.65,53.81,155.14,38
NDC,24208029905,loteprednol etabonate 0.5 % Suspension 5 mL Bottle,978.67,538.27,293.6,846.55,38
NDC,24208041601,Fluocinolone Acetonide 0.59 MG Implant 1 Each Package,79915.0,43953.25,423.87,69126.48,63
NDC,24208048510,dorzolamide 2 % Solution 10 mL Bottle,138.97,76.44,41.69,120.21,38
NDC,24208053920,acetylcholine 20 MG Recon Soln 1 Each Vial,720.08,396.05,216.02,622.87,38
NDC,24208055555,bacitracin/polymyxin B 500-10000 UNIT/GM Ointment 3.5 g Tube,100.23,55.13,30.07,86.7,38
NDC,24208058559,tropicamide 1 % Solution 2 mL Bottle,48.0,26.4,14.4,41.52,38
NDC,24208067004,sulfacetamide 10 % Solution 15 mL Bottle,190.63,104.85,57.19,164.89,38
NDC,24208073006,proparacaine 0.5 % Solution 15 mL Bottle,142.8,78.54,42.84,123.52,38
NDC,24208078055,neomycin/bacitracin zinc/polymyxin 5-400-10000 Ointment 3.5 g Tube,179.5,98.73,53.85,155.27,38
NDC,24208079535,neomycin/polymyxin/dexamethasone 0.1 % Ointment 3.5 g Tube,75.62,41.6,22.69,65.41,38
NDC,24208083060,neomycin-polymyxin-dexameth 3.5-10000-0.1 Suspension 5 mL Bottle,75.62,41.6,22.69,65.41,38
NDC,24208083060,neomycin/polymyxin/dexamethasone 0.1 % Suspension 5 mL Bottle,75.62,41.6,22.69,65.41,38
NDC,24208091055,erythromycin 5 MG/GM Ointment 3.5 g Tube,73.2,40.26,21.96,63.32,38
NDC,24338023015,niMODipine 6 MG/ML Solution 5 mL Syringe,150.21,82.62,45.06,129.93,38
NDC,24338026008,niMODipine 6 MG/ML Solution 237 mL Bottle,7022.5,3862.38,2106.75,6074.46,38
NDC,24385035210,oxymetazoline 0.05 % Solution 30 mL Bottle,31.13,17.13,9.34,26.93,38
NDC,24385037926,diphenhydrAMINE 12.5 MG/5ML Liquid 118 mL Bottle,13.56,7.46,4.07,11.73,38
NDC,24979000406,donepezil 23 MG Tab 30 Each Bottle,13.8,7.59,4.14,11.94,38
NDC,25021005205,dexAMETHasone 20 MG/5ML Solution 5 mL Vial,38.76,21.32,0.1,33.53,48
NDC,25021010910,cefOXitin 1 g Recon Soln 1 Each Vial,67.0,36.85,3.83,57.96,48
NDC,25021010910,cefOXitin Recon Soln 1 Each Vial,67.0,36.85,20.1,57.96,38
NDC,25021011920,cefuroxime 1.5 g Recon Soln 1 Each Vial,62.98,34.64,1.62,54.48,48
NDC,25021012850,cefTAZidime 2 g Recon Soln 1 Each Vial,91.5,50.33,1.42,79.15,48
NDC,25021013283,levoFLOXacin 750 MG/150ML Solution 150 mL Flex Cont,74.75,41.12,1.62,64.66,48
NDC,25021018467,fluconazole 800 mg/400 ml Solution 200 mL Flex Cont,60.8,33.44,2.05,52.59,48
NDC,25021018482,fluconazole in NS 200-0.9 MG/100ML-% Solution 100 mL Flex Cont,79.0,43.45,2.05,68.34,48
NDC,25021019010,micafungin 50 MG Recon Soln 1 Each Vial,576.0,316.8,0.24,498.24,48
NDC,25021019110,micafungin 100 MG Recon Soln 1 Each Vial,1024.8,563.64,0.24,886.45,48
NDC,25021020401,vinorelbine 10 MG/ML Solution 1 mL Vial,147.5,81.13,5.58,127.59,48
NDC,25021023120,decitabine 5 mg/mL Recon Soln 1 Each Vial,500.0,275.0,2.0,432.5,48
NDC,25021023604,topoTECAN 4 MG/4ML Solution 4 mL Vial,735.0,404.25,1.53,635.78,48
NDC,25021024410,bortezomib 2.5 mg/mL Injection 1 Each Vial,359.0,197.45,1.91,310.54,48
NDC,25021024410,bortezomib Recon Soln 1 Each Vial,359.0,197.45,1.91,310.54,48
NDC,25021030167,adenosine 10 mcg/mL 6 MG/2ML Solution 2 mL Syringe,124.0,68.2,0.28,107.26,48
NDC,25021030167,adenosine 6 MG/2ML Solution 2 mL Syringe,124.0,68.2,0.28,107.26,48
NDC,25021030167,n,124.0,68.2,0.28,107.26,48
NDC,25021030520,chlorothiazide Recon Soln 1 Each Vial,375.0,206.25,51.91,324.38,48
NDC,25021060203,caffeine citrate 20 MG/ML Solution 3 mL Vial,60.0,33.0,18.0,51.9,38
NDC,25021070001,ketorolac 15 MG/ML Solution 1 mL Vial,53.05,29.18,0.31,45.89,63
NDC,25021079002,prochlorperazine 10 MG/2ML Solution 2 mL Vial,62.1,34.16,2.54,53.72,48
NDC,25021079120,Lacosamide 200 MG/20ML Solution 20 mL Vial,407.64,224.21,122.29,352.61,48
NDC,25021080166,zoledronic acid 4 MG/5ML Conc 5 mL Vial,987.0,542.85,4.82,853.76,48
NDC,25021081230,acetylcysteine 200 MG/ML Solution 30 mL Vial,614.94,338.22,0.47,531.92,48
NDC,25021082682,zoledronic acid 4 MG/100ML Solution 100 mL Plas Cont,735.0,404.25,4.82,635.78,48
NDC,25357002503,riboflavin 5'-phosphate 0.146 &0.146-20 % Solution Prefilled Syringe 6 mL Box,13690.0,7529.5,2349.13,11841.85,48
NDC,25682000101,eculizumab 300 MG/30ML Solution 30 mL Vial,26759.26,14717.6,44.82,23146.76,63
NDC,25682002501,ravulizumab-cwvz 300 MG/3ML Solution 3 mL Vial,26796.53,14738.1,189.41,23179.0,63
NDC,25682002801,ravulizumab-cwvz 1100 MG/11ML Solution 11 mL Vial,98213.94,54017.67,189.41,84955.06,63
NDC,25767073545,"HTK custodial Solution 1,000 mL Bag",45.0,24.75,13.5,38.93,38
NDC,27241009706,DULoxetine HCl 20 MG Cap DR Particles 60 Each Bottle,8.99,4.95,2.7,7.78,38
NDC,27241009903,DULoxetine HCl 60 MG Cap DR Particles 30 Each Bottle,8.99,4.95,2.7,7.78,38
NDC,27241011603,fenofibrate 54 MG Tab 90 Each Bottle,8.73,4.81,2.62,7.55,38
NDC,27241011703,fenofibrate 160 MG Tab 90 Each Bottle,9.28,5.11,2.78,8.03,38
NDC,27241012502,ranolazine 500 MG TABLET SR 12 HR 60 Each Bottle,9.65,5.31,2.9,8.35,38
NDC,27241014401,silodosin 4 mg Cap 30 Each Bottle,10.0,5.5,3.0,8.65,38
NDC,27241016201,captopril 50 MG Tab 100 Each Bottle,11.2,6.16,3.36,9.69,38
NDC,27241024201,guanFACINE 1 MG Tab 100 Each Bottle,9.65,5.31,2.9,8.35,38
NDC,27808015501,rosuvastatin 5 MG Tab 90 Each Bottle,8.37,4.61,2.51,7.24,38
NDC,27808015701,rosuvastatin 20 MG Tab 90 Each Bottle,8.37,4.61,2.51,7.24,38
NDC,29300011101,lamoTRIgine 25 MG Tab 100 Each Bottle,8.2,4.51,2.46,7.09,38
NDC,29300011201,lamoTRIgine 100 MG Tab 100 Each Bottle,8.24,4.54,2.47,7.13,38
NDC,29300012601,bisoprolol fumarate 5 MG Tab 100 Each Bottle,8.66,4.77,2.6,7.49,38
NDC,29300012901,hydroCHLOROthiazide 50 MG Tab 100 Each Bottle,8.22,4.53,2.47,7.11,38
NDC,29300013101,zaleplon 5 MG Cap 100 Each Bottle,11.19,6.16,3.36,9.68,38
NDC,29300013201,zaleplon 10 MG Cap 100 Each Bottle,11.21,6.17,3.36,9.7,38
NDC,29300024401,busPIRone 5 MG Tab 100 Each Bottle,8.16,4.49,2.45,7.06,38
NDC,31722000631,itraconazole 10 MG/ML Solution 150 mL Bottle,757.15,416.44,227.15,654.93,38
NDC,31722001230,deferasirox 180 MG Tab 30 Each Bottle,15.2,8.36,4.56,13.15,38
NDC,31722001330,deferasirox 360 MG Tab 30 Each Bottle,20.76,11.42,6.23,17.96,38
NDC,31722004930,eplerenone 25 mg Tab 30 Each Bottle,9.5,5.23,2.85,8.22,38
NDC,31722017301,methylphenidate 2.5 mg half tablet Tab 0.5 tablet Package,10.25,5.64,3.08,8.87,38
NDC,31722017301,methylphenidate 5 MG Tab 100 Each Bottle,10.49,5.77,3.15,9.07,38
NDC,31722020431,pantoprazole 40 mg Recon Soln 1 Each Vial,58.38,32.11,8.4,50.5,48
NDC,31722030801,OLANZapine 10 MG Recon Soln 1 Each Vial,150.0,82.5,0.65,129.75,48
NDC,31722050430,efavirenz 600 MG Tab 30 Each Bottle,15.0,8.25,4.5,12.98,38
NDC,31722050660,lamiVUDine/zidovudine 150-300 mg Tab 60 Each Bottle,13.68,7.53,4.1,11.83,38
NDC,31722052201,hydrALAZINE 100 MG Tab 100 Each Bottle,8.47,4.66,2.54,7.33,38
NDC,31722053401,methocarbamol 750 MG Tab 100 Each Bottle,8.21,4.52,2.46,7.1,38
NDC,31722055612,lopinavir/ritonavir 200-50 mg Tab 120 Each Bottle,25.91,14.26,7.77,22.41,38
NDC,31722055760,abacavir 300 MG Tab 60 Each Bottle,14.5,7.98,4.35,12.54,38
NDC,31722056424,citalopram 10 MG/5ML Solution 240 mL Bottle,222.63,122.45,66.79,192.57,38
NDC,31722057447,levETIRAcetam 100 MG/ML Solution 473 mL Bottle,106.34,58.49,31.9,91.98,38
NDC,31722057960,maraviroc 150 MG Tab 60 Each Bottle,37.5,20.63,11.25,32.44,38
NDC,31722059730,ritonavir 100 MG Tab 30 Each Bottle,15.0,8.25,4.5,12.98,38
NDC,31722062921,atovaquone 750 MG/5ML Suspension 210 mL Bottle,1207.15,663.94,362.15,1044.18,38
NDC,31722068147,acyclovir 200 MG/5ML Suspension 473 mL Bottle,271.79,149.49,81.54,235.1,38
NDC,31722068725,OXcarbazepine 300 MG/5ML Suspension 250 mL Bottle,502.0,276.1,150.6,434.23,38
NDC,31722071290,pantoprazole 20 MG Tablet Delayed Response 90 Each Bottle,8.37,4.61,2.51,7.24,38
NDC,31722077701,acyclovir 400 MG Tab 100 Each Bottle,8.42,4.64,2.53,7.28,38
NDC,31722077805,acyclovir 800 MG Tab 500 Each Bottle,8.7,4.79,2.61,7.53,38
NDC,31722082830,ARIPiprazole 15 MG Tab 30 Each Bottle,8.99,4.95,2.7,7.78,38
NDC,31722083260,valGANciclovir 450 MG Tab 60 Each Bottle,19.5,10.73,5.85,16.87,38
NDC,31722083330,entecavir 0.5 MG Tab 30 Each Bottle,11.0,6.05,3.3,9.52,38
NDC,31722083430,entecavir 1 MG Tab 30 Each Bottle,11.0,6.05,3.3,9.52,38
NDC,31722084230,eltrombopag olamine 25 MG Tab 30 Each Bottle,498.57,274.22,149.57,431.26,38
NDC,31722084330,eltrombopag olamine 50 MG Tab 30 Each Bottle,898.21,494.02,269.46,776.95,38
NDC,31722086831,tolvaptan 15 MG Tab 1 Each Blister,149.0,81.95,44.7,128.89,38
NDC,31722088490,rosuvastatin 20 MG Tab 90 Each Bottle,8.29,4.56,2.49,7.17,38
NDC,31722089901,colchicine 0.6 MG Tab 100 Each Bottle,8.68,4.78,2.6,7.51,38
NDC,31722093502,albendazole 200 MG Tab 2 Each Bottle,77.0,42.35,23.1,66.61,38
NDC,32909071103,barium sulfate 2 % Suspension 450 mL Bottle,21.37,11.76,6.41,18.49,38
NDC,33342000109,lamiVUDine 150 MG Tab 60 Each Bottle,9.5,5.23,2.85,8.22,38
NDC,33342002507,famciclovir 250 MG Tab 30 Each Bottle,8.6,4.73,2.58,7.44,38
NDC,33342002607,famciclovir 500 MG Tab 30 Each Bottle,10.5,5.78,3.15,9.08,38
NDC,33342027809,tadalafil (PAH) 20 MG Tab 60 Each Bottle,9.65,5.31,2.9,8.35,38
NDC,33342032915,triamcinolone acetonide 0.1 % Cream 15 g Tube,32.6,17.93,9.78,28.2,38
NDC,33342044711,pyrazinamide 500 MG Tab 100 Each Bottle,20.3,11.17,6.09,17.56,38
NDC,34580273000,acetaminophen 650 MG Suppos 1 Each,5.49,3.02,1.65,4.75,38
NDC,36000024201,tobramycin 1.2 GM/30ML Solution 30 mL Vial,159.43,87.69,1.69,137.91,48
NDC,37000002404,psyllium 51.7 % Pack 30 Each Box,4.6,2.53,1.38,3.98,38
NDC,37000002410,psyllium 51.7 % Pack 1 Each Package,4.3,2.37,1.29,3.72,38
NDC,38779052608,Polysorbate 80 Liquid 500 mL Bottle,210.0,115.5,63.0,181.65,38
NDC,38779058208,acetic acid glacial 99 % Solution 500 mL Bottle,1231.5,677.33,369.45,1065.25,38
NDC,38779104604,bismuth subgallate Powder 25 g Bottle,396.23,217.93,118.87,342.74,38
NDC,38779193805,phenol 89 % Liquid 100 mL Bottle,263.8,145.09,79.14,228.19,38
NDC,38779193808,phenol 89 % Liquid 500 mL Bottle,1291.0,710.05,387.3,1116.72,38
NDC,39328006250,sodium hypochlorite 0.5 % Solution 473 mL Bottle,20.0,11.0,6.0,17.3,38
NDC,39328006325,sodium hypochlorite 0.25 % Solution 473 mL Bottle,20.0,11.0,6.0,17.3,38
NDC,39328006412,sodium hypochlorite 0.125 % Solution 473 mL Bottle,20.0,11.0,6.0,17.3,76
NDC,39328010710,phosphorus 250 MG Tab 100 Each Bottle,8.0,4.4,2.4,6.92,38
NDC,39822019001,acetaZOLAMIDE Recon Soln 1 Each Vial,204.0,112.2,18.57,176.46,48
NDC,39822031007,neomycin 500 MG Tab 1 Each Blister,11.07,6.09,3.32,9.58,38
NDC,39822041201,tobramycin 20 mg/mL Recon Soln 1 Each Vial,495.0,272.25,1.69,428.18,48
NDC,39822061502,colistimethate 150 mg Recon Soln 1 Each Vial,183.0,100.65,54.9,158.3,38
NDC,39822070602,streptomycin sulfate 1 g Recon Soln 1 Each Vial,465.0,255.75,24.26,402.23,48
NDC,39822105505,amphotericin B - conventional Recon Soln 1 Each Vial,303.0,166.65,42.98,262.1,48
NDC,39822105505,amphotericin B 100 mcg/mL Recon Soln 1 Each Vial,303.0,166.65,42.98,262.1,48
NDC,39822105505,amphotericin B 500 mcg/mL Recon Soln 1 Each Vial,303.0,166.65,42.98,262.1,48
NDC,39822105505,amphotericin Nebu Soln 1 Each Vial,303.0,166.65,90.9,262.1,38
NDC,39822200001,cloNIDine 100 MCG/ML Solution 10 mL Vial,182.5,100.38,14.37,157.86,48
NDC,39822210002,DACTINomycin 0.5 mg/mL Recon Soln 1 Each Vial,3343.75,1839.07,278.87,2892.34,63
NDC,40565012255,cadexomer iodine 0.9 % Gel 10 g Tube,94.83,52.16,28.45,82.03,76
NDC,40985022731,fish oil 1000 MG Cap 90 Each Bottle,4.33,2.39,1.3,3.75,38
NDC,41167000883,menthol-methyl salicylate Cream 35.4 g Tube,29.29,16.11,8.79,25.34,38
NDC,42023010401,tuberculin PPD skin test 5 UNIT/0.1ML Solution 1 mL Vial,610.24,335.64,24.26,527.86,53
NDC,42023010501,methohexital Recon Soln 1 Each Vial,617.26,339.5,185.18,533.93,38
NDC,42023011602,oxytocin 10 UNIT/ML Solution 10 mL Vial,111.0,61.05,1.73,96.02,48
NDC,42023012006,liothyronine sodium 10 MCG/ML Solution 1 mL Vial,2181.75,1199.97,654.53,1887.21,38
NDC,42023015925,EPINEPHrine 1 MG/ML Solution 1 mL Vial,117.24,64.49,3.6,101.41,48
NDC,42023016801,EPINEPHrine 1 MG/ML Solution 30 mL Vial,682.51,375.39,3.6,590.37,48
NDC,42023016801,EPINEPHrine 1 mg/mL Solution 30 mL Vial,1368.02,752.42,3.6,1183.34,48
NDC,42023017901,buprenorphine 0.3 MG/ML Solution 1 mL Vial,108.53,59.7,3.69,93.88,48
NDC,42023017905,buprenorphine 0.3 MG/ML Solution 1 mL Vial,108.53,59.7,3.69,93.88,48
NDC,42023020601,treprostinil 1 mg/mL Solution 20 mL Vial,6547.16,3600.94,48.04,5663.29,63
NDC,42023020701,treprostinil 2.5 mg/mL Solution 20 mL Vial,12711.39,6991.27,48.04,10995.35,63
NDC,42023020801,treprostinil 5 mg/mL Solution 20 mL Vial,25412.78,13977.03,48.04,21982.05,63
NDC,42023021401,phenylephrine 10 MG/ML Solution 5 mL Vial,163.0,89.65,0.01,141.0,48
NDC,42023021401,phenylephrine 4 mg/40 mL Solution 40 mL Syringe,65.8,36.19,0.01,56.92,48
NDC,42023021601,ePHEDrine 50 MG/ML Solution 1 mL Vial,189.24,104.09,56.77,163.69,38
NDC,42023023701,vasopressin 20 units in 100 mL 0.2 units/mL Solution 100 mL Vial,272.5,149.88,1.4,235.71,48
NDC,42023024301,ePHEDrine 5 MG/ML Solution 10 mL Vial,189.0,103.95,56.7,163.49,38
NDC,42023024301,ePHEDrine Sulfate (Pressors) 5 MG/ML Solution 10 mL Vial,189.0,103.95,56.7,163.49,38
NDC,42023031501,EPINEPHrine 16 mcg/mL Solution 250 mL Flex Cont,255.0,140.25,76.5,220.58,38
NDC,42192032701,thyroid 15 MG Tab 100 Each Bottle,8.76,4.82,2.63,7.58,38
NDC,42192033901,hyoscyamine 0.125 MG SL Tab 100 Each Bottle,9.49,5.22,2.85,8.21,38
NDC,42192060816,gabapentin 250 MG/5ML Solution 470 mL Bottle,315.1,173.31,94.53,272.56,38
NDC,42192060816,gabapentin 250 MG/5ML Solution 8 mL Oral Syringe,13.23,7.28,3.97,11.44,38
NDC,42367054032,dantrolene 250 MG Recon Susp 1 Each Vial,13930.31,7661.68,4179.09,12049.72,38
NDC,42385092160,atazanavir sulfate 200 MG Cap 60 Each Bottle,15.91,8.76,4.77,13.76,38
NDC,42385092230,atazanavir sulfate 300 MG Cap 30 Each Bottle,22.04,12.13,6.61,19.06,38
NDC,42457042001,glutamine (sickle cell) 5 g Pack 1 Each Packet,69.91,38.46,20.97,60.47,38
NDC,42494041501,PHENobarbital 65 MG/ML Solution 1 mL Vial,172.08,94.65,26.42,184.68,48
NDC,42494045020,vancomycin 125 MG Cap 20 Each Box,9.6,5.28,2.88,8.3,38
NDC,42571017601,piroxicam 10 MG Cap 100 Each Bottle,9.1,5.01,2.73,7.87,38
NDC,42571017701,piroxicam 20 MG Cap 100 Each Bottle,10.6,5.83,3.18,9.17,38
NDC,42658002101,DAUNOrubicin hydrochloride 5 MG/ML Solution 4 mL Vial,646.36,355.5,20.2,559.1,63
NDC,42747076101,Mogamulizumab-kpkc 20 MG/5ML Solution 5 mL Vial,20181.07,11099.59,208.92,17456.63,63
NDC,42794001812,liothyronine 5 MCG Tab 90 Each Bottle,9.04,4.98,2.71,7.82,38
NDC,42794001912,liothyronine 25 MCG Tab 90 Each Bottle,9.64,5.31,2.89,8.34,38
NDC,42799012001,bumetanide 1 MG Tab 100 Each Bottle,9.12,5.02,2.74,7.89,38
NDC,42806016101,hydrOXYzine HCl 50 MG Tab 100 Each Bottle,9.24,5.09,2.77,7.99,38
NDC,42806026698,cholestyramine 4 g Pack 1 Each Packet,10.0,5.5,3.0,8.65,38
NDC,42806075760,sulfADIAZINE 500 MG Tab 60 Each Bottle,49.28,27.11,14.78,42.63,38
NDC,42858015091,scopolamine 1 mg/3 days/patch PATCH 72 HR 1 Each Package,27.26,15.0,8.18,23.58,38
NDC,42858030125,HYDROmorphone 2 MG Tab 100 Each Box,10.42,5.74,3.13,9.01,38
NDC,42858030225,HYDROmorphone 4 MG Tab 100 Each Box,10.55,5.81,3.17,9.13,38
NDC,42858035340,buprenorphine 7.5 MCG/HR PATCH WEEKLY 4 Each Box,158.33,87.09,47.5,136.96,38
NDC,42858049340,buprenorphine 10 MCG/HR PATCH WEEKLY 4 Each Box,169.07,92.99,50.72,146.25,38
NDC,42858050103,buprenorphine 2 MG SL Tab 30 Each Bottle,11.2,6.16,3.36,9.69,38
NDC,42858058640,buprenorphine 15 MCG/HR PATCH WEEKLY 4 Each Box,240.35,132.2,72.11,207.9,38
NDC,42858070101,theophylline 400 MG Tablet Extended Release 24 Hour 100 Each Bottle,8.0,4.4,2.4,6.92,38
NDC,42858075040,buprenorphine 5 MCG/HR PATCH WEEKLY 4 Each Box,115.38,63.46,34.61,99.8,38
NDC,42858083940,buprenorphine 20 MCG/HR PATCH WEEKLY 4 Each Box,293.15,161.24,87.95,253.57,38
NDC,43066001001,DOCEtaxel 160 MG/16ML Solution 16 mL Vial,1313.14,722.23,0.62,1135.87,48
NDC,43066001501,ROPivacaine 0.2 % Solution 20 mL Vial,62.5,34.38,0.05,54.06,48
NDC,43066015010,amiodarone 150 MG/100ML Solution 100 mL Plas Cont,193.5,106.43,58.05,167.38,38
NDC,43386092060,oxyCODONE 100 MG/5ML Conc 30 mL Bottle,358.46,197.16,107.54,310.07,38
NDC,43386092060,oxyCODONE 50 mg/2.5 mL Conc 2.5 mL Plas Cont,38.12,20.97,11.44,32.97,38
NDC,43528000301,hepatitis B vac recomb adj 20 MCG/0.5ML Solution Prefilled Syringe 0.5 mL Syringe,856.05,470.83,144.5,1198.53,53
NDC,43547027509,donepezil 5 MG Tab 90 Each Bottle,8.55,4.71,2.57,7.4,38
NDC,43547027603,donepezil 10 MG Tab 30 Each Bottle,8.55,4.71,2.57,7.4,38
NDC,43547034206,risperiDONE 2 MG Tab 60 Each Bottle,8.72,4.8,2.62,7.54,38
NDC,43547054301,glycopyrrolate 0.2 MG/ML Solution 1 mL Vial,45.4,24.97,0.46,39.27,126
NDC,43547054810,enalapril 20 MG Tab 100 Each Bottle,8.98,4.94,2.69,7.77,38
NDC,43598012811,methylPREDNISolone sod succ 500 mg Recon Soln 1 Each Vial,163.0,89.65,0.21,141.0,63
NDC,43598016630,OLANZapine 10 MG Tab 30 Each Bottle,8.79,4.84,2.64,7.6,38
NDC,43598020453,amoxicillin/clavulanate 250-62.5 mg/5 mL Recon Susp 150 mL Bottle,540.25,297.14,162.08,467.32,38
NDC,43598028335,DOXOrubicin liposome 2 MG/ML Suspension 10 mL Vial,2145.0,1179.75,108.47,1855.43,63
NDC,43598029190,pregabalin 25 mg Cap 90 Each Bottle,10.17,5.6,3.05,8.8,38
NDC,43598029290,pregabalin 50 mg Cap 90 Each Bottle,10.17,5.6,3.05,8.8,38
NDC,43598029390,pregabalin 75 mg Cap 90 Each Bottle,10.17,5.6,3.05,8.8,38
NDC,43598029790,pregabalin 225 mg Cap 90 Each Bottle,10.21,5.62,3.06,8.83,38
NDC,43598033960,aspirin/dipyridamole 25-200 MG CAPSULE SR 12 HR 60 Each Bottle,10.0,5.5,3.0,8.65,38
NDC,43598051030,esomeprazole magnesium 40 MG CAPSULE DELAYED RELEASE 30 Each Bottle,9.56,5.26,2.87,8.27,38
NDC,43598058723,nitroprusside 25 MG/ML Solution 2 mL Vial,150.0,82.5,45.0,129.75,38
NDC,43598069811,carboprost 250 MCG/ML Solution 1 mL Vial,1737.55,955.66,521.27,1502.98,38
NDC,43598075058,naloxone 2 MG/2ML Solution Prefilled Syringe 2 mL Syringe,203.1,111.71,0.35,175.68,48
NDC,43825020001,terlipressin 0.85 MG Recon Soln 1 Each Vial,5350.2,2942.61,1605.06,4627.92,48
NDC,43825060641,"thrombin (recombinant) 5,000 units Recon Soln 1 Each Vial",531.0,292.05,159.3,459.32,38
NDC,43825070750,"thrombin (recombinant) 20,000 units Recon Soln 1 Each Box",1899.6,1044.78,569.88,1643.15,38
NDC,44087115001,choriogonadotropin alfa 250 MCG/0.5ML Solution Prefilled Syringe 0.5 mL Syringe,1374.94,756.22,412.48,1189.32,38
NDC,44087353501,avelumab 200 MG/10ML Solution 10 mL Vial,9085.66,4997.12,83.24,7859.1,63
NDC,44206025110,albumin human 25 % Solution 100 mL Vial,735.0,404.25,45.57,635.78,38
NDC,44206043605,immune globulin 10% 5 g/50 mL Solution 50 mL Vial,5098.56,2804.21,42.32,4410.25,63
NDC,44206043605,immune globulin 10% Solution 50 mL Vial,5098.56,2804.21,42.32,4410.25,63
NDC,44206043710,immune globulin 10% 10 g/100 mL Solution 100 mL Vial,10182.12,5600.17,42.32,8807.53,63
NDC,44206043710,immune globulin 10% Solution 100 mL Vial,10182.12,5600.17,42.32,8807.53,63
NDC,44206043820,immune globulin 10% 20 g/200 mL Solution 200 mL Vial,15825.52,8704.04,42.32,13689.07,63
NDC,44206043820,immune globulin 10% Solution 200 mL Vial,15825.52,8704.04,42.32,13689.07,63
NDC,44206043940,immune globulin 10% 40 g/400 mL Solution 400 mL Vial,31641.04,17402.58,42.32,27369.5,63
NDC,44567024010,cefepime Recon Soln 1 Each Vial,64.9,35.7,1.06,56.14,48
NDC,44567024625,cefOXitin 2 g Recon Soln 1 Each Vial,149.68,82.33,3.83,129.47,48
NDC,44567031201,penicillin G potassium Recon Soln 1 Each Vial,314.94,173.22,0.65,272.42,48
NDC,44567053001,CISplatin 50 MG Recon Soln 1 Each Vial,2380.0,1309.0,2.31,2058.7,48
NDC,44567062001,calcium gluconate 1 g/50 mL Solution 50 mL Flex Cont,118.75,65.32,0.1,102.72,48
NDC,44567062024,calcium gluconate 1 g/50 mL Solution 50 mL Flex Cont,118.75,65.32,0.1,102.72,48
NDC,44567081210,"esmolol in water 2,000 mg/100 mL Solution 100 mL Flex Cont",533.0,293.15,0.31,461.05,48
NDC,45334010016,cottonseed oil Oil 474 mL Bottle,54.84,30.17,16.45,47.44,38
NDC,45334030001,emollient Cream 453 g Jar,51.71,28.45,15.51,44.73,76
NDC,45334030004,emollient Cream 113 g Tube,34.24,18.84,10.27,29.62,38
NDC,45567003001,technetium Tc-99m sulfur colloid Kit 20 millicurie,401.75,220.97,120.53,353.54,48
NDC,45567004001,technetium Tc-99m medronate Kit 30 millicurie,140.51,77.29,42.15,123.65,48
NDC,45567006001,technetium Tc-99m pyrophosphate Kit 25 millicurie,216.83,119.26,65.05,190.81,48
NDC,45567045502,technetium Tc-99m mebrofenin Kit 15 millicurie,97.35,53.55,29.21,85.67,48
NDC,45567047501,technetium Tc-99m disofenin Kit 15 millicurie,139.73,76.86,41.92,122.96,48
NDC,45567055501,technetium Tc-99m sestamibi Kit 30 millicurie,528.34,290.59,158.5,464.94,48
NDC,45802001405,hydrocortisone 2.5 % Ointment 454 g Jar,142.35,78.3,42.71,123.13,38
NDC,45802004064,selenium sulfide 2.5 % Lotion 120 mL Bottle,54.86,30.18,16.46,47.45,38
NDC,45802005436,triamcinolone acetonide 0.025 % Ointment 80 g Tube,48.56,26.71,14.57,42.0,38
NDC,45802006336,triamcinolone acetonide 0.025 % Cream 80 g Tube,48.56,26.71,14.57,42.0,38
NDC,45802006405,triamcinolone acetonide 0.1 % Cream 454 g Jar,88.33,48.59,26.5,76.41,38
NDC,45802006436,triamcinolone acetonide 0.1 % Cream 80 g Tube,47.72,26.25,14.32,41.28,38
NDC,45802010752,pseudoephedrine 120 MG TABLET SR 12 HR 10 Each Box,4.05,2.23,1.22,3.5,38
NDC,45802014370,neomycin/polymyxin/bacitracin 5-400-5000 Ointment 0.9 g Packet,4.6,2.53,1.38,3.98,38
NDC,45802014464,hydrocortisone acetate/pramoxine 1-1 % Cream 30 g Tube,409.29,225.11,122.79,354.04,38
NDC,45802017453,menthol-methyl salicylate Cream 85 g Tube,30.12,16.57,9.04,26.05,38
NDC,45802021001,nitroglycerin 0.4 mg/spray Solution 4.9 g Spray Bottle,622.95,342.63,186.89,538.85,38
NDC,45802027603,hydrocortisone 1 % Ointment 28 g Tube,27.35,15.05,8.21,23.66,38
NDC,45802056202,clindamycin phosphate 1 % Solution 60 mL Bottle,188.84,103.87,56.65,163.35,38
NDC,45802073033,acetaminophen 650 MG Suppos 100 Each Box,4.92,2.71,1.48,4.26,38
NDC,45802073200,acetaminophen 120 MG Suppos 1 Each Box,4.08,2.25,1.22,3.53,38
NDC,45802088094,nystatin/triamcinolone 100000-0.1 UNIT/GM-% Cream 30 g Tube,123.01,67.66,36.9,106.4,38
NDC,45802095301,diclofenac 1 % Gel 100 g Tube,63.05,34.68,18.92,54.54,38
NDC,46122001433,polyethylene glycol 3350 17 GM/SCOOP Powder 238 g Bottle,43.32,23.83,13.0,37.47,38
NDC,46122035274,nicotine 14 mg/24 hour PATCH 24 HR 14 Each Box,13.1,7.21,3.93,11.33,38
NDC,46122035374,nicotine 21 mg/24 hour PATCH 24 HR 14 Each Box,13.1,7.21,3.93,11.33,38
NDC,46122035474,nicotine 7 mg/24 hour PATCH 24 HR 14 Each Box,13.1,7.21,3.93,11.33,38
NDC,46122043140,aluminum & magnesium hydroxide/simethicone 400-400-40 MG/5ML Suspension 355 mL Bottle,37.4,20.57,11.22,32.35,38
NDC,46122045773,caffeine 200 MG Tab 16 Each Box,4.41,2.43,1.32,3.81,38
NDC,46122070165,bismuth subsalicylate 262 MG Chew Tab 30 Each Box,4.36,2.4,1.31,3.77,38
NDC,46287000660,sodium polystyrene 15 GM/60ML Suspension 60 mL Bottle,89.77,49.38,26.93,77.65,38
NDC,46287050030,Sorbitol 70 % Solution 30 mL Bottle,17.5,9.63,5.25,15.14,38
NDC,46414222201,amyl nitrite 0.3 ML Solution 1 Each Ampule,12.24,6.74,3.67,10.59,38
NDC,47335005040,DOXOrubicin liposome 2 MG/ML Suspension 25 mL Vial,5650.0,3107.5,108.47,4887.25,63
NDC,47335006186,dofetilide 125 MCG Cap 60 Each Bottle,11.8,6.49,3.54,10.21,38
NDC,47335017795,tildrakizumab-asmn 100 MG/ML Solution Prefilled Syringe 1 mL Syringe,75448.05,41496.43,114.35,65262.56,63
NDC,47335047281,imatinib 100 MG Tab 90 Each Bottle,11.92,6.56,3.58,10.31,38
NDC,47335048583,bicalutamide 50 MG Tab 30 Each Bottle,9.65,5.31,2.9,8.35,38
NDC,47335057983,lurasidone 120 MG Tab 30 Each Bottle,9.5,5.23,2.85,8.22,38
NDC,47781029603,nitroglycerin 0.1 mg/hour PATCH 24 HR 30 Each Box,9.65,5.31,2.9,8.35,38
NDC,47781029803,nitroglycerin 0.4 mg/hour PATCH 24 HR 30 Each Box,9.45,5.2,2.84,8.17,38
NDC,47781033530,pyRIDostigmine bromide 180 MG Tab CR 30 Each Bottle,49.54,27.25,14.86,42.85,38
NDC,47781042611,fentaNYL 50 mcg/hr/patch PATCH 72 HR 1 Each Package,33.33,18.34,10.0,28.83,38
NDC,47781058656,labetalol 5 MG/ML Solution 40 mL Vial,163.0,89.65,0.25,141.0,48
NDC,47781059891,vancomycin 500 mg Recon Soln 1 Each Vial,47.5,26.13,0.15,41.09,48
NDC,47781402411,fentaNYL 25 mcg/hr PATCH 72 HR 1 Each Package,23.97,13.19,7.19,20.73,38
NDC,48433023015,iodine strong 5 % Solution 14 mL Bottle,132.9,73.1,39.87,114.96,76
NDC,48783011208,ferric subsulfate Solution 8 mL Bottle,20.0,11.0,6.0,17.3,38
NDC,49230020950,"DELFLEX 2.5% dextrose 394 mOsmo/L low magnesium/low calcium 394 MOSM/L Solution 5,000 mL Flex Cont",183.75,101.07,55.13,158.94,38
NDC,49281012488,influenza trivalent HIGH-DOSE vaccine 0.5 mL Suspension Prefilled Syringe 0.5 mL Syringe,71.0,39.05,21.3,563.56,53
NDC,49281021515,tetanus/diphtheria toxoids (Td) 5-2 LFU Injection 0.5 mL Syringe,153.1,84.21,28.75,245.5,38
NDC,49281057488,nirsevimab-alip 100 mg/mL Solution Prefilled Syringe 1 mL Syringe,3018.1,1659.96,905.43,2610.66,38
NDC,49281057500,nirsevimab-alip 50 mg/0.5 mL Solution Prefilled Syringe 0.5 mL Syringe,3018.1,1659.96,905.43,2610.66,38
NDC,49281079051,typhoid vi polysaccharide 25 MCG/0.5ML Solution Prefilled Syringe 0.5 mL Syringe,465.3,255.92,101.45,402.48,38
NDC,49281086010,poliovirus (inactivated) vaccine Injection 5 mL Vial,2430.53,1336.8,45.96,2102.41,38
NDC,49281091501,yellow fever Injection 1 Each Vial,706.77,388.73,151.61,611.36,38
NDC,49401010101,belimumab 80 mg/mL Recon Soln 1 Each Vial,3442.65,1893.46,47.14,2977.89,63
NDC,49401010201,belimumab 400 mg Recon Soln 1 Each Vial,8895.94,4892.77,47.14,7694.99,63
NDC,49471000105,benzylpenicilloyl polylysine 0.25 ML Solution 0.25 mL Ampule,974.04,535.73,292.21,842.54,38
NDC,49483022110,nitroglycerin 2.5 MG Cap CR 100 Each Bottle,9.63,5.3,2.89,8.33,38
NDC,49609010101,fludeoxyglucose F-18 20-300 MCI/ML Solution 45 millicurie,1724.05,948.23,517.22,1517.16,48
NDC,49702021326,zidovudine 10 MG/ML Solution 20 mL Vial,190.2,104.61,1.3,164.52,48
NDC,49702022813,dolutegravir 50 MG Tab 30 Each Bottle,191.01,105.06,57.3,165.22,38
NDC,49702024015,cabotegravir & rilpivirine ER 600 mg/3 mL & 900 mg/3 mL Suspension Extended Release 6 mL Box,28524.88,15688.69,19.89,24674.02,63
NDC,49702025315,cabotegravir & rilpivirine ER 400 mg/2 mL & 600 mg/2 mL Suspension Extended Release 4 mL Box,19019.92,10460.96,19.89,16452.23,63
NDC,49702026423,cabotegravir 600 mg/3 mL Suspension Extended Release 3 mL Vial,16915.92,9303.76,5.91,14632.27,63
NDC,49771000201,mitoMYcin 0.4 mg/mL Solution 12.5 mL Vial,151.87,83.53,45.56,131.37,38
NDC,49884005601,imipramine 50 MG Tab 100 Each Bottle,9.02,4.97,2.71,7.8,38
NDC,49884015576,varenicline 0.5 MG Tab 56 Each Bottle,9.95,5.48,2.99,8.61,38
NDC,49884015676,varenicline 1 MG Tab 56 Each Bottle,9.95,5.48,2.99,8.61,38
NDC,49884025601,minoxidil 2.5 MG Tab 100 Each Bottle,8.69,4.78,2.61,7.52,38
NDC,49884031152,risperiDONE 0.5 MG TABLET DISPERSIBLE 1 Each Blister,17.49,9.62,5.25,15.13,38
NDC,49884031552,risperiDONE 1 MG TABLET DISPERSIBLE 1 Each Blister,19.26,10.6,5.78,16.66,38
NDC,49884036201,dantrolene 25 MG Cap 100 Each Bottle,8.94,4.92,2.68,7.73,38
NDC,49884040191,risperiDONE 2 MG TABLET DISPERSIBLE 28 Each Box,23.93,13.17,7.18,20.7,38
NDC,49884040291,risperiDONE 3 MG TABLET DISPERSIBLE 28 Each Box,28.62,15.75,8.59,24.76,38
NDC,49884041872,testosterone 25 MG/2.5GM (1%) Gel 2.5 g Package,34.52,18.99,10.36,29.86,38
NDC,49884098401,nateglinide 60 MG Tab 100 Each Bottle,10.55,5.81,3.17,9.13,38
NDC,50016095711,cross-linked hyaluronate 30 MG/3ML Prefilled Syringe 3 mL Syringe,6224.99,3423.75,451.94,5384.62,63
NDC,50024043203,benzocaine 20 % Gel 9 g Tube,20.0,11.0,6.0,17.3,38
NDC,50090025100,gentamicin 0.3 % Ointment 3.5 g Tube,88.85,48.87,26.66,76.86,38
NDC,50090453800,lidocaine 2 % Prefilled Syringe 20 mL Syringe,40.3,22.17,12.09,34.86,38
NDC,50111033306,metroNIDAZOLE 250 MG Tab 250 Each Bottle,8.97,4.94,2.69,7.76,38
NDC,50111033402,metroNIDAZOLE 500 MG Tab 500 Each Bottle,9.6,5.28,2.88,8.3,38
NDC,50111064701,FLUoxetine 10 MG Cap 100 Each Bottle,8.18,4.5,2.45,7.08,38
NDC,50111078810,azithromycin 500 MG Tab 30 Each Bottle,21.48,11.82,6.44,18.58,38
NDC,50111091701,torsemide 20 MG Tab 100 Each Bottle,8.85,4.87,2.66,7.66,38
NDC,50228010901,carisoprodol 350 MG Tab 100 Each Bottle,10.3,5.67,3.09,8.91,38
NDC,50228011930,rosuvastatin 40 MG Tab 30 Each Bottle,8.25,4.54,2.48,7.14,38
NDC,50242004062,omalizumab 150 MG Recon Soln 1 Each Vial,7662.05,4214.13,32.43,6627.67,63
NDC,50242004164,alteplase 1 mg/mL Recon Soln 1 Each Vial,1014.92,558.21,78.54,877.91,63
NDC,50242004164,alteplase 2 mg/mL Solution 1 Each Vial,1014.92,558.21,78.54,877.91,63
NDC,50242004413,alteplase 1 mg/mL Recon Soln 1 Each Vial,18490.76,10169.92,78.54,15994.51,63
NDC,50242005121,riTUXimab 1 mg/0.1 mL Solution 0.5 mL Syringe,250.79,137.94,65.88,512.53,63
NDC,50242005121,riTUXimab 10 mg/mL Solution 10 mL Vial,4252.84,2339.07,65.88,3678.71,63
NDC,50242005121,riTUXimab 100 MG/10ML Solution 10 mL Vial,4252.84,2339.07,65.88,3678.71,126
NDC,50242005306,riTUXimab 500 MG/50ML Solution 50 mL Vial,20219.68,11120.83,65.88,17490.02,63
NDC,50242006001,bevacizumab 100 MG/4ML Solution 4 mL Vial,3611.23,1986.18,62.84,3123.71,63
NDC,50242006001,bevacizumab 25 mg/mL Solution 4 mL Vial,3611.23,1986.18,1.58,3123.71,63
NDC,50242006101,bevacizumab 400 MG/16ML Solution 16 mL Vial,13727.37,7550.06,62.84,11874.18,63
NDC,50242007001,obinutuzumab 1000 MG/40ML Solution 40 mL Vial,35327.15,19429.94,64.25,30557.98,63
NDC,50242007701,"trastuzumab/hyaluronidase-oysk 600-10,000 mg-unit/5 mL Solution 5 mL Vial",20123.53,11067.95,54.14,17406.85,63
NDC,50242008003,Ranibizumab 0.5 MG/0.05ML Solution Prefilled Syringe 0.05 mL Syringe,10545.0,5799.75,86.38,9121.43,63
NDC,50242008201,ranibizumab 0.3 MG/0.05ML Solution 0.05 mL Vial,6333.0,3483.15,86.38,5478.05,63
NDC,50242008525,alteplase 1 MG/ML Recon Soln 1 Each Vial,36971.51,20334.34,78.54,31980.36,63
NDC,50242008527,alteplase 1 mg/mL Recon Soln 1 Each Vial,36971.51,20334.34,78.54,31980.36,63
NDC,50242008701,Ado-Trastuzumab Emtansine 160 MG Recon Soln 1 Each Vial,26186.94,14402.82,35.18,22651.7,63
NDC,50242008801,ado-trastuzumab emtansine 100 MG Recon Soln 1 Each Vial,17175.41,9446.48,35.18,14856.73,63
NDC,50242008801,ado-trastuzumab emtansine 20 mg/mL Recon Soln 1 Each Vial,17175.41,9446.48,35.18,14856.73,63
NDC,50242009606,faricimab-svoa 6 mg/0.05mL Solution Prefilled Syringe 0.05 mL Syringe,9626.53,5294.6,30.27,8326.95,63
NDC,50242010039,dornase alfa 2.5 MG/2.5ML Solution 2.5 mL Plas Cont,326.05,179.33,97.82,282.03,38
NDC,50242010301,polatuzumab vedotin-piiq 20 mg/mL Recon Soln 1 Each Vial,17169.13,9443.03,114.13,14851.3,63
NDC,50242010501,polatuzumab vedotin-piiq 20 mg/mL Recon Soln 1 Each Vial,76321.78,41976.98,114.13,66018.34,63
NDC,50242012047,tenecteplase 50 mg/10 mL Kit 1 Each Box,34858.49,19172.17,139.46,30152.59,63
NDC,50242012501,glofitamab-gxbm 2.5 MG/2.5ML Solution 2.5 mL Vial,11334.93,6234.22,2379.1,18701.35,63
NDC,50242012701,glofitamab-gxbm 10 MG/10ML Solution 10 mL Vial,43169.76,23743.37,2379.1,37341.84,63
NDC,50242013201,trastuzumab 21 mg/mL Recon Soln 1 Each Vial,7037.89,3870.84,66.15,6087.77,63
NDC,50242013501,tocilizumab 80 MG/4ML Solution 4 mL Vial,2883.26,1585.8,5.13,2494.02,63
NDC,50242013601,tocilizumab 200 mg/10 mL Solution 10 mL Vial,7185.71,3952.15,5.13,6215.64,63
NDC,50242013701,tocilizumab 400 mg/20 mL Solution 20 mL Vial,11164.44,6140.45,5.13,9657.24,63
NDC,50242013801,tocilizumab 162 MG/0.9ML Solution Prefilled Syringe 0.9 mL Syringe,6358.97,3497.44,5.13,5500.51,63
NDC,50242014201,Mosunetuzumab-axgb 30 MG/30ML Solution 30 mL Vial,76798.37,42239.11,654.63,66430.59,53
NDC,50242014501,pertuzumab 420 MG/14ML Solution 14 mL Vial,27979.02,15388.47,13.9,24201.85,63
NDC,50242015001,ocrelizumab 300 MG/10ML Solution 10 mL Vial,86702.03,47686.12,50.46,74997.26,63
NDC,50242015901,mosunetuzumab-axgb 1 mg/mL Solution 1 mL Vial,2834.13,1558.78,654.63,2451.52,53
NDC,50242021401,omalizumab 75 MG/0.5ML Solution Prefilled Syringe 0.5 mL Syringe,3838.52,2111.19,32.43,3320.32,63
NDC,50242021501,omalizumab 150 mg/mL Solution Prefilled Syringe 1 mL Syringe,7662.05,4214.13,32.43,6627.67,63
NDC,50242022701,omalizumab 300 mg/2 mL Solution Prefilled Syringe 2 mL Syringe,11905.41,6547.98,32.43,10298.18,63
NDC,50242024501,pertuzumab/trastuzumab/hyaluronidase-zzxf 80-40-2000 MG-MG-U/ML Solution 15 mL Vial,57072.79,31390.04,54.85,49367.96,63
NDC,50242026001,pertuzumab/trastuzumab/hyaluronidase-zzxf 60-60-2000 MG-MG-U/ML Solution 10 mL Vial,38052.01,20928.61,54.85,32914.99,63
NDC,50242055401,ocrelizumab-hyaluronidase-ocsq 920-23000 mg-unit/23 mL Solution 23 mL Vial,173394.06,95366.74,47.23,149985.86,63
NDC,50242091701,atezolizumab 1200 MG/20ML Solution 20 mL Vial,46147.46,25381.11,75.74,39917.55,63
NDC,50242091801,Atezolizumab 840 MG/14ML Solution 14 mL Vial,32307.72,17769.25,75.74,27946.18,63
NDC,50242092201,emicizumab-kxwh 105 MG/0.7ML Solution 0.7 mL Vial,49535.38,27244.46,44.67,43591.13,63
NDC,50268005011,acebutolol 200 MG Cap 1 Each Blister,11.44,6.3,3.43,9.9,38
NDC,50268010611,baclofen 10 MG Tab 1 Each Blister,8.56,4.71,2.57,7.4,38
NDC,50268019411,cloNIDine 0.3 MG Tab 1 Each Blister,9.19,5.06,2.76,7.95,38
NDC,50268043011,indomethacin 25 MG Cap 1 Each Blister,9.19,5.06,2.76,7.95,38
NDC,50268043115,indomethacin 50 MG Cap 50 Each Box,9.08,5.0,2.72,7.85,38
NDC,50268047611,letrozole 2.5 MG Tab 1 Each Blister,8.68,4.78,2.6,7.51,38
NDC,50268052215,meclizine 12.5 MG Tab 50 Each Box,4.68,2.58,1.4,4.05,38
NDC,50268052311,meclizine 25 MG Tab 1 Each Blister,5.38,2.96,1.61,4.65,38
NDC,50268052511,meloxicam 7.5 MG Tab 1 Each Blister,8.56,4.71,2.57,7.4,38
NDC,50268059411,naproxen 250 MG Tab 1 Each Blister,8.86,4.88,2.66,7.66,38
NDC,50268059511,naproxen 375 MG Tab 1 Each Blister,8.89,4.89,2.67,7.69,38
NDC,50268063911,pantoprazole 40 MG Tablet Delayed Response 1 Each Blister,8.59,4.73,2.58,7.43,38
NDC,50268063915,pantoprazole 2 mg/mL Suspension 10 mL Oral Syringe,14.77,8.13,4.43,12.78,38
NDC,50268063915,pantoprazole 2 mg/mL Suspension 20 mL Oral Syringe,21.53,11.85,6.46,18.62,38
NDC,50268064011,PARoxetine 10 MG Tab 1 Each Blister,9.0,4.95,2.7,7.79,38
NDC,50268068511,prochlorperazine 10 MG Tab 1 Each Blister,10.6,5.83,0.68,9.17,48
NDC,50268071811,sirolimus 1 MG Tab 1 Each Blister,31.41,17.28,0.91,27.17,48
NDC,50268072411,sotalol 80 MG Tab 1 Each Blister,8.99,4.95,2.7,7.78,38
NDC,50268073111,sennosides 8.8 MG/5ML Syrup 5 mL Cup,16.18,8.9,4.85,14.0,38
NDC,50268075515,torsemide 10 MG Tab 50 Each Box,9.01,4.96,2.7,7.79,38
NDC,50268075715,torsemide 100 MG Tab 50 Each Box,9.35,5.15,2.81,8.09,38
NDC,50268076511,terazosin 2 MG Cap 1 Each Blister,9.51,5.24,2.85,8.23,38
NDC,50268076611,terazosin 5 MG Cap 1 Each Blister,9.52,5.24,2.86,8.23,38
NDC,50268076615,terazosin 5 MG Cap 50 Each Box,9.52,5.24,2.86,8.23,38
NDC,50268085211,cyanocobalamin 100 MCG Tab 1 Each Blister,8.59,4.73,2.58,7.43,38
NDC,50289325001,witch hazel/glycerin Pads 40 Each Jar,20.22,11.13,6.07,17.49,38
NDC,50383004248,prednisoLONE 15 MG/5ML Solution 480 mL Bottle,294.7,162.09,88.41,254.92,38
NDC,50383004316,hydrocodone/homatropine 5-1.5 mg/5 mL Solution 473 mL Bottle,239.01,131.46,71.7,206.74,38
NDC,50383007916,acetaminophen/codeine 120-12 mg/5 mL Solution 473 mL Bottle,30.1,16.56,9.03,26.04,38
NDC,50383036317,lidocaine viscous 2 % Solution 15 mL Cup,10.97,6.04,3.29,9.49,38
NDC,50383074120,albuterol 0.5% Nebu Soln 20 mL Bottle,151.9,83.55,45.57,131.39,38
NDC,50383077816,ferrous sulfate 220 (44 Fe) MG/5ML Solution 473 mL Bottle,31.41,17.28,9.42,27.17,38
NDC,50383079216,valproic acid 250 MG/5ML Solution 473 mL Bottle,70.44,38.75,21.13,60.93,38
NDC,50383082316,sulfamethoxazole/trimethoprim oral desensitization Suspension 473 mL Bottle,303.01,166.66,90.9,262.1,38
NDC,50383082420,sulfamethoxazole/trimethoprim 200-40 mg/5 mL Suspension 20 mL Cup,21.07,11.59,6.32,18.23,38
NDC,50419025091,riociguat 0.5 MG Tab 9 Each Bottle,381.27,209.7,114.38,329.8,38
NDC,50419025191,riociguat 1 MG Tab 9 Each Bottle,381.27,209.7,114.38,329.8,38
NDC,50419025391,riociguat 2 MG Tab 9 Each Bottle,381.27,209.7,114.38,329.8,38
NDC,50419025491,riociguat 2.5 MG Tab 9 Each Bottle,381.27,209.7,114.38,329.8,38
NDC,50419042301,levonorgestrel 20 MCG/DAY IUD 1 Each Box,6574.0,3615.7,1972.2,5686.51,38
NDC,50419042401,levonorgestrel 19.5 MG IUD 1 Each Box,2920.11,1606.07,876.03,2525.9,48
NDC,50419077301,ciprofloxacin 500 MG/5ML (10%) Recon Susp 100 mL Bottle,463.9,255.15,139.17,401.27,38
NDC,50458002802,esketamine 28 MG/DEVICE Solution Therapy Pack 1 Each Box,1261.3,693.72,378.39,1091.02,38
NDC,50458002803,esketamine 28 MG/DEVICE Solution Therapy Pack 1 Each Box,1261.31,693.73,378.39,1091.03,38
NDC,50458009801,pentosan polysulfate sodium 100 MG Cap 100 Each Bottle,38.33,21.09,11.5,33.16,38
NDC,50458030611,risperiDONE microspheres ER 25 mg/2 mL Suspension Reconstituted ER 1 Each Vial,3499.57,1924.77,9.44,3027.13,63
NDC,50458030711,risperiDONE microspheres ER 37.5 mg/2 mL Suspension Reconstituted ER 1 Each Vial,5242.04,2883.13,9.44,4534.36,63
NDC,50458030811,risperiDONE microspheres ER 50 mg/2 mL Suspension Reconstituted ER 1 Each Vial,6984.62,3841.55,9.44,6041.7,63
NDC,50458030911,risperiDONE Microspheres ER 12.5 mg/2 mL Suspension Reconstituted ER 1 Each Vial,1757.47,966.61,9.44,1520.21,63
NDC,50458056201,paliperidone palmitate ER 117 mg/0.7 mL Suspension Prefilled Syringe 0.75 mL Syringe,9651.57,5308.37,12.65,8348.61,63
NDC,50458056301,paliperidone palmitate ER 156 mg/mL Suspension Prefilled Syringe 1 mL Syringe,10003.86,5502.13,12.65,8653.34,63
NDC,50458056401,paliperidone palmitate ER 234 mg/1.5 mL Suspension Prefilled Syringe 1.5 mL Syringe,15000.43,8250.24,12.65,12975.37,63
NDC,50458057710,rivaroxaban 2.5 MG Tab 100 Each Box,32.91,18.11,9.87,28.47,38
NDC,50458057801,rivaroxaban 15 MG Tab 1 Each Blister,36.9,20.3,11.07,31.92,38
NDC,50458057901,rivaroxaban 20 MG Tab 1 Each Blister,59.84,32.92,17.95,51.76,38
NDC,50458058001,rivaroxaban 10 MG Tab 1 Each Blister,59.84,32.92,17.95,51.76,38
NDC,50474057009,brivaracetam 50 MG Tab 100 Each Box,72.29,39.76,21.69,62.53,38
NDC,50474065165,sodium hyaluronate 18 mg/mL Solution Prefilled Syringe 0.85 mL Syringe,828.72,455.8,248.62,716.84,38
NDC,50474070062,certolizumab pegol 200 mg/mL Kit 1 Each Box,25207.61,13864.19,3.35,21804.58,63
NDC,50474071079,certolizumab pegol 2 x 200 mg/mL Prefilled Syringe Kit 1 Each Box,25207.61,13864.19,3.35,21804.58,63
NDC,50474077009,brivaracetam 100 MG Tab 100 Each Box,72.29,39.76,21.69,62.53,38
NDC,50474087015,brivaracetam 10 MG/ML Solution 10 mL Oral Syringe,112.11,61.67,33.63,96.98,38
NDC,50474087015,brivaracetam 10 MG/ML Solution 2.5 mL Oral Syringe,34.78,19.13,10.43,30.08,38
NDC,50474087015,brivaracetam 10 MG/ML Solution 300 mL Bottle,3102.3,1706.27,930.69,2683.49,38
NDC,50474097063,brivaracetam 50 MG/5ML Solution 5 mL Vial,393.78,216.58,118.13,340.62,48
NDC,50484001030,collagenase 250 UNIT/GM Ointment 30 g Tube,962.38,529.31,288.71,832.46,76
NDC,50632000103,"smallpox and monkeypox, live, non-replicating vaccine 0.5 ML Suspension 0.5 mL Vial",850.4,467.72,0.01,735.6,53
NDC,50633011012,crotalidae polyval immune fab Recon Soln 1 Each Vial,13441.6,7392.88,1528.0,12562.63,63
NDC,50633012011,digoxin immune fab 40 MG Recon Soln 1 Each Vial,20900.8,11495.44,4353.08,33537.92,126
NDC,50633031011,hydroxocobalamin 5 g Recon Soln 1 Each Box,5404.2,2972.31,4.45,4674.63,63
NDC,50742010701,metoprolol tartrate 12.5 mg half tablet Tab 0.5 tablet Package,8.04,4.43,2.41,6.95,38
NDC,50742024001,mexiletine 200 MG Cap 100 Each Bottle,9.65,5.31,2.9,8.35,38
NDC,50742024101,mexiletine 250 MG Cap 100 Each Bottle,9.1,5.01,2.73,7.87,38
NDC,50742025190,dilTIAZem 300 MG CAPSULE SR 24 HR 90 Each Bottle,9.18,5.05,2.75,7.94,38
NDC,50742026301,colchicine/probenecid 0.5-500 MG Tab 100 Each Bottle,11.82,6.51,3.55,10.22,38
NDC,50742036260,ivabradine 5 MG Tab 60 Each Bottle,14.25,7.84,4.28,12.33,38
NDC,50742052005,cycloPHOSphamide 200 mg/mL Solution 5 mL Vial,3321.25,1826.69,0.78,2872.88,63
NDC,50742062001,NIFEdipine 30 MG Tablet Extended Release 24 Hour 100 Each Bottle,8.83,4.86,2.65,7.64,38
NDC,50742062101,NIFEdipine 60 MG Tablet Extended Release 24 Hour 100 Each Bottle,9.04,4.98,2.71,7.82,38
NDC,50742062201,NIFEdipine 90 MG Tablet Extended Release 24 Hour 100 Each Bottle,8.68,4.78,2.6,7.51,38
NDC,50881001060,ruxolitinib 10 MG Tab 60 Each Bottle,709.0,389.95,212.7,613.29,38
NDC,50881002060,ruxolitinib 10 mg half tablet Tab 0.5 tablet Packet,709.0,389.95,212.7,613.29,38
NDC,50881002311,axatilimab-csfr 50 mg/mL Solution 0.44 mL Vial,47370.0,26053.5,55.65,40975.05,63
NDC,50881003412,axatilimab-csfr 50 mg/mL Solution 0.18 mL Vial,20337.5,11185.63,55.65,17591.94,63
NDC,50914772008,Iodinated I 131 Albumin 25 MCCI/ML Solution Prefilled Syringe 1 Each Syringe,1080.0,594.0,324.0,950.4,48
NDC,50930009802,saliva substitute Solution 59 mL Spray Bottle,38.38,21.11,11.51,33.2,38
NDC,51079007401,hydrALAZINE 10 MG Tab 1 Each Blister,8.76,4.82,2.63,7.58,38
NDC,51079028401,diazePAM 2 MG Tab 1 Each Blister,10.15,5.59,3.05,8.78,38
NDC,51079028420,diazePAM 1 mg half tablet Tab 0.5 tablet Package,10.08,5.55,3.02,8.72,38
NDC,51079028501,diazePAM 5 MG Tab 1 Each Blister,10.18,5.6,3.05,8.81,38
NDC,51079028520,diazePAM 5 MG Tab 100 Each Box,10.17,5.6,3.05,8.8,38
NDC,51079043620,doxepin 10 MG Cap 100 Each Box,8.6,4.73,2.58,7.44,38
NDC,51079044501,levothyroxine 150 MCG Tab 1 Each Blister,9.04,4.98,2.71,7.82,38
NDC,51079052720,furosemide 80 MG Tab 100 Each Box,8.4,4.62,2.52,7.27,38
NDC,51079067001,methotrexate 2.5 MG Tab 1 Each Blister,15.31,8.43,0.15,13.24,48
NDC,51079073501,haloperidol 2 MG Tab 1 Each Blister,8.68,4.78,2.6,7.51,38
NDC,51079092501,dilTIAZem HCl 90 MG CAPSULE SR 12 HR 1 Each Blister,18.67,10.27,5.6,16.15,38
NDC,51079097801,carbidopa-levodopa 25-100 mg Tab CR 1 Each Blister,9.25,5.09,2.78,8.0,38
NDC,51144000301,tisotumab vedotin-tftv 40 MG Recon Soln 1 Each Vial,29219.3,16070.62,156.15,25274.69,63
NDC,51144002001,enfortumab vedotin-ejfv 20 MG Recon Soln 1 Each Vial,12098.7,6654.29,31.47,10465.38,63
NDC,51144003001,enfortumab vedotin-ejfv 30 MG Recon Soln 1 Each Vial,18138.05,9975.93,31.47,15689.41,63
NDC,51144005001,brentuximab 5 mg/mL Recon Soln 1 Each Vial,50035.0,27519.25,213.73,43280.28,126
NDC,51293062701,PHENobarbital 64.8 MG Tab 100 Each Bottle,11.52,6.34,3.46,9.96,38
NDC,51522000009,glucose (tolerance test) 100 g Solution 1 Bottle Bottle,10.11,5.57,3.03,8.75,38
NDC,51522000009,glucose (tolerance test) 75 g Solution 1 Bottle Bottle,10.11,5.57,3.03,8.75,38
NDC,51522000010,glucose (tolerance test) 75 g Solution 1 Bottle Bottle,10.11,5.57,3.03,8.75,38
NDC,51522000011,glucose (tolerance test) 50 g Solution 1 Bottle Bottle,10.11,5.57,3.03,8.75,38
NDC,51552005506,acetic acid 5 % Solution 500 mL Bottle,77.75,42.77,23.33,67.25,38
NDC,51552024704,fd & c blue #2 Powder 25 g Bottle,144.53,79.5,43.36,125.02,38
NDC,51552132006,hydrochloric acid 37 % Liquid 500 mL Bottle,172.25,94.74,51.68,149.0,38
NDC,51672126705,triamcinolone acetonide 0.1 % Paste 5 g Tube,224.53,123.5,67.36,194.22,38
NDC,51672127201,nystatin/triamcinolone 100000-0.1 UNIT/GM-% Ointment 15 g Tube,74.6,41.03,22.38,64.53,38
NDC,51672128408,triamcinolone acetonide 0.1 % Ointment 80 g Tube,54.72,30.1,16.42,47.33,38
NDC,51672138509,ibuprofen 100 MG/5ML Suspension 473 mL Bottle,90.73,49.91,27.22,78.48,38
NDC,51672207308,Loratadine 5 MG/5ML Solution 120 mL Bottle,34.14,18.78,10.24,29.53,38
NDC,51672211402,acetaminophen 80 MG Suppos 6 Each Box,6.27,3.45,1.88,5.42,38
NDC,51672211602,acetaminophen 325 MG Suppos 6 Each Box,6.56,3.61,1.97,5.67,38
NDC,51672300302,hydrocortisone 2.5 % Cream 28.35 g Tube,30.12,16.57,9.04,26.05,38
NDC,51672400201,nortriptyline 25 MG Cap 100 Each Bottle,8.88,4.89,2.66,7.68,38
NDC,51672400301,nortriptyline 50 MG Cap 100 Each Bottle,9.08,5.0,2.72,7.85,38
NDC,51672401106,clomiPRAMINE 25 MG Cap 30 Each Bottle,9.65,5.31,2.9,8.35,38
NDC,51672402601,ketoconazole 200 MG Tab 100 Each Bottle,13.65,7.51,4.1,11.81,38
NDC,51672403701,enalapril 2.5 MG Tab 100 Each Bottle,8.53,4.7,2.56,7.38,38
NDC,51672403801,enalapril 5 MG Tab 100 Each Bottle,8.69,4.78,2.61,7.52,38
NDC,51672406901,phenytoin 125 MG/5ML Suspension 237 mL Bottle,86.99,47.85,26.1,75.25,38
NDC,51672411101,phenytoin ER 100 MG Cap 100 Each Bottle,8.82,4.86,2.65,7.63,38
NDC,51672411606,metroNIDAZOLE 0.75 % Gel 45 g Tube,333.53,183.45,100.06,288.5,38
NDC,51672411806,fluorouracil 5 % Cream 40 g Tube,349.62,192.3,104.89,302.42,38
NDC,51672412301,carBAMazepine 100 MG TABLET SR 12 HR 100 Each Bottle,9.49,5.22,2.85,8.21,38
NDC,51672412401,carBAMazepine 200 MG TABLET SR 12 HR 100 Each Bottle,9.7,5.34,2.91,8.39,38
NDC,51672412501,carBAMazepine 400 MG TABLET SR 12 HR 100 Each Bottle,11.8,6.49,3.54,10.21,38
NDC,51672413204,lamoTRIgine 150 MG Tab 60 Each Bottle,8.29,4.56,2.49,7.17,38
NDC,51672414601,phenytoin 50 MG Chew Tab 100 Each Bottle,9.39,5.17,2.82,8.12,38
NDC,51754010301,copper 0.4 MG/ML Solution 10 mL Vial,172.2,94.71,51.66,148.95,38
NDC,51754050001,caffeine citrate 60 MG/3ML Solution 3 mL Vial,98.0,53.9,1.73,84.77,48
NDC,51754050103,caffeine citrate 20 MG/ML Solution 3 mL Vial,43.0,23.65,12.9,37.2,38
NDC,51754100601,nitroprusside 50 MG/100ML Solution 100 mL Vial,235.0,129.25,70.5,203.28,38
NDC,51754425001,ePHEDrine 5 MG/ML Solution 5 mL Syringe,100.28,55.16,30.08,86.74,38
NDC,51754500105,sodium bicarbonate 1 mEq/mL Solution 50 mL Vial,86.25,47.44,25.88,74.61,38
NDC,51754501104,sodium bicarbonate 1 mEq/mL Solution 10 mL Vial,89.4,49.17,26.82,77.33,38
NDC,51759020813,eculizumab-aagh 300 mg/30 mL Solution 30 mL Vial,19653.8,10809.59,31.35,17000.54,63
NDC,51808020301,sincalide Recon Soln 1 Each Vial,288.6,158.73,86.58,917.8,48
NDC,51991000633,desvenlafaxine succinate 25 MG Tablet Extended Release 24 Hour 30 Each Bottle,9.93,5.47,2.98,8.59,38
NDC,51991031190,desvenlafaxine succinate 50 MG Tablet Extended Release 24 Hour 90 Each Bottle,9.27,5.1,2.78,8.02,38
NDC,51991031233,desvenlafaxine succinate 100 MG Tablet Extended Release 24 Hour 30 Each Bottle,9.27,5.1,2.78,8.02,38
NDC,51991036060,asenapine 10 MG SL Tab 60 Each Box,19.77,10.88,5.93,17.1,38
NDC,51991073532,granisetron 1 MG Tab 2 Each Box,33.0,18.15,9.9,54.7,48
NDC,52015008001,fidaxomicin 200 MG Tab 20 Each Bottle,629.6,346.28,188.88,544.6,38
NDC,52244002006,alprostadil 20 MCG Kit 1 Each Box,3797.65,2088.71,1139.3,3284.97,38
NDC,52244010010,theophylline 100 MG CAPSULE SR 24 HR 100 Each Bottle,18.61,10.24,5.58,16.1,38
NDC,52244020010,theophylline 200 MG CAPSULE SR 24 HR 100 Each Bottle,21.53,11.85,6.46,18.62,38
NDC,52565000950,lidocaine HCl 4 % Solution 50 mL Bottle,190.01,104.51,57.0,164.36,38
NDC,52609000105,melphalan 2 MG Tab 50 Each Bottle,36.56,20.11,10.97,31.62,48
NDC,52652900101,topiramate 25 mg/mL Solution 473 mL Bottle,2321.39,1276.77,696.42,2008.0,38
NDC,52800048856,cetaphil Lotion 473 mL Bottle,44.83,24.66,13.45,38.78,38
NDC,52817033250,cyclobenzaprine  10 MG Tab 500 Each Bottle,8.07,4.44,2.42,6.98,38
NDC,52817081615,acetic acid 2 % Solution 15 mL Bottle,118.02,64.92,35.41,102.09,38
NDC,52959055230,fentaNYL 200 MCG LOLLIPOP 30 Each Box,349.97,192.49,104.99,302.72,38
NDC,53276101001,microfibrillar collagen Powder 0.5 g Jar,249.98,137.49,74.99,216.23,38
NDC,53329006801,petrolatum Gel 28.4 g Tube,20.0,11.0,6.0,17.3,38
NDC,53746055401,demeclocycline 150 MG Tab 100 Each Bottle,23.1,12.71,6.93,19.98,38
NDC,54092018981,mesalamine 250 MG Cap CR 240 Each Bottle,16.11,8.87,4.83,13.94,38
NDC,54162010002,benzoin compound Tincture 58 mL Bottle,34.62,19.05,10.39,29.95,38
NDC,54162018525,mineral oil light 100 % Oil 25 mL Bottle,34.88,19.19,10.46,30.17,38
NDC,54162019016,mineral oil Oil 472 mL Bottle,27.36,15.05,8.21,23.67,38
NDC,54288010301,EPINEPHrine 1 mg/mL Solution 1 mL Ampule,91.5,50.33,11.4,79.15,48
NDC,54288010310,EPINEPHrine (preservative free) 1 MG/ML Solution 1 mL Ampule,91.5,50.33,2.04,79.15,48
NDC,54288010502,ethyl alcohol 99 % Solution 5 mL Ampule,5388.0,2963.4,1616.4,4660.62,38
NDC,54288012701,tetracaine 1 % Solution 2 mL Vial,525.0,288.75,157.5,454.13,38
NDC,54288014701,methylene blue 1 % Solution 10 mL Vial,1149.0,631.95,7.64,993.89,63
NDC,54288016501,CARBOplatin 150 MG/15ML Solution 15 mL Vial,157.75,86.77,3.12,136.45,48
NDC,54288016601,CARBOplatin 450 MG/45ML Solution 45 mL Vial,356.56,196.11,3.12,308.42,48
NDC,54288016701,CARBOplatin 600 MG/60ML Solution 60 mL Vial,453.0,249.15,3.12,391.85,48
NDC,54323021502,flanders buttocks Ointment 113 g Tube,41.75,22.97,12.53,36.11,38
NDC,54482005301,procarbazine 50 MG Cap 100 Each Bottle,240.01,132.01,72.0,207.61,38
NDC,54482014508,levOCARNitine 1 GM/10ML Solution 118 mL Bottle,143.51,78.94,43.05,124.14,38
NDC,54482014701,levOCARNitine 200 MG/ML Solution 5 mL Vial,248.25,136.54,21.94,214.74,48
NDC,54643564901,multivitamin Solution 10 mL Vial,119.97,65.99,35.99,103.77,38
NDC,54799043105,homatropine 5 % Solution 5 mL Bottle,149.33,82.14,44.8,129.17,38
NDC,54838011680,docusate sodium 150 MG/15ML Liquid 473 mL Bottle,55.52,30.54,16.66,48.02,38
NDC,54838020980,guaiFENesin/dextromethorphan 100-10 MG/5ML Syrup 5 mL Oral Syringe,5.37,2.96,1.61,4.65,38
NDC,54838052340,FLUoxetine 20 MG/5ML Solution 120 mL Bottle,214.0,117.7,64.2,185.11,38
NDC,54838056670,lamiVUDine 10 MG/ML Solution 240 mL Bottle,282.03,155.12,84.61,243.96,38
NDC,54879000716,sulfamethoxazole/trimethoprim 200-40 mg/5 mL Suspension 473 mL Bottle,318.62,175.25,95.59,275.61,38
NDC,54879002101,cycloPHOSphamide 25 MG Cap 100 Each Bottle,15.55,8.56,0.72,13.45,48
NDC,55111016330,OLANZapine 2.5 MG Tab 30 Each Bottle,8.47,4.66,2.54,7.33,38
NDC,55111016730,OLANZapine 15 MG Tab 30 Each Bottle,9.21,5.07,2.76,7.97,38
NDC,55111018015,tiZANidine 4 MG Tab 150 Each Bottle,8.34,4.59,2.5,7.21,38
NDC,55111019605,clopidogrel 75 mg Tab 500 Each Bottle,8.55,4.71,2.57,7.4,38
NDC,55111025760,ziprasidone 40 MG Cap 60 Each Bottle,9.65,5.31,2.9,8.35,38
NDC,55111052501,tacrolimus 0.5 MG Cap 100 Each Bottle,9.22,5.08,0.15,7.98,48
NDC,55111052601,tacrolimus 1 MG Cap 100 Each Bottle,9.17,5.05,0.15,7.93,48
NDC,55111052701,tacrolimus 5 MG Cap 100 Each Bottle,17.36,9.55,0.15,15.02,48
NDC,55111055610,decitabine 10 mg/mL Recon Soln 1 Each Vial,2725.0,1498.75,2.0,2357.13,48
NDC,55111062660,zafirlukast 20 MG Tab 60 Each Bottle,12.41,6.83,3.72,10.73,38
NDC,55111067811,fondaparinux 2.5 MG/0.5ML Solution 0.5 mL Syringe,179.25,98.59,0.58,155.05,48
NDC,55111067910,fondaparinux 5 MG/0.4ML Solution 0.4 mL Syringe,346.8,190.74,0.58,299.98,48
NDC,55135013201,sacituzumab Govitecan-hziy 10 mg/mL Recon Soln 1 Each Vial,10826.93,5954.82,30.43,9365.29,63
NDC,55150011620,ampicillin/sulbactam 1.5 (1-0.5) g Recon Soln 1 Each Vial,45.44,25.0,1.41,39.31,48
NDC,55150011720,ampicillin/sulbactam 3 (2-1) g Recon Soln 1 Each Vial,62.49,34.37,1.41,54.05,48
NDC,55150012030,piperacillin/tazobactam Recon Soln 1 Each Vial,63.5,34.93,0.98,54.93,48
NDC,55150012150,piperacillin/tazobactam 4.5 (4-0.5) g Recon Soln 1 Each Vial,70.5,38.78,0.98,60.98,48
NDC,55150012215,nafcillin 1 g Recon Soln 1 Each Vial,96.05,52.83,0.24,83.08,48
NDC,55150012315,nafcillin 2 g Recon Soln 1 Each Vial,101.25,55.69,0.24,87.58,86
NDC,55150015974,lidocaine (PF) 1 % Solution 5 mL Ampule,41.84,23.02,12.55,36.19,38
NDC,55150016402,lidocaine (PF) 2 % Solution 2 mL Vial,50.01,27.51,15.0,43.26,38
NDC,55150016830,BUPivacaine (PF) 0.25 % Solution 30 mL Vial,42.55,23.41,0.01,36.81,48
NDC,55150017030,BUPivacaine (PF) 0.5 % Solution 30 mL Vial,44.35,24.4,0.01,38.36,48
NDC,55150017301,SUMAtriptan 6 MG/0.5ML Solution 0.5 mL Vial,91.5,50.33,27.45,171.65,48
NDC,55150017410,azithromycin Recon Soln 1 Each Vial,68.4,37.62,1.83,59.17,48
NDC,55150018301,niCARdipine 2.5 MG/ML Solution 10 mL Vial,158.06,86.94,0.06,136.72,48
NDC,55150019410,esmolol 100 MG/10ML Solution 10 mL Vial,58.0,31.9,0.18,50.17,48
NDC,55150020830,meropenem 1 g Recon Soln 1 Each Vial,91.5,50.33,0.33,79.15,48
NDC,55150021899,eptifibatide 75 mg in 100 mL 75 MG/100ML Solution 100 mL Vial,615.0,338.25,21.75,531.98,48
NDC,55150023200,fondaparinux 7.5 MG/0.6ML Solution 0.6 mL Syringe,363.0,199.65,0.58,314.0,48
NDC,55150023300,fondaparinux 10 MG/0.8ML Solution 0.8 mL Syringe,363.6,199.98,0.58,314.51,48
NDC,55150023410,polymyxin B Recon Soln 1 Each Vial,95.0,52.25,28.5,82.18,38
NDC,55150023501,vecuronium Recon Soln 1 Each Vial,58.0,31.9,17.4,50.17,38
NDC,55150028220,ertapenem 1 g Recon Soln 1 Each Vial,375.0,206.25,9.45,324.38,48
NDC,55150028701,milrinone 20 MG/100ML Solution 100 mL Flex Cont,96.0,52.8,1.13,83.04,48
NDC,55150032801,naloxone 0.4 MG/ML Solution 10 mL Vial,636.0,349.8,0.35,550.14,48
NDC,55150032801,naloxone 4 MG/10ML Solution 10 mL Vial,636.0,349.8,0.35,550.14,48
NDC,55150032810,naloxone 4 MG/10ML Solution 10 mL Vial,636.0,349.8,0.35,550.14,48
NDC,55150034301,verapamil 2.5 MG/ML Solution 4 mL Vial,195.0,107.25,58.5,168.68,38
NDC,55150037001,vasopressin 20 UNIT/ML Solution 1 mL Vial,183.0,100.65,1.4,158.3,48
NDC,55150043801,ketamine 10 MG/ML Solution 20 mL Vial,213.0,117.15,63.9,184.25,38
NDC,55292020111,succimer 100 MG Cap 100 Each Bottle,65.49,36.02,19.65,56.65,38
NDC,55292070254,hemin 350 MG Recon Soln 1 Each Vial,45960.06,25278.04,28.44,39755.45,63
NDC,55513000504,darbepoetin alfa 100 MCG/ML Solution 1 mL Vial,4194.6,2307.03,2.56,3628.33,63
NDC,55513002304,darbepoetin alfa 60 MCG/0.3ML Solution Prefilled Syringe 0.3 mL Syringe,2522.76,1387.52,2.56,2182.19,63
NDC,55513002504,darbepoetin alfa 100 MCG/0.5ML Solution Prefilled Syringe 0.5 mL Syringe,4194.6,2307.03,2.56,3628.33,63
NDC,55513002704,darbepoetin alfa 150 mcg/0.3 mL Solution Prefilled Syringe 0.3 mL Syringe,6284.4,3456.42,2.56,5436.01,63
NDC,55513002801,darbepoetin alfa 200 MCG/0.4ML Solution Prefilled Syringe 0.4 mL Syringe,8374.2,4605.81,2.56,7243.68,63
NDC,55513003201,darbepoetin alfa 500 MCG/ML Solution Prefilled Syringe 1 mL Syringe,16264.0,8945.2,2.56,14068.36,63
NDC,55513005601,aflibercept-ayyh 2 MG/0.05ML Solution Prefilled Syringe 0.05 mL Syringe,9006.0,4953.3,859.36,7790.19,63
NDC,55513005901,tarlatamab-dlle 1 MG Recon Soln 1 Each Vial,8115.0,4463.25,1352.66,10580.56,63
NDC,55513007701,tarlatamab-dlle 10 MG Recon Soln 1 Each Vial,63010.0,34655.5,1352.66,54503.65,63
NDC,55513011101,darbepoetin alfa 300 MCG/0.6ML Solution Prefilled Syringe 0.6 mL Syringe,9762.4,5369.32,2.56,8444.48,63
NDC,55513011201,Tezepelumab-ekko 210 MG/1.91ML Solution Prefilled Syringe 1.91 mL Syringe,18359.64,10097.81,15.6,15881.09,63
NDC,55513013201,trastuzumab-anns 21 mg/ml Recon Soln 1 Each Vial,16395.17,9017.35,29.78,14181.82,63
NDC,55513014101,trastuzumab-anns 21 mg/mL Recon Soln 1 Each Vial,6145.32,3379.93,29.78,5315.7,63
NDC,55513014401,epoetin alfa 10000 UNIT/ML Solution 1 mL Vial,910.32,500.68,5.55,787.43,63
NDC,55513014801,epoetin alfa 4000 UNIT/ML Solution 1 mL Vial,412.92,227.11,5.55,357.18,63
NDC,55513016001,blinatumomab 12.5 mcg/mL Recon Soln 1 Each Vial,22797.76,12538.77,130.94,19720.06,63
NDC,55513018001,eculizumab-aeeb 300 mg/30 mL Solution 30 mL Vial,24084.87,13246.68,40.31,20833.41,63
NDC,55513019001,pegfilgrastim 6 MG/0.6ML Solution Prefilled Syringe 0.6 mL Syringe,26965.56,14831.06,17.15,23325.21,63
NDC,55513019201,pegfilgrastim 6 MG/0.6ML Prefilled Syringe Kit 0.6 mL Syringe,26965.56,14831.06,17.15,23325.21,63
NDC,55513020601,bevacizumab-awwb 100 MG/4ML Solution 4 mL Vial,3164.79,1740.64,24.67,2737.54,63
NDC,55513020701,bevacizumab-awwb 400 MG/16ML Solution 16 mL Vial,12020.85,6611.47,24.67,10398.04,63
NDC,55513020910,filgrastim (G-CSF) 480 mcg/0.8 mL Solution Prefilled Syringe 0.8 mL Syringe,2884.71,1586.6,0.85,2495.27,63
NDC,55513022101,romiPLOStim 250 MCG Recon Soln 1 Each Vial,11572.68,6364.98,9.05,10010.37,63
NDC,55513022201,romiPLOStim 500 MCG Recon Soln 1 Each Vial,23135.28,12724.41,9.05,20012.02,63
NDC,55513022301,romiPLOStim 125 MCG Recon Soln 1 Each Vial,7448.26,4096.55,9.05,6442.74,63
NDC,55513022401,riTUXimab-arrx 100 mg/10 mL Solution 10 mL Vial,3250.6,1787.83,26.51,2811.77,63
NDC,55513032601,riTUXimab-arrx 500 mg/50 mL Solution 50 mL Vial,15431.2,8487.16,26.51,13347.99,63
NDC,55513053001,filgrastim (G-CSF) 300 mcg/mL Solution 1 mL Vial,1715.08,943.3,0.85,1483.54,63
NDC,55513053010,filgrastim Solution 1 mL Vial,1715.1,943.31,0.85,1483.56,63
NDC,55513054601,filgrastim (G-CSF) 480 mcg/1.6mL Solution 1.6 mL Vial,2722.18,1497.2,0.85,2354.69,63
NDC,55513054610,filgrastim (G-CSF) 480 mcg/1.6mL Solution 1.6 mL Vial,2722.18,1497.2,0.85,2354.69,63
NDC,55513067001,inFLIXimab-axxq 100 MG Recon Soln 1 Each Vial,2715.0,1493.25,17.03,2348.48,63
NDC,55513071001,denosumab 60 MG/ML Solution Prefilled Syringe 1 mL Syringe,8464.44,4655.45,23.75,7321.74,63
NDC,55513073001,denosumab 120 MG/1.7ML Solution 1.7 mL Vial,14498.91,7974.41,23.75,12541.56,63
NDC,55513080060,ivabradine 2.5 mg half tablet Tab 0.5 tablet Package,20.08,11.05,6.02,17.37,38
NDC,55513088002,romosozumab 105 MG/1.17ML Solution Prefilled Syringe 1.17 mL Syringe,7113.08,3912.2,9.86,6152.81,63
NDC,55513092410,filgrastim (G-CSF) 300 mcg/0.5mL Solution Prefilled Syringe 0.5 mL Syringe,1817.01,999.36,0.85,1571.71,63
NDC,55513095401,panitumumab 100 MG/5ML Solution 5 mL Vial,8177.43,4497.59,142.28,7073.48,63
NDC,55513095601,panitumumab 400 MG/20ML Solution 20 mL Vial,29726.06,16349.34,142.28,25713.04,63
NDC,55566280001,dinoprostone 10 MG INSERT 1 Each Box,1325.43,728.99,397.63,1146.5,38
NDC,55566410001,Sodium Hyaluronate 20 MG/2ML Solution Prefilled Syringe 2 mL Syringe,1962.4,1079.32,103.62,1697.48,63
NDC,55566830301,degarelix acetate 80 MG Recon Soln 1 Each Vial,2325.72,1279.15,3.68,2011.75,63
NDC,55566840301,degarelix acetate 120 MG/VIAL Recon Soln 1 Each Vial,1834.02,1008.72,3.68,1586.43,63
NDC,55566980002,"fecal microbiota, live-jslm 150 ML Suspension 150 mL Box",38377.0,21107.35,54.61,33196.11,63
NDC,57074000177,aluminum acetate Pack 12 Each Box,9.0,4.95,2.7,7.79,38
NDC,57237001106,mirtazapine 15 MG TABLET DISPERSIBLE 30 Each Box,8.82,4.86,2.65,7.63,38
NDC,57237001206,mirtazapine 30 MG TABLET DISPERSIBLE 30 Each Box,9.16,5.04,2.75,7.92,38
NDC,57237001306,mirtazapine 45 MG TABLET DISPERSIBLE 30 Each Box,9.39,5.17,2.82,8.12,38
NDC,57237010099,"metoprolol tartrate 25 MG Tab 1,000 Each Bottle",8.11,4.47,2.43,7.02,38
NDC,57237010199,"metoprolol tartrate 50 MG Tab 1,000 Each Bottle",8.09,4.45,2.43,7.0,38
NDC,57237010901,felodipine 5 MG Tablet Extended Release 24 Hour 100 Each Bottle,8.63,4.75,2.59,7.46,38
NDC,57237015035,fluconazole 40 MG/ML Recon Susp 35 mL Bottle,127.02,69.87,38.11,109.87,38
NDC,57237023305,sulfamethoxazole/trimethoprim 800-160 mg Tab 500 Each Bottle,8.2,4.51,2.46,7.09,38
NDC,57237031903,sodium citrate/citric acid 500-334 MG/5ML Solution 30 mL Cup,23.71,13.05,7.11,20.51,38
NDC,57237032521,glycerin (adult) 2 g Suppos 12 Each Box,4.31,2.38,1.29,3.73,38
NDC,57665010141,amphotericin B lipid complex 5 mg/mL Suspension 20 mL Vial,582.0,320.1,8.85,503.43,63
NDC,57894003001,inFLIXimab 100 mg Recon Soln 1 Each Vial,6321.23,3476.68,26.21,5467.86,63
NDC,57894005427,ustekinumab 130 MG/26ML Solution 26 mL Vial,8912.53,4901.9,10.96,7709.34,63
NDC,57894006003,ustekinumab 45 MG/0.5ML Solution Prefilled Syringe 0.5 mL Syringe,61228.11,33675.47,133.84,52962.32,63
NDC,57894006103,ustekinumab 90 mg/mL Solution Prefilled Syringe 1 mL Syringe,122446.13,67345.38,133.84,105915.9,63
NDC,57894044901,teclistamab-cqyv 10 mg/mL Solution 3 mL Vial,8914.48,4902.97,33.58,7711.03,53
NDC,57894045001,teclistamab-cqyv 90 mg/mL Solution 1.7 mL Vial,41321.6,22726.88,33.58,35743.18,53
NDC,57894046901,talquetamab-tgvs 3 MG/1.5ML Solution 1.5 mL Vial,3785.02,2081.77,60.08,3274.04,63
NDC,57894047001,talquetamab-tgvs 40 MG/ML Solution 1 mL Vial,45692.36,25130.8,60.08,39523.89,126
NDC,57894050101,amivantamab-vmjw 350 mg/7mL Solution 7 mL Vial,16388.71,9013.8,18.51,14176.23,63
NDC,57894050205,daratumumab 100 MG/5ML Solution 5 mL Vial,3515.34,1933.44,56.09,3040.77,63
NDC,57894050220,Daratumumab 400 MG/20ML Solution 20 mL Vial,12667.59,6967.18,56.09,10957.47,63
NDC,57894050301,daratumumab-hyaluronidase-fihj 1800-30000 mg-UT/15 mL Solution 15 mL Vial,43359.65,23847.81,44.12,37506.1,63
NDC,57894065001,guselkumab 200 MG/20ML Solution 20 mL Vial,61189.05,33653.98,63.13,52928.53,63
NDC,57896046208,sennosides 8.8 MG/5ML Syrup 237 mL Bottle,42.06,23.14,12.62,36.38,38
NDC,57896087005,FLORANEX (lactobacillus acidophilus) Tab 50 Each Bottle,8.33,4.59,2.5,7.21,38
NDC,57896090110,"aspirin 325 MG Tab 1,000 Each Bottle",4.03,2.22,1.21,3.49,38
NDC,57970010001,dalbavancin 500 mg Recon Soln 1 Each Vial,9622.3,5292.27,13.4,8323.29,63
NDC,58160081052,Diphtheria/acellular pertussis/tetanus vaccine 25-58-10 LF-MCG/0.5 Suspension 0.5 mL Syringe,105.31,57.93,30.38,91.09,38
NDC,58160081552,hepatitis A/hepatitis B vaccine 720-20 ELU-MCG/ML Suspension Prefilled Syringe 1 mL Syringe,421.18,231.65,111.04,364.32,38
NDC,58160082052,hepatitis B vaccine 10 mcg/0.5 mL Suspension Prefilled Syringe 0.5 mL Syringe,113.31,62.33,26.42,213.77,53
NDC,58160082311,zoster recombinant adjuvanted vaccine 50 MCG/0.5ML Recon Susp 1 Each Vial,680.38,374.21,204.11,588.53,38
NDC,58160082415,"measles, mumps, & rubella vaccine Recon Susp 1 Each Vial",350.72,192.9,96.31,303.37,38
NDC,58160082543,hepatitis A 720 EL U/0.5ML Suspension Prefilled Syringe 0.5 mL Syringe,148.86,81.88,36.05,128.76,38
NDC,58160082652,hepatitis A vaccine 1440 EL U/ML Suspension 1 mL Syringe,318.14,174.98,61.49,490.59,38
NDC,58160082703,Meningococcal A C Y&W-135 oligosaccharide Solution 0.5 mL Vial,528.25,290.54,156.09,456.94,38
NDC,58160084211,tetanus/diphtheria/acellular pertussis (Tdap) vaccine 5-2.5-18.5 LF-MCG/0.5 Suspension 0.5 mL Vial,183.49,100.92,33.17,268.04,38
NDC,58160084243,tetanus/diphtheria/acellular pertussis (Tdap) vaccine 5-2.5-18.5 LF-MCG/0.5 Suspension Prefilled Syringe 0.5 mL Syringe,183.49,100.92,33.17,268.04,38
NDC,58160084811,RSV adjuvanted RSVpreF3 vaccine 120 MCG/0.5ML Recon Susp 1 Each Box,963.81,530.1,289.14,833.7,38
NDC,58160088441,influenza trivalent vaccine 0.5 mL Suspension Prefilled Syringe 0.5 mL Syringe,20.0,11.0,6.0,150.86,53
NDC,58160096412,"rabies vaccine, PCEC Recon Susp 1 Each Vial",1190.6,654.83,281.44,2106.2,53
NDC,58160097602,meningococcal group B vaccine Suspension Prefilled Syringe 0.5 mL Syringe,747.83,411.31,213.92,646.87,38
NDC,58204000411,multivitamin special formulation Chew Tab 60 Each Bottle,4.91,2.71,1.47,4.25,38
NDC,58394063303,coagulation factor IX recombinant 250 units Kit 1 Each Vial,31.79,17.49,1.58,27.98,63
NDC,58406001004,etanercept 25 MG/0.5ML Solution Prefilled Syringe 0.5 mL Syringe,5521.38,3036.76,678.97,4775.99,63
NDC,58468003001,Thyrotropin Alfa 0.9 MG Recon Soln 1 Each Vial,8502.95,4676.63,1775.5,14264.37,63
NDC,58468004001,Agalsidase beta 35 MG Recon Soln 1 Each Vial,32885.37,18086.96,191.92,28445.85,63
NDC,58468004101,agalsidase beta 5 mg/mL Recon Soln 1 Each Vial,6052.31,3328.78,191.92,5235.25,63
NDC,58468007001,laronidase 2.9 MG/5ML Solution 5 mL Vial,6027.25,3314.99,33.17,5213.57,63
NDC,58468008001,antithymocyte globulin (rabbit) Recon Soln 1 Each Vial,6060.14,3333.08,815.9,6725.63,63
NDC,58468009001,Hylan G-F 20 16 MG/2ML Solution Prefilled Syringe 2 mL Syringe,2480.32,1364.18,7.87,2145.48,63
NDC,58468009003,hylan 48 mg/6mL Solution Prefilled Syringe 6 mL Syringe,7410.95,4076.03,7.87,6410.47,63
NDC,58468020001,alemtuzumab 12 MG/1.2ML Solution 1.2 mL Vial,123698.91,68034.41,2072.11,106999.56,63
NDC,58468022501,caplacizumab-yhdp 11 MG Kit 1 Each Box,36011.06,19806.09,10803.32,31149.57,48
NDC,58468466301,imiglucerase 400 units Recon Soln 1 Each Vial,9379.3,5158.62,37.24,8113.09,63
NDC,58657050508,guaiFENesin/dextromethorphan 100-10 MG/5ML Syrup 237 mL Bottle,30.66,16.87,9.2,26.52,38
NDC,58657052016,acetaminophen 160 MG/5ML Liquid 473 mL Bottle,18.9,10.4,5.67,16.35,38
NDC,58657052516,acetaminophen 160 MG/5ML Liquid 473 mL Bottle,57.21,31.47,17.16,49.49,38
NDC,58914008052,dicyclomine 10 MG/ML Solution 2 mL Ampule,519.35,285.65,12.79,449.24,48
NDC,58980001205,bacitracin/polymyxin B 500-10000 UNIT/GM Ointment 14.2 g Tube,32.23,17.73,9.67,27.88,38
NDC,58980040912,glycerin (pediatric) 1 g Suppos 12 Each Box,4.74,2.61,1.42,4.1,38
NDC,58980061030,urea 20 % Cream 85 g Tube,55.11,30.32,16.53,47.67,38
NDC,59011041020,oxyCODONE 10 MG Tablet Extended Release 12 hour Abuse-Deterrent 20 Each Box,21.22,11.68,6.37,18.36,38
NDC,59011042020,oxyCODONE 20 MG Tablet Extended Release 12 hour Abuse-Deterrent 20 Each Box,29.67,16.32,8.9,25.66,38
NDC,59011043020,oxyCODONE 30 MG Tablet Extended Release 12 hour Abuse-Deterrent 20 Each Box,38.15,20.99,11.45,33.0,38
NDC,59011044020,oxyCODONE 40 MG Tablet Extended Release 12 hour Abuse-Deterrent 20 Each Box,45.1,24.81,13.53,39.01,38
NDC,59011048020,oxyCODONE 80 MG Tablet Extended Release 12 hour Abuse-Deterrent 20 Each Box,72.77,40.03,21.83,62.95,38
NDC,59137023101,aminolevulinic acid 1.5 g Recon Soln 1 Each Vial,7675.4,4221.47,2302.62,6639.22,38
NDC,59148001871,ARIPiprazole ER 300 mg/1.5 mL Suspension Reconstituted ER 1 Each Vial,9158.99,5037.45,6.07,7922.53,63
NDC,59148001971,ARIPiprazole ER 400 mg/2 mL Suspension Reconstituted ER 1 Each Vial,12208.65,6714.76,6.07,10560.48,63
NDC,59148003613,brexpiprazole 0.25 mg half tablet Tab 0.5 tablet Package,65.63,36.1,19.69,56.77,38
NDC,59148003613,brexpiprazole 0.5 MG Tab 30 Each Bottle,126.26,69.45,37.88,109.21,38
NDC,59148003813,brexpiprazole 1 mg half tablet Tab 0.5 tablet Package,65.63,36.1,19.69,56.77,38
NDC,59148003813,brexpiprazole 2 MG Tab 30 Each Bottle,126.26,69.45,37.88,109.21,38
NDC,59310061031,reslizumab 10 mg/mL Solution 10 mL Vial,6030.6,3316.83,8.87,5216.47,63
NDC,59338077501,ferumoxytol 510 MG/17ML Solution 17 mL Vial,6460.55,3553.31,0.32,5588.38,63
NDC,59365606500,ferric subsulfate 259 MG/GM Solution 8 g Bottle,56.1,30.86,16.83,48.53,38
NDC,59390021805,fluorescein-benoxinate 0.25-0.4 % Solution 5 mL Bottle,132.0,72.6,39.6,114.18,38
NDC,59390021805,fluorescein-benoxinate Solution 5 mL Bottle,132.0,72.6,39.6,114.18,38
NDC,59572071101,luspatercept-aamt 50 mg/mL Recon Soln 1 Each Vial,16946.46,9320.56,35.44,14658.69,63
NDC,59572073014,azaCITIDine 200 MG Tab 14 Each Bottle,3632.11,1997.67,1089.63,3141.78,48
NDC,59572074014,azaCITIDine 300 MG Tab 14 Each Bottle,3632.11,1997.67,1089.63,3141.78,48
NDC,59572077501,luspatercept-aamt 50 mg/mL Recon Soln 1 Each Vial,50819.16,27950.54,35.44,43958.57,63
NDC,59572098401,romiDEPsin 5 mg/mL Recon Soln 1 Each Vial,13774.2,7575.81,26.09,11914.68,63
NDC,59584013801,candida albicans skin test Solution 1 mL Vial,1753.8,964.59,526.14,1517.04,38
NDC,59630026610,cefiderocol sulfate tosylate 1 g Recon Soln 1 Each Vial,1272.34,699.79,1.96,1100.57,63
NDC,59651005290,ezetimibe 10 MG Tab 90 Each Bottle,8.9,4.9,2.67,7.7,38
NDC,59651029960,tamoxifen 10 MG Tab 60 Each Bottle,8.63,4.75,2.59,7.46,38
NDC,59651033201,flucytosine 500 MG Cap 100 Each Bottle,60.0,33.0,18.0,51.9,38
NDC,59651042101,ursodiol 300 MG Cap 100 Each Bottle,9.37,5.16,2.81,8.11,38
NDC,59651048401,predniSONE 1 MG Tab 100 Each Bottle,8.33,4.59,0.01,7.21,48
NDC,59651087350,ciprofloxacin 750 MG Tab 50 Each Bottle,8.61,4.74,2.58,7.45,38
NDC,59676027801,rilpivirine 25 MG Tab 30 Each Bottle,123.67,68.02,37.1,106.97,38
NDC,59676032000,"epoetin alfa 20,000 units/mL Solution 1 mL Vial",2901.3,1595.72,5.55,2509.62,63
NDC,59676032004,"epoetin alfa 20,000 units/mL Solution 1 mL Vial",2901.3,1595.72,5.55,2509.62,63
NDC,59676032004,epoetin alfa 20000 UNIT/ML Solution 1 mL Vial,2901.3,1595.72,5.55,2509.62,63
NDC,59676034001,"epoetin alfa 40,000 units/mL Solution 1 mL Vial",5787.6,3183.18,5.55,5006.27,63
NDC,59676034001,epoetin alfa 40000 units/mL Solution 1 mL Vial,5787.6,3183.18,5.55,5006.27,63
NDC,59676036001,hyaluronan 30 MG/2ML Solution Prefilled Syringe 2 mL Syringe,2596.2,1427.91,79.11,2245.71,63
NDC,59676057101,etravirine 200 MG Tab 60 Each Bottle,73.41,40.38,22.02,63.5,38
NDC,59676057530,darunavir-cobicistat 800-150 MG Tab 30 Each Bottle,202.34,111.29,60.7,175.02,38
NDC,59676061001,trabectedin 0.05 mg/mL Recon Soln 1 Each Vial,15884.16,8736.29,311.46,13739.8,63
NDC,59746000106,methylPREDNISolone 4 MG Tab 100 Each Bottle,9.06,4.99,0.22,7.84,48
NDC,59746011306,prochlorperazine 5 MG Tab 100 Each Bottle,9.15,5.04,0.68,7.91,48
NDC,59746017210,"predniSONE 5 MG Tab 1,000 Each Bottle",8.5,4.68,0.01,7.35,48
NDC,59746038306,terazosin 1 MG Cap 100 Each Bottle,8.59,4.73,2.58,7.43,38
NDC,59746038606,terazosin 10 MG Cap 100 Each Bottle,8.59,4.73,2.58,7.43,38
NDC,59762005501,medroxyPROGESTERone 2.5 MG Tab 100 Each Bottle,8.47,4.66,2.54,7.33,38
NDC,59762005601,medroxyPROGESTERone 10 MG Tab 100 Each Bottle,8.87,4.88,2.66,7.67,38
NDC,59762007301,hydrocortisone 5 MG Tab 50 Each Bottle,8.57,4.72,2.57,7.41,38
NDC,59762007401,hydrocortisone 10 MG Tab 100 Each Bottle,8.94,4.92,2.68,7.73,38
NDC,59762007501,hydrocortisone 20 MG Tab 100 Each Bottle,8.54,4.7,2.56,7.39,38
NDC,59762011803,mesalamine 1000 MG Suppos 30 Each Box,21.23,11.68,6.37,18.36,38
NDC,59762013105,silver sulfADIAZINE 1% Cream 50 g Tube,62.88,34.59,18.86,54.39,38
NDC,59762033302,latanoprost 0.005 % Solution 2.5 mL Bottle,28.75,15.82,8.63,24.87,38
NDC,59762106102,"diphenoxylate/atropine 2.5-0.025 MG Tab 1,000 Each Bottle",11.03,6.07,3.31,9.54,38
NDC,59762135101,pregabalin 150 mg Cap 90 Each Bottle,10.54,5.8,3.16,9.12,38
NDC,59762201206,asenapine 5 MG SL Tab 10 Each Box,22.21,12.22,6.66,19.21,38
NDC,59762285801,exemestane 25 MG Tab 30 Each Bottle,12.0,6.6,3.6,10.38,38
NDC,59762371901,ALPRAZolam 0.125 mg half tablet Tab 0.5 tablet Package,8.05,4.43,2.42,6.96,38
NDC,59762371901,ALPRAZolam 0.25 MG Tab 100 Each Bottle,10.08,5.55,3.02,8.72,38
NDC,59762374202,medroxyPROGESTERone 10 MG Tab 100 Each Bottle,8.87,4.88,2.66,7.67,38
NDC,59762491005,sertraline 100 MG Tab 500 Each Bottle,8.32,4.58,2.5,7.2,38
NDC,59762500005,sulfaSALAzine 500 MG Tab 100 Each Bottle,8.64,4.76,2.59,7.47,38
NDC,59762531001,prazosin 1 MG Cap 90 Each Bottle,9.0,4.95,2.7,7.79,38
NDC,60219167701,chlordiazePOXIDE/clidinium 5-2.5 MG Cap 100 Each Bottle,9.4,5.17,2.82,8.13,38
NDC,60258000316,potassium citrate/citric acid 1100-334 MG/5ML Solution 473 mL Bottle,214.04,117.73,64.21,185.14,38
NDC,60258000601,potassium & sodium phosphate 280-160-250 MG Pack 100 Each Box,8.63,4.75,2.59,7.46,38
NDC,60267070550,sodium thiosulfate 250 MG/ML Solution 50 mL Vial,30.0,16.5,0.8,25.95,48
NDC,60432006547,amoxicillin/clavulanate 250-62.5 mg/5 mL Recon Susp 10 mL Oral Syringe,27.31,15.03,8.19,23.62,38
NDC,60432053716,nystatin 100000 UNIT/ML Suspension 473 mL Bottle,301.45,165.8,90.44,260.75,38
NDC,60505004206,acyclovir 200 MG Cap 100 Each Bottle,8.59,4.73,2.58,7.43,38
NDC,60505009300,doxazosin 1 MG Tab 100 Each Bottle,9.4,5.17,2.82,8.13,38
NDC,60505009400,doxazosin 2 MG Tab 100 Each Bottle,9.4,5.17,2.82,8.13,38
NDC,60505014200,glipiZIDE 10 MG Tab 100 Each Bottle,8.26,4.55,2.48,7.14,38
NDC,60505015701,buPROPion 100 MG Tab 100 Each Bottle,9.14,5.03,2.74,7.91,38
NDC,60505015900,sotalol 120 MG Tab 100 Each Bottle,8.41,4.63,2.52,7.27,38
NDC,60505016909,pravastatin 20 MG Tab 90 Each Bottle,8.86,4.88,2.66,7.66,38
NDC,60505017009,pravastatin 40 MG Tab 90 Each Bottle,9.27,5.1,2.78,8.02,38
NDC,60505025103,tiZANidine 2 MG Tab 150 Each Bottle,8.55,4.71,2.57,7.4,38
NDC,60505081500,desmopressin 0.01 % Solution 5 mL Bottle,415.17,228.35,124.55,359.12,38
NDC,60505082306,calcitonin (salmon) 200 UNIT/ACT Solution 3.7 mL Bottle,258.33,142.09,77.5,223.46,38
NDC,60505082901,fluticasone propionate 50 mcg/act Suspension 16 g Bottle,83.0,45.65,24.9,71.8,38
NDC,60505083305,azelastine hydrochloride 137 mcg/spray Solution 30 mL Bottle,96.13,52.88,28.84,83.15,38
NDC,60505100301,ketorolac 0.5 % Solution 5 mL Bottle,132.21,72.72,39.66,114.36,38
NDC,60505132101,midodrine 5 MG Tab 100 Each Bottle,9.2,5.06,2.76,7.96,38
NDC,60505132309,pravastatin 80 MG Tab 90 Each Bottle,9.27,5.1,2.78,8.02,38
NDC,60505252603,modafinil 100 MG Tab 30 Each Bottle,12.18,6.7,3.65,10.54,38
NDC,60505257809,atorvastatin 10 MG Tab 90 Each Bottle,8.56,4.71,2.57,7.4,38
NDC,60505257908,"atorvastatin 20 MG Tab 1,000 Each Bottle",8.8,4.84,2.64,7.61,38
NDC,60505267303,ARIPiprazole 2.5 mg half tablet Tab 0.5 tablet Package,9.23,5.08,2.77,7.98,38
NDC,60505325006,lamiVUDine 100 MG Tab 60 Each Bottle,37.64,20.71,11.29,32.56,38
NDC,60505362906,dasatinib 50 MG Tab 60 Each Bottle,207.48,114.12,62.24,179.47,38
NDC,60505463003,cycloSPORINE modified 25 mg Cap 30 Each Box,10.3,5.67,0.71,8.91,48
NDC,60505463203,cycloSPORINE modified 100 mg Cap 30 Each Box,20.19,11.11,1.89,17.46,48
NDC,60505464203,prasugrel 5 MG Tab 30 Each Bottle,9.48,5.22,2.84,8.2,38
NDC,60505464303,prasugrel 10 MG Tab 30 Each Bottle,9.48,5.22,2.84,8.2,38
NDC,60505476505,APO-varenicline 0.5 MG Tab 56 Each Bottle,26.04,14.33,7.81,22.52,38
NDC,60505476606,APO-varenicline 1 MG Tab 56 Each Bottle,26.04,14.33,7.81,22.52,38
NDC,60505477303,vilazodone 20 MG Tab 30 Each Bottle,19.78,10.88,5.93,17.11,38
NDC,60505613000,ondansetron 4 MG/2ML Solution 2 mL Vial,33.68,18.53,0.08,29.13,48
NDC,60505614600,cefepime Recon Soln 1 Each Vial,60.35,33.2,1.06,52.2,48
NDC,60505614600,cefepime Recon Soln 1 g Flex Cont,74.84,41.17,1.06,64.74,48
NDC,60505614604,cefepime Recon Soln 1 Each Vial,60.32,33.18,1.06,52.18,48
NDC,60505614700,cefepime Recon Soln 1 Each Vial,111.85,61.52,1.06,96.75,48
NDC,60505614704,cefepime Recon Soln 1 Each Vial,111.85,61.52,1.06,96.75,48
NDC,60505619702,sirolimus 1 MG/ML Solution 60 mL Bottle,2848.13,1566.48,0.91,2463.63,48
NDC,60505620202,cycloSPORINE 0.05 % Emulsion 60 Each Plas Cont,19.6,10.78,5.88,16.95,38
NDC,60505622600,atropine 1 % Solution 2 mL Bottle,147.3,81.02,44.19,127.41,38
NDC,60505622601,atropine 1 % Solution 5 mL Bottle,175.3,96.42,52.59,151.63,38
NDC,60574411301,palivizumab 100 MG/ML Solution 1 mL Vial,14449.26,7947.1,641.4,12498.61,53
NDC,60687011221,anastrozole 1 MG Tab 30 Each Box,9.72,5.35,2.92,8.41,38
NDC,60687012911,docusate sodium 100 MG Cap 1 Each Blister,8.59,4.73,2.58,7.43,38
NDC,60687013411,predniSONE 10 MG Tab 1 Each Blister,8.58,4.72,0.01,7.42,48
NDC,60687014511,predniSONE 20 MG Tab 1 Each Blister,8.65,4.76,0.01,7.48,48
NDC,60687015211,cephALEXin 250 MG Cap 1 Each Blister,9.07,4.99,2.72,7.85,38
NDC,60687017311,memantine 5 MG Tab 1 Each Blister,9.58,5.27,2.87,8.29,38
NDC,60687018411,memantine 10 MG Tab 1 Each Blister,9.0,4.95,2.7,7.79,38
NDC,60687019511,dilTIAZem 120 MG CAPSULE SR 24 HR 1 Each Blister,9.43,5.19,2.83,8.16,38
NDC,60687020611,dilTIAZem 180 MG CAPSULE SR 24 HR 1 Each Blister,9.43,5.19,2.83,8.16,38
NDC,60687021001,simvastatin 40 MG Tab 100 Each Box,8.64,4.76,2.59,7.47,38
NDC,60687021711,dilTIAZem 240 MG CAPSULE SR 24 HR 1 Each Blister,8.84,4.87,2.65,7.65,38
NDC,60687022901,loperamide 2 MG Cap 100 Each Box,9.55,5.26,2.87,8.26,38
NDC,60687023011,zonisamide 100 MG Cap 1 Each Blister,10.33,5.69,3.1,8.94,38
NDC,60687024211,sertraline 50 MG Tab 1 Each Blister,9.29,5.11,2.79,8.04,38
NDC,60687032511,lisinopril 10 MG Tab 1 Each Blister,8.41,4.63,2.52,7.27,38
NDC,60687033311,lisinopril 20 MG Tab 1 Each Blister,8.41,4.63,2.52,7.27,38
NDC,60687033811,QUEtiapine 50 MG Tab 1 Each Blister,8.56,4.71,2.57,7.4,38
NDC,60687034511,calcitriol 0.25 MCG Cap 1 Each Blister,9.22,5.08,2.77,7.98,38
NDC,60687034911,QUEtiapine 100 MG Tab 1 Each Blister,8.59,4.73,2.58,7.43,38
NDC,60687039579,albuterol (2.5 mg/3mL) 0.083% Nebu Soln 3 mL Plas Cont,8.96,4.93,2.69,7.75,38
NDC,60687039583,albuterol (2.5 mg/3mL) 0.083% Nebu Soln 3 mL Plas Cont,8.95,4.93,2.69,7.74,38
NDC,60687040111,LORazepam 0.5 MG Tab 1 Each Blister,10.35,5.7,3.11,8.95,38
NDC,60687040211,metoprolol succinate 50 MG Tablet Extended Release 24 Hour 1 Each Blister,9.92,5.46,2.98,8.58,38
NDC,60687040411,cloZAPine 25 MG Tab 1 Each Blister,8.97,4.94,2.69,7.76,38
NDC,60687040579,ipratropium/albuterol 0.5-2.5 (3) MG/3ML Solution 3 mL Plas Cont,10.15,5.59,3.05,8.78,38
NDC,60687041511,cloZAPine 100 MG Tab 1 Each Blister,12.01,6.61,3.6,10.39,38
NDC,60687042811,finasteride 5 MG Tab 1 Each Blister,9.7,5.34,2.91,8.39,38
NDC,60687043198,polyethylene glycol 3350 17 g Pack 14 Each Box,12.06,6.64,3.62,10.43,38
NDC,60687043611,celecoxib 100 MG Cap 1 Each Blister,11.35,6.25,3.41,9.82,38
NDC,60687044311,traZODone 50 MG Tab 1 Each Blister,8.43,4.64,2.53,7.29,38
NDC,60687044611,ibuprofen 400 MG Tab 1 Each Blister,8.41,4.63,2.52,7.27,38
NDC,60687044711,celecoxib 200 MG Cap 1 Each Blister,13.07,7.19,3.92,11.31,38
NDC,60687045011,labetalol 200 MG Tab 1 Each Blister,8.75,4.82,2.63,7.57,38
NDC,60687045401,traZODone 100 MG Tab 100 Each Box,8.61,4.74,2.58,7.45,38
NDC,60687045411,traZODone 100 MG Tab 1 Each Blister,8.61,4.74,2.58,7.45,38
NDC,60687045711,ibuprofen 600 MG Tab 1 Each Blister,8.63,4.75,2.59,7.46,38
NDC,60687046511,spironolactone 25 MG Tab 1 Each Blister,8.63,4.75,2.59,7.46,38
NDC,60687047511,levothyroxine 75 MCG Tab 1 Each Blister,8.76,4.82,2.63,7.58,38
NDC,60687047911,carBAMazepine 100 MG Chew Tab 1 Each Blister,9.61,5.29,2.88,8.31,38
NDC,60687048701,spironolactone 100 MG Tab 100 Each Box,9.19,5.06,2.76,7.95,38
NDC,60687048811,amLODIPine 5 MG Tab 1 Each Blister,8.53,4.7,2.56,7.38,38
NDC,60687049111,naproxen 500 MG Tab 1 Each Blister,8.72,4.8,2.62,7.54,38
NDC,60687049701,levothyroxine 100 MCG Tab 100 Each Box,8.81,4.85,2.64,7.62,38
NDC,60687050811,levothyroxine 112 MCG Tab 1 Each Blister,9.04,4.98,2.71,7.82,38
NDC,60687052479,budesonide 0.5 MG/2ML Suspension 2 mL Plas Cont,35.0,19.25,10.5,30.28,38
NDC,60687053511,bumetanide 2 MG Tab 1 Each Blister,12.22,6.73,3.67,10.57,38
NDC,60687055901,methocarbamol 500 MG Tab 100 Each Box,8.83,4.86,2.65,7.64,38
NDC,60687055911,methocarbamol 500 MG Tab 1 Each Blister,8.83,4.86,2.65,7.64,38
NDC,60687057511,rifAMPin 150 MG Cap 1 Each Blister,16.57,9.12,4.97,14.33,38
NDC,60687057811,acetaZOLAMIDE 500 MG CAPSULE SR 12 HR 1 Each Blister,21.27,11.7,6.38,18.4,38
NDC,60687058611,rifAMPin 300 MG Cap 1 Each Blister,12.58,6.92,3.77,10.88,38
NDC,60687058711,propranolol 10 MG Tab 1 Each Blister,8.83,4.86,2.65,7.64,38
NDC,60687059101,gabapentin 300 MG Cap 100 Each Box,8.46,4.66,2.54,7.32,38
NDC,60687059111,gabapentin 300 MG Cap 1 Each Blister,8.46,4.66,2.54,7.32,38
NDC,60687059311,hydroCHLOROthiazide 25 MG Tab 1 Each Blister,8.69,4.78,2.61,7.52,38
NDC,60687059801,propranolol 20 MG Tab 100 Each Box,9.52,5.24,2.86,8.23,38
NDC,60687059811,propranolol 20 MG Tab 1 Each Blister,9.52,5.24,2.86,8.23,38
NDC,60687060201,gabapentin 400 MG Cap 100 Each Box,8.64,4.76,2.59,7.47,38
NDC,60687061911,acetaZOLAMIDE 250 MG Tab 1 Each Blister,17.47,9.61,5.24,15.11,38
NDC,60687062201,senna/docusate 8.6-50 mg Tab 100 Each Box,4.72,2.6,1.42,4.08,38
NDC,60687062845,potassium chloride 20 MEQ/15ML (10%) Solution 30 mL Cup,86.92,47.81,26.08,75.19,38
NDC,60687063101,metoclopramide 10 MG Tab 100 Each Box,8.8,4.84,2.64,7.61,38
NDC,60687065301,potassium chloride 10 MEQ Cap CR 100 Each Box,9.55,5.26,2.87,8.26,38
NDC,60687065711,levETIRAcetam 500 MG Tab 1 Each Blister,8.89,4.89,2.67,7.69,38
NDC,60687066101,carbidopa/levodopa 25-100 mg Tab 100 Each Box,9.2,5.06,2.76,7.96,38
NDC,60687066291,albuterol HFA 108 (90 Base) MCG/ACT Aero Soln 6.7 g Inhaler,107.49,59.12,32.25,92.98,38
NDC,60687066711,lisinopril 5 MG Tab 1 Each Blister,8.56,4.71,2.57,7.4,38
NDC,60687067501,hydrOXYzine HCl 25 MG Tab 100 Each Box,9.04,4.98,2.71,7.82,38
NDC,60687067711,allopurinol 100 MG Tab 1 Each Blister,9.37,5.16,2.81,8.11,38
NDC,60687067811,lisinopril 40 MG Tab 1 Each Blister,8.63,4.75,2.59,7.46,38
NDC,60687068111,folic acid 1 MG Tab 1 Each Blister,8.57,4.72,2.57,7.41,38
NDC,60687068601,hydrOXYzine HCl 50 MG Tab 100 Each Box,9.25,5.09,2.78,8.0,38
NDC,60687068811,allopurinol 300 MG Tab 1 Each Blister,9.21,5.07,2.76,7.97,38
NDC,60687069011,glipiZIDE 5 MG Tab 1 Each Blister,9.04,4.98,2.71,7.82,38
NDC,60687069511,sucralfate 1 g Tab 1 Each Blister,9.27,5.1,2.78,8.02,38
NDC,60687070911,propafenone 150 MG Tab 1 Each Blister,9.34,5.14,2.8,8.08,38
NDC,60687071101,OXcarbazepine 150 MG Tab 100 Each Box,8.62,4.75,2.59,7.46,38
NDC,60687071111,OXcarbazepine 150 MG Tab 1 Each Blister,8.62,4.75,2.59,7.46,38
NDC,60687071995,emtricitabine/tenofovir DF 200/300 mg Tab 1 Each Blister,12.84,7.07,1.57,11.75,63
NDC,60687072811,dilTIAZem 60 MG Tab 1 Each Blister,8.52,4.69,2.56,7.37,38
NDC,60687073211,desmopressin 0.2 mg Tab 1 Each Blister,16.41,9.03,4.92,14.19,38
NDC,60687073842,sucralfate 1 GM/10ML Suspension 10 mL Cup,37.75,20.77,11.33,32.65,38
NDC,60687074265,azithromycin 250 MG Tab 50 Each Box,11.68,6.43,3.5,10.1,38
NDC,60687075611,potassium chloride crys 20 MEQ Tab CR 1 Each Blister,8.53,4.7,2.56,7.38,38
NDC,60687076513,valGANciclovir 50 MG/ML Recon Soln 88 mL Bottle,1684.17,926.3,505.25,1456.81,38
NDC,60687077711,rivastigmine 1.5 MG Cap 1 Each Blister,16.95,9.33,5.09,14.66,38
NDC,60687079411,isosorbide mononitrate 60 MG Tablet Extended Release 24 Hour 1 Each Blister,9.37,5.16,2.81,8.11,38
NDC,60687080040,nystatin 100000 UNIT/ML Suspension 5 mL Cup,14.27,7.85,4.28,12.34,38
NDC,60687080611,lithium 300 MG Cap 1 Each Blister,8.97,4.94,2.69,7.76,38
NDC,60687083311,hydrALAZINE 50 MG Tab 1 Each Blister,9.02,4.97,2.71,7.8,38
NDC,60687083811,zolpidem 5 MG Tab 1 Each Blister,10.38,5.71,3.11,8.98,38
NDC,60687085401,predniSONE 50 MG Tab 100 Each Box,9.48,5.22,0.01,8.2,48
NDC,60687085411,predniSONE 50 MG Tab 1 Each Blister,9.48,5.22,0.01,8.2,48
NDC,60758011905,prednisoLONE acetate 1 % Suspension 5 mL Bottle,174.0,95.7,52.2,150.51,38
NDC,60758088005,fluorometholone 0.1 % Suspension 5 mL Bottle,266.68,146.68,80.0,230.68,38
NDC,60793020505,thrombin 5000 units Kit 1 Each Box,545.82,300.21,163.75,472.13,38
NDC,60793021505,thrombin 5000 unit Recon Soln 1 Each Vial,469.68,258.33,140.9,406.27,38
NDC,60793021722,thrombin 20000 units Kit 1 Each Box,1862.07,1024.14,558.62,1610.69,38
NDC,60793070010,penicillin G benzathine 600000 UNIT/ML Suspension Prefilled Syringe 1 mL Syringe,1165.61,641.09,23.03,1008.25,63
NDC,60793070102,penicillin G benzathine 1200000 UNIT/2ML Suspension Prefilled Syringe 2 mL Syringe,2007.82,1104.31,23.03,1736.76,63
NDC,60793070210,penicillin G benzathine 2400000 UNIT/4ML Suspension Prefilled Syringe 4 mL Syringe,4098.59,2254.23,23.03,3545.28,63
NDC,60793070505,thrombin 5000 units Kit 1 Each Box,520.62,286.35,156.19,450.34,38
NDC,60977014101,pralidoxime Recon Soln 1 Each Vial,535.2,294.36,89.33,462.95,48
NDC,61269073063,miconazole 2 % Cream 45 g Tube,40.79,22.44,12.24,35.28,38
NDC,61269098937,docosanol 10 % Cream 2 g Pump Btl,66.76,36.72,20.03,57.75,38
NDC,61314012605,ketorolac 0.5 % Solution 5 mL Bottle,118.0,64.9,35.4,102.07,38
NDC,61314020415,pilocarpine 2 % Solution 15 mL Bottle,277.13,152.43,83.14,239.72,38
NDC,61314020615,pilocarpine 4 % Solution 15 mL Bottle,289.8,159.39,86.94,250.68,38
NDC,61314022605,timolol 0.25 % Solution 5 mL Bottle,38.1,20.96,11.43,32.96,38
NDC,61314022705,timolol 0.5 % Solution 5 mL Bottle,53.78,29.58,16.13,46.52,38
NDC,61314024501,betaxolol 0.5 % Solution 5 mL Bottle,180.69,99.38,54.21,156.3,38
NDC,61314031801,filgrastim-sndz 300 mcg/0.5 mL Solution Prefilled Syringe 0.5 mL Syringe,1496.54,823.1,0.31,1294.51,63
NDC,61314032601,filgrastim-sndz 480 mcg/0.8 mL Solution Prefilled Syringe 0.8 mL Syringe,2385.49,1312.02,0.31,2063.45,63
NDC,61314039601,cyclopentolate 1 % Solution 2 mL Bottle,61.83,34.01,18.55,53.48,38
NDC,61314062810,trimethoprim/polymyxin B 10000-0.1 UNIT/ML-% Solution 10 mL Bottle,56.23,30.93,16.87,48.64,38
NDC,61314063305,gentamicin 0.3 % Solution 5 mL Bottle,37.5,20.63,11.25,32.44,38
NDC,61314063705,prednisoLONE acetate 1 % Suspension 5 mL Bottle,174.88,96.19,52.46,151.27,38
NDC,61314064305,tobramycin 0.3 % Solution 5 mL Bottle,74.25,40.84,22.28,64.23,38
NDC,61314064511,neomycin/polymyxin/hydrocortisone 3.5-10000-1 Suspension 10 mL Bottle,287.68,158.23,86.3,248.84,38
NDC,61314064610,neomycin/polymyxin/hydrocortisone 3.5-10000-1 Solution 10 mL Bottle,287.68,158.23,86.3,248.84,38
NDC,61314065605,ciprofloxacin 0.3 % Solution 5 mL Bottle,69.0,37.95,20.7,59.69,38
NDC,61314066505,apraclonidine 0.5 % Solution 5 mL Bottle,223.81,123.1,67.14,193.6,38
NDC,61314086601,pegfilgrastim-bmez 6 MG/0.6ML Solution Prefilled Syringe 0.6 mL Syringe,16497.23,9073.48,21.21,14270.1,63
NDC,61553011302,fentaNYL 10 mcg/mL Solution 250 mL Bag,314.0,172.7,94.2,271.61,38
NDC,61553014978,methadone 10 MG/ML Solution 1 mL Syringe,253.39,139.37,17.74,219.18,48
NDC,61553660044,morphine 10 mg/mL Solution 30 mL Syringe,148.5,81.68,44.55,128.45,38
NDC,61703030538,cytarabine 20 MG/ML Solution 5 mL Vial,59.82,32.91,0.68,51.74,48
NDC,61703030906,vinCRIStine 1 MG/ML Solution 1 mL Vial,113.43,62.39,7.16,98.12,48
NDC,61703032322,bleomycin 30 units Recon Soln 1 Each Vial,470.01,258.51,17.95,406.56,48
NDC,61703032418,pamidronate 30 MG/10ML Solution 10 mL Vial,113.86,62.63,10.8,98.49,48
NDC,61703032618,pamidronate 90 MG/10ML Solution 10 mL Vial,239.88,131.94,10.8,207.5,48
NDC,61703033218,bleomycin Recon Soln 1 Each Vial,267.16,146.94,17.95,231.09,48
NDC,61703034222,PACLitaxel 100 MG/16.7ML Conc 16.7 mL Vial,162.49,89.37,0.1,140.55,48
NDC,61703034366,mitoXANTRONE 30 MG/15ML Conc 15 mL Vial,1246.55,685.61,23.88,1078.27,63
NDC,61703034916,Irinotecan HCl 40 MG/2ML Solution 2 mL Vial,97.02,53.37,1.69,83.92,48
NDC,61755000501,aflibercept 2 MG/0.05ML Solution Prefilled Syringe 0.05 mL Syringe,10254.75,5640.12,687.8,8870.36,63
NDC,61755001001,Evinacumab-dgnb 1200 MG/8ML Solution 8 mL Vial,105292.29,57910.76,159.97,91077.83,63
NDC,61755001301,evinacumab-dgnb 345 MG/2.3ML Solution 2.3 mL Vial,52982.67,29140.47,159.97,45830.01,63
NDC,61755002401,casirivimab 300 MG/2.5ML Solution 11.1 mL Vial,30.09,16.55,9.03,26.03,38
NDC,61755005001,aflibercept 8 MG/0.07ML Solution 0.07 mL Vial,11255.5,6190.53,282.53,9736.01,63
NDC,61874011511,cariprazine 1.5 MG Cap 10 Each Blister,115.21,63.37,34.56,99.66,38
NDC,61874013011,cariprazine 3 MG Cap 10 Each Blister,115.21,63.37,34.56,99.66,38
NDC,61924017404,dry skin Cream 106 g Jar,20.0,11.0,6.0,17.3,38
NDC,61958060101,emtricitabine 200 MG Cap 30 Each Bottle,54.29,29.86,16.29,46.96,38
NDC,61958190101,elvitegravir-cobicistat-emtricitabine-tenofovir AF 150-150-200-10 MG Tab 30 Each Bottle,342.29,188.26,102.69,296.08,38
NDC,61958200202,emtricitabine/tenofovir AF 200/25 mg Tab 30 Each Box,181.18,99.65,54.35,481.07,63
NDC,61958250101,bictegravir-emtricitabine-tenofovir AF 50-200-25 mg Tab 30 Each Bottle,342.29,188.26,102.69,296.08,38
NDC,61958290102,remdesivir 5 mg/mL Recon Soln 1 Each Vial,3443.19,1893.76,5.45,2978.36,63
NDC,61958300201,lenacapavir 463.5 MG/1.5ML Solution 1.5 mL Vial,40960.0,22528.0,18.87,35430.4,63
NDC,62011004702,nicotine polacrilex 2 MG Gum 10 Each Box,20.82,11.46,6.25,18.01,38
NDC,62064012201,ibalizumab-uiyk 200 mg/1.33 mL Solution 1.33 mL Vial,8247.3,4536.02,66.22,7133.91,63
NDC,62103033304,zinc oxide 16 % Ointment 113 g Tube,38.59,21.23,11.58,33.38,38
NDC,62135000347,lactulose 10 GM/15ML Solution 473 mL Bottle,73.56,40.46,22.07,63.63,38
NDC,62327033303,sterile talc 3 g Powder 1 Each Vial,585.38,321.96,175.61,506.35,38
NDC,62332003631,rOPINIRole 5 MG Tab 100 Each Bottle,8.46,4.66,2.54,7.32,38
NDC,62332006460,rivastigmine 3 MG Cap 60 Each Bottle,8.75,4.82,2.63,7.57,38
NDC,62332009730,ARIPiprazole 2 MG Tab 30 Each Bottle,8.77,4.83,2.63,7.59,38
NDC,62332009830,ARIPiprazole 5 MG Tab 30 Each Bottle,8.78,4.83,2.63,7.59,38
NDC,62332009930,ARIPiprazole 10 MG Tab 30 Each Bottle,8.78,4.83,2.63,7.59,38
NDC,62332010130,ARIPiprazole 20 MG Tab 30 Each Bottle,8.93,4.92,2.68,7.72,38
NDC,62332010230,ARIPiprazole 30 MG Tab 30 Each Bottle,8.93,4.92,2.68,7.72,38
NDC,62332019030,febuxostat 40 MG Tab 30 Each Bottle,12.3,6.77,3.69,10.64,38
NDC,62332019130,febuxostat 80 MG Tab 30 Each Bottle,12.3,6.77,3.69,10.64,38
NDC,62332023230,vilazodone 10 MG Tab 30 Each Bottle,20.18,11.1,6.05,17.46,38
NDC,62332049430,lurasidone 20 MG Tab 30 Each Bottle,9.0,4.95,2.7,7.79,38
NDC,62332049530,lurasidone 40 MG Tab 30 Each Bottle,9.0,4.95,2.7,7.79,38
NDC,62332054410,asenapine 2.5 MG SL Tab 10 Each Box,22.21,12.22,6.66,19.21,38
NDC,62530000011,Urea 15 g Pack 1 Each Box,17.88,9.84,5.36,15.47,38
NDC,62559013811,hydrocortisone 100 MG/60ML Enema 60 mL Bottle,78.69,43.28,23.61,68.07,38
NDC,62559015901,fluvoxaMINE 50 MG Tab 100 Each Bottle,8.8,4.84,2.64,7.61,38
NDC,62559019016,metoclopramide 5 MG/5ML Solution 473 mL Bottle,239.01,131.46,71.7,206.74,38
NDC,62559026530,tranexamic acid 650 MG Tab 30 Each Bottle,15.0,8.25,4.5,12.98,38
NDC,62559042011,mesalamine 4 g Enema 60 mL Bottle,52.95,29.13,15.89,45.8,38
NDC,62559043130,hydrocortisone acetate rectal 2.5 % Cream 30 g Tube,240.23,132.13,72.07,207.8,38
NDC,62559051101,indapamide 2.5 MG Tab 100 Each Bottle,8.66,4.77,2.6,7.49,38
NDC,62559063001,erythromycin ethylsuccinate 200 mg/5 mL Recon Susp 100 mL Bottle,629.8,346.39,188.94,544.78,38
NDC,62584026711,metoprolol tartrate 100 MG Tab 1 Each Blister,8.92,4.91,2.68,7.72,38
NDC,62584073311,hydrALAZINE 25 MG Tab 1 Each Blister,8.79,4.84,2.64,7.6,38
NDC,62584098411,warfarin 2 mg Tab 1 Each Blister,9.05,4.98,2.72,7.83,38
NDC,62584099411,warfarin 5 mg Tab 1 Each Blister,9.1,5.01,2.73,7.87,38
NDC,62756005940,epoprostenol 0.5 mg Recon Soln 1 Each Vial,164.63,90.55,14.12,142.4,48
NDC,62756006040,epoprostenol 1.5 mg Recon Soln 1 Each Vial,282.0,155.1,14.12,243.93,48
NDC,62856021501,lecanemab-irmb 500 MG/5ML Solution 5 mL Vial,3506.69,1928.68,1.32,3033.29,53
NDC,62856038901,eriBULin 1 MG/2ML Solution 2 mL Vial,6370.0,3503.5,89.34,5510.05,63
NDC,62935022305,leuprolide acetate 22.5 MG Kit 1 Each Box,6122.82,3367.56,155.23,5296.24,63
NDC,62935030330,leuprolide acetate 30 MG Kit 1 Each Box,8155.42,4485.49,155.23,7054.44,63
NDC,62935046150,leuprolide acetate 45 MG Kit 1 Each Box,11673.56,6420.46,155.23,10097.63,63
NDC,62935075680,leuprolide acetate 7.5 MG Kit 1 Each Box,2152.94,1184.12,155.23,1862.29,63
NDC,63020053330,PONATinib 30 MG Tab 30 Each Bottle,1816.2,998.91,544.86,1571.01,48
NDC,63020053430,PONATinib 45 MG Tab 30 Each Bottle,1816.2,998.91,544.86,1571.01,48
NDC,63020053530,PONATinib 15 mg Tab 30 Each Bottle,1816.2,998.91,544.86,1571.01,48
NDC,63020053630,PONATinib 10 MG Tab 30 Each Bottle,1816.2,998.91,544.86,1571.01,48
NDC,63037010005,fentaNYL 10 mcg/mL Solution 100 mL Flex Cont,440.0,242.0,132.0,380.6,38
NDC,63135058110,Lidocaine (Anorectal) 5 % Gel 10 g Tube,39.6,21.78,11.88,34.25,38
NDC,63304069201,clindamycin hydrochloride 150 MG Cap 100 Each Bottle,8.48,4.67,2.54,7.34,38
NDC,63323001020,gentamicin 40 MG/ML Solution 20 mL Vial,214.92,118.21,2.12,185.91,48
NDC,63323001020,gentamicin neonatal 40 MG/ML Solution 20 mL Vial,214.92,118.21,2.12,185.91,48
NDC,63323001115,chloramphenicol Recon Soln 1 Each Vial,306.9,168.8,50.12,265.47,48
NDC,63323001211,oxytocin 10 UNIT/ML Solution 1 mL Vial,50.88,27.99,1.73,44.01,48
NDC,63323001301,thiamine 100 MG/ML Solution 2 mL Vial,94.65,52.06,1.51,81.87,48
NDC,63323004710,heparin 5000 UNIT/ML Solution 10 mL Vial,133.04,73.18,0.17,115.08,48
NDC,63323006403,magnesium sulfate 50 % Solution 2 mL Vial,42.03,23.12,0.42,36.36,48
NDC,63323009301,sodium chloride 4 MEQ/ML Solution 30 mL Vial,78.55,43.21,23.57,67.95,38
NDC,63323009330,sodium chloride 23.4% Solution 30 mL Vial,78.55,43.21,23.57,67.95,38
NDC,63323009330,sodium chloride 4 mEq/mL Solution 30 mL Vial,78.55,43.21,23.57,67.95,38
NDC,63323010161,DOXOrubicin 2 MG/ML Solution 100 mL Vial,656.51,361.09,2.85,567.88,48
NDC,63323010600,magnesium sulfate in water 4 GM/100ML Solution 100 mL Flex Cont,79.6,43.78,0.42,68.85,48
NDC,63323010602,magnesium sulfate 2 GM/50ML Solution 50 mL Flex Cont,84.25,46.34,0.42,72.88,48
NDC,63323010615,magnesium sulfate in water 20 GM/500ML Solution 500 mL Flex Cont,61.0,33.55,0.42,52.77,48
NDC,63323011310,pentamidine Recon Soln 1 Each Vial,916.21,503.92,274.86,792.52,38
NDC,63323011710,fluorouracil 50 mg/mL Solution 10 mL Vial,46.07,25.34,1.91,39.85,48
NDC,63323011710,fluorouracil 500 MG/10ML Solution 10 mL Vial,46.07,25.34,1.91,39.85,96
NDC,63323011720,fluorouracil 1 GM/20ML Solution 20 mL Vial,62.15,34.19,1.91,53.76,48
NDC,63323011751,fluorouracil 2.5 GM/50ML Solution 50 mL Vial,98.86,54.38,1.91,85.51,48
NDC,63323012020,cytarabine 100 MG/ML Solution 20 mL Vial,128.23,70.53,0.68,110.92,48
NDC,63323012710,dacarbazine 10 mg/mL Recon Soln 1 Each Vial,88.23,48.53,3.58,76.32,48
NDC,63323012820,dacarbazine 10 mg/ml Recon Soln 1 Each Vial,86.4,47.52,3.58,74.74,48
NDC,63323013002,doxycycline Recon Soln 1 Each Vial,172.98,95.14,0.6,149.63,48
NDC,63323013011,doxycycline Recon Soln 1 Each Vial,172.98,95.14,51.89,149.63,38
NDC,63323013210,mitoXANTRONE HCl 20 MG/10ML Conc 10 mL Vial,1946.0,1070.3,23.88,1683.29,63
NDC,63323014507,floxuridine 0.5 g Recon Soln 1 Each Vial,589.3,324.12,176.79,27847.46,63
NDC,63323016200,ketorolac 30 MG/ML Solution 1 mL Vial,64.9,35.7,0.31,56.14,63
NDC,63323016202,ketorolac 60 MG/2ML Solution 2 mL Vial,82.4,45.32,0.31,71.28,63
NDC,63323016530,dexAMETHasone 120 MG/30ML Solution 30 mL Vial,293.46,161.41,0.1,253.84,48
NDC,63323017015,sodium phosphate 45 MMOLE/15ML Solution 15 mL Vial,213.09,117.2,63.93,184.32,38
NDC,63323017302,gentamicin (preservative free) 10 MG/ML Solution 2 mL Vial,68.19,37.51,20.46,58.98,38
NDC,63323017302,gentamicin (preservative free) 10 mg/mL Solution 2 mL Vial,68.19,37.51,20.46,58.98,38
NDC,63323017302,gentamicin 10 mg/ml Solution 2 mL Vial,68.19,37.51,2.12,58.98,48
NDC,63323018001,pyridoXINE 100 MG/ML Solution 1 mL Vial,161.25,88.69,13.55,139.48,48
NDC,63323018410,folic acid 5 MG/ML Solution 10 mL Vial,398.52,219.19,0.3,344.72,48
NDC,63323018507,sterile water for injection (PF) Solution 10 mL Vial,62.5,34.38,18.75,54.06,38
NDC,63323018601,sodium chloride (PF) 0.9 % Solution 10 mL Vial,8.06,4.44,2.42,6.97,38
NDC,63323019202,fludarabine phosphate 25 mg/mL Solution 2 mL Vial,1307.84,719.32,68.2,1131.28,126
NDC,63323020110,lidocaine 1 % Solution 10 mL Vial,44.95,24.73,13.49,38.88,38
NDC,63323022905,protamine 10 MG/ML Solution 5 mL Vial,120.62,66.35,0.98,104.34,48
NDC,63323022930,protamine 10 MG/ML Solution 25 mL Vial,332.4,182.82,0.98,287.53,48
NDC,63323024120,Sodium Glycerophosphate 1 mmol/mL Solution 20 mL Vial,104.5,57.48,31.35,90.39,38
NDC,63323025410,mineral oil light 100 % Oil 10 mL Vial,99.73,54.86,29.92,86.27,38
NDC,63323026201,heparin 5000 UNIT/ML Solution 1 mL Vial,56.2,30.91,0.17,48.61,48
NDC,63323026203,heparin 5000 UNIT/ML Solution 1 mL Vial,56.2,30.91,0.17,48.61,48
NDC,63323026206,heparin 5000 UNIT/ML Solution 1 mL Vial,56.2,30.91,0.17,48.61,48
NDC,63323026922,propofol 10 MG/ML Emulsion 20 mL Vial,67.0,36.85,0.06,57.96,48
NDC,63323026922,propofol 200 MG/20ML Emulsion 20 mL Vial,67.0,36.85,0.06,57.96,48
NDC,63323026950,propofol (10 mg/mL) Emulsion 50 mL Vial,117.5,64.63,0.06,101.64,48
NDC,63323026950,propofol 10 MG/ML Emulsion 50 mL Vial,117.5,64.63,0.06,101.64,48
NDC,63323026965,propofol (10 mg/mL) Emulsion 100 mL Vial,195.0,107.25,0.06,168.68,48
NDC,63323027810,vinBLAStine 1 MG/ML Solution 10 mL Vial,282.67,155.47,4.15,244.51,48
NDC,63323028520,ROPivacaine 0.2 % 0.2 % Solution 20 mL Ampule,92.76,51.02,0.05,80.24,48
NDC,63323028564,ROPivacaine 0.2 % Solution 200 mL Vial,503.4,276.87,0.05,435.44,48
NDC,63323028565,ROPivacaine 0.2 % Solution 100 mL Glass Cont,259.2,142.56,0.05,224.21,48
NDC,63323028630,ROPivacaine 0.5% 0.5 % Solution 30 mL Vial,161.18,88.65,0.05,139.42,48
NDC,63323028635,ROPivacaine 0.5 % Solution 30 mL Vial,166.84,91.77,0.05,144.32,48
NDC,63323028820,ROPivacaine 1 % 1 % Solution 20 mL Ampule,167.55,92.16,0.05,144.93,48
NDC,63323028820,ROPivacaine 10 MG/ML Solution 20 mL Ampule,167.55,92.16,0.05,144.93,48
NDC,63323029337,mepivacaine (PF) 1.5 % Solution 30 mL Vial,118.28,65.06,3.04,102.31,48
NDC,63323029427,mepivacaine (PF) 2 % (PF) Solution 20 mL Vial,100.34,55.19,3.04,86.79,48
NDC,63323030351,tobramycin (preservative free) 80 mg/mL Nebu Soln 1 Each Vial,516.0,283.8,154.8,446.34,38
NDC,63323030351,tobramycin (preservative free) 80 mg/mL Solution 1 Each Vial,516.0,283.8,1.69,446.34,48
NDC,63323030630,tobramycin 40 mg/mL Solution 30 mL Vial,162.94,89.62,1.69,140.94,48
NDC,63323031501,ganciclovir 50 mg/mL Recon Soln 1 Each Vial,487.17,267.95,24.67,421.4,48
NDC,63323031501,ganciclovir Recon Soln 1 Each Vial,487.17,267.95,24.67,421.4,48
NDC,63323032503,acyclovir 50 mg/mL Solution 10 mL Vial,142.2,78.21,0.05,123.0,48
NDC,63323032510,acyclovir (neonatal) 5 mg/ml Solution 30 mL Syringe,353.4,194.37,106.02,305.69,38
NDC,63323034610,cefTRIAXone Recon Soln 1 Each Vial,54.25,29.84,16.28,46.93,38
NDC,63323034925,imipenem/cilastatin Recon Soln 1 Each Vial,131.09,72.1,6.18,113.39,48
NDC,63323036003,calcium gluconate 10 % Solution 50 mL Vial,177.0,97.35,0.04,153.11,48
NDC,63323036005,calcium gluconate 10 % Solution 100 mL Vial,339.0,186.45,0.04,293.24,48
NDC,63323036019,calcium gluconate 0.465 mEq/mL Solution 10 mL Vial,85.13,46.83,0.04,73.64,48
NDC,63323036019,calcium gluconate 10 % Solution 10 mL Vial,85.13,46.83,0.04,73.64,48
NDC,63323036059,calcium gluconate 0.465 mEq/mL Solution 50 mL Vial,177.0,97.35,0.04,153.11,48
NDC,63323036061,calcium gluconate 0.465 mEq/mL Solution 100 mL Vial,339.0,186.45,0.04,293.24,48
NDC,63323037600,octreotide 100 MCG/ML Solution 1 mL Vial,94.58,52.02,28.37,81.81,38
NDC,63323037700,octreotide 500 MCG/ML Solution 1 mL Vial,313.14,172.23,93.94,270.87,38
NDC,63323037905,octreotide 1000 MCG/ML Solution 5 mL Vial,2698.15,1483.99,809.45,2333.9,38
NDC,63323039306,colistimethate 150 MG Recon Soln 1 Each Vial,182.94,100.62,10.44,158.24,48
NDC,63323039306,colistimethate 4.1 mg/mL Recon Soln 1 Each Vial,182.94,100.62,10.44,158.24,48
NDC,63323040101,aztreonam Recon Soln 1 Each Vial,231.48,127.32,1.77,200.23,48
NDC,63323040120,aztreonam Recon Soln 1 Each Vial,231.48,127.32,69.44,200.23,38
NDC,63323040201,aztreonam Recon Soln 1 Each Vial,454.86,250.18,1.77,393.45,48
NDC,63323041820,cisatracurium 200 MG/20ML Solution 20 mL Vial,1475.7,811.64,442.71,1276.48,38
NDC,63323043400,acetaminophen 10 mg/mL Solution 100 mL Flex Cont,82.6,45.43,0.04,71.45,48
NDC,63323045100,Morphine Sulfate (PF) 10 MG/ML Solution 1 mL Vial,69.65,38.31,3.48,60.25,48
NDC,63323046301,"BUPivacaine/epinephrine 0.5%/1:200,000 Solution 50 mL Vial",154.88,85.19,46.46,133.97,38
NDC,63323046802,"BUPivacaine/EPINEPHrine (PRESERVATIVE FREE) 0.25%/1:200,000 Solution 30 mL Vial",98.59,54.23,29.58,85.28,38
NDC,63323047400,haloperidol lactate 5 MG/ML Solution 1 mL Vial,66.93,36.82,1.04,57.89,48
NDC,63323047701,chloroprocaine PF 2 % Solution 20 mL Vial,177.95,97.88,0.03,153.93,48
NDC,63323047827,chloroprocaine PF 3 % Solution 20 mL Vial,165.47,91.01,0.03,143.13,48
NDC,63323048157,"lidocaine/EPINEPHrine 0.5%-1:200,000 Solution 50 mL Vial",89.05,48.98,26.72,77.03,38
NDC,63323048203,"lidocaine/EPINEPHrine 1%-1:100,000 Solution 20 mL Vial",64.2,35.31,19.26,55.53,38
NDC,63323048205,"lidocaine/EPINEPHrine 1%-1:100,000 Solution 50 mL Vial",104.5,57.48,31.35,90.39,38
NDC,63323048327,"lidocaine/EPINEPHrine 2%-1:100,000 Solution 20 mL Vial",64.76,35.62,19.43,56.02,38
NDC,63323048501,lidocaine 1 % Solution 20 mL Vial,50.5,27.78,15.15,43.68,38
NDC,63323048503,lidocaine 1 % Solution 50 mL Vial,64.9,35.7,19.47,56.14,38
NDC,63323048602,lidocaine 2 % Solution 20 mL Vial,53.8,29.59,16.14,46.54,38
NDC,63323048657,lidocaine 2 % Solution 50 mL Vial,75.05,41.28,22.52,64.92,38
NDC,63323048701,"lidocaine/EPINEPHrine 1%-1:200,000 Solution 10 mL Vial",91.76,50.47,27.53,79.37,38
NDC,63323048817,"lidocaine/EPINEPHrine (preservative free) 1.5%/1:200,000 Solution 10 mL Vial",90.98,50.04,27.29,78.7,38
NDC,63323048831,"lidocaine/EPINEPHrine (preservative free) 1.5%/1:200,000 Solution 30 mL Vial",94.49,51.97,28.35,81.73,38
NDC,63323048902,"lidocaine/EPINEPHrine 2%/1:200,000 Solution 20 mL Vial",172.75,95.02,51.83,149.43,38
NDC,63323049157,lidocaine PF 0.5 % Solution 50 mL Vial,114.25,62.84,34.28,98.83,38
NDC,63323049204,lidocaine (PF) 1 % Solution 2 mL Vial,42.7,23.49,12.81,36.94,38
NDC,63323049207,lidocaine (PF) 1 % Solution 30 mL Vial,96.64,53.16,28.99,83.59,38
NDC,63323049257,lidocaine (PF) 1 % Solution 5 mL Vial,54.48,29.97,16.34,47.13,38
NDC,63323049504,lidocaine (PF) 2 % Solution 5 mL Vial,51.93,28.57,15.58,44.92,38
NDC,63323049697,lidocaine (PF) 2 % Solution 10 mL Ampule,73.51,40.44,22.05,63.59,38
NDC,63323050601,dexAMETHasone preservative-free 10 MG/ML Solution 1 mL Vial,77.5,42.63,0.1,67.04,48
NDC,63323050801,meropenem 1 g Recon Soln 1 Each Vial,66.3,36.47,0.33,57.35,48
NDC,63323052277,"heparin 25,000 units in 500 mL D5W 50 UNIT/ML Solution 500 mL Flex Cont",156.0,85.8,0.17,134.94,48
NDC,63323052277,"heparin 25,000 units in dextrose 5 % 500 mL 50 Solution 500 mL Flex Cont",156.0,85.8,46.8,134.94,38
NDC,63323053190,enoxaparin 80 mg/0.8mL Solution Prefilled Syringe 0.8 mL Syringe,123.35,67.85,0.48,106.7,48
NDC,63323054005,heparin 1000 UNIT/ML Solution 10 mL Vial,75.89,41.74,0.17,65.64,48
NDC,63323054005,heparin DIALYSIS 1000 unit/ml Solution 10 mL Vial,75.89,41.74,22.77,65.64,38
NDC,63323054031,heparin 1000 UNIT/ML Solution 30 mL Vial,74.98,41.24,0.17,64.86,48
NDC,63323054031,heparin 1000 unit/mL Solution 30 mL Vial,74.98,41.24,22.49,64.86,38
NDC,63323054036,heparin 1000 UNIT/ML Solution 30 mL Vial,74.98,41.24,0.17,64.86,48
NDC,63323054505,heparin (porcine) lock flush 100 UNIT/ML Solution 5 mL Vial,45.92,25.26,0.02,39.72,48
NDC,63323055921,enoxaparin 30 mg/0.3mL Solution Prefilled Syringe 0.3 mL Syringe,45.77,25.18,0.48,39.59,48
NDC,63323056421,enoxaparin 40 mg/0.4mL Solution Prefilled Syringe 0.4 mL Syringe,52.6,28.93,0.48,45.5,48
NDC,63323056621,enoxaparin 60 mg/0.6mL Solution Prefilled Syringe 0.6 mL Syringe,62.59,34.43,0.48,54.14,48
NDC,63323058499,enoxaparin 80 mg/0.8mL Solution Prefilled Syringe 0.8 mL Syringe,76.8,42.24,0.48,66.43,48
NDC,63323058621,enoxaparin 100 mg/mL Solution Prefilled Syringe 1 mL Syringe,90.24,49.64,0.48,78.06,48
NDC,63323058994,enoxaparin 150 mg/mL Solution Prefilled Syringe 1 mL Syringe,110.74,60.91,0.48,95.79,48
NDC,63323059303,glucagon 1 mg Recon Soln 1 Each Vial,1379.47,758.71,96.08,1193.24,63
NDC,63323061400,hydrALAZINE 20 MG/ML Solution 1 mL Vial,113.08,62.2,3.5,97.81,48
NDC,63323061603,amiodarone 150 MG/3ML Solution 3 mL Vial,40.01,22.01,0.33,34.61,48
NDC,63323064201,magnesium sulfate 50 % Solution 20 mL Vial,88.42,48.64,0.42,76.48,48
NDC,63323064220,magnesium sulfate 4.06 mEq/mL Solution 20 mL Vial,88.42,48.64,0.42,76.48,48
NDC,63323064810,levothyroxine 100 mcg/mL Recon Soln 1 Each Vial,2865.71,1576.15,4.63,2478.84,48
NDC,63323065521,enoxaparin 120 mg/0.8mL Solution Prefilled Syringe 0.8 mL Syringe,92.09,50.65,0.48,79.66,48
NDC,63323065820,chlorothiazide Recon Soln 1 Each Vial,1622.58,892.42,51.91,1403.53,48
NDC,63323066400,diphenhydrAMINE 50 MG/ML Solution 1 mL Vial,47.58,26.17,0.62,41.16,48
NDC,63323066500,terbutaline 1 MG/ML Solution 1 mL Vial,148.05,81.43,1.84,128.06,48
NDC,63323073820,famotidine 200 MG/20ML Solution 20 mL Vial,88.0,48.4,0.05,76.12,48
NDC,63323073911,famotidine 20 MG/2ML Solution 2 mL Vial,37.2,20.46,0.05,32.18,48
NDC,63323075100,phenylephrine 10 MG/ML Solution 1 mL Vial,49.0,26.95,0.01,42.39,48
NDC,63323076305,PACLitaxel 30 MG/5ML Conc 5 mL Vial,90.77,49.93,0.1,78.52,96
NDC,63323076350,PACLitaxel 300 MG/50ML Conc 50 mL Vial,637.71,350.75,0.1,551.62,48
NDC,63323080601,fentaNYL Citrate (PF) 50 MCG/ML Solution 1 mL Vial,58.73,32.31,0.73,50.8,48
NDC,63323082005,"fat emulsion fish oil based (SMOFLIPID) 20 % Emulsion 1,000 mL Flex Cont",291.0,160.05,87.3,251.72,38
NDC,63323082074,fat emulsion fish oil based (SMOFLIPID) 20 % Emulsion 250 mL Flex Cont,162.5,89.38,48.75,140.56,38
NDC,63323087715,pentamidine Recon Soln 1 Each Vial,916.21,503.92,274.86,792.52,38
NDC,63323088510,levothyroxine 100 MCG/5ML Solution 5 mL Vial,547.14,300.93,3.29,473.28,63
NDC,63323096730,potassium chloride 2 MEQ/ML Solution 30 mL Vial,57.51,31.64,0.09,49.75,48
NDC,63459010310,riTUXimab-abbs 100 MG/10ML Solution 10 mL Vial,3829.98,2106.49,27.33,3312.93,63
NDC,63459010450,riTUXimab-abbs 500 MG/50ML Solution 50 mL Vial,18199.33,10009.64,27.33,15742.42,63
NDC,63459030343,trastuzumab-pkrb 21 mg/mL Recon Soln 1 Each Vial,6336.25,3484.94,61.8,5480.86,63
NDC,63459030741,trastuzumab-pkrb 21 mg/mL Recon Soln 1 Each Vial,16906.1,9298.36,61.8,14623.78,63
NDC,63459034804,bendamustine 100 MG/4ML Solution 4 mL Vial,11157.1,6136.41,11.55,9650.89,63
NDC,63459039008,bendamustine 25 MG Recon Soln 1 Each Vial,3368.28,1852.56,1.55,2913.56,63
NDC,63459039008,bendamustine 5 mg/mL Recon Soln 1 Each Vial,3368.28,1852.56,1.55,2913.56,63
NDC,63459039120,bendamustine 5 mg/ml Recon Soln 1 Each Vial,12798.74,7039.31,1.55,11070.91,63
NDC,63459054128,fentaNYL 100 MCG Tab 28 Each Box,165.29,90.91,49.59,142.98,38
NDC,63459091011,tbo-filgrastim 300 mcg/0.5 mL Solution Prefilled Syringe 0.5 mL Syringe,1364.24,750.34,0.28,1180.07,63
NDC,63459091211,tbo-filgrastim 480 mcg/0.8 mL Solution Prefilled Syringe 0.8 mL Syringe,2174.41,1195.93,0.28,1880.86,63
NDC,63546031025,albumin human 5 % Solution 250 mL Vial,411.0,226.05,45.57,358.29,53
NDC,63736002403,permethrin 1 % Liquid 59 mL Bottle,20.0,11.0,6.0,17.3,38
NDC,63739026310,clonazePAM 0.5 mg Tab 100 Each Box,10.28,5.66,3.08,8.89,38
NDC,63739026910,tamoxifen 10 MG Tab 100 Each Box,9.58,5.27,2.87,8.29,38
NDC,63739043402,aspirin 81 MG Chew Tab 30 Each Box,4.3,2.37,1.29,3.72,38
NDC,63807060005,heparin (porcine) lock flush 100 UNIT/ML Solution 5 mL Syringe,38.0,20.9,11.4,32.87,38
NDC,63833039601,prothrombin complex conc human 500 units Kit 1 Each Vial,36.62,20.15,1.9,32.23,63
NDC,63833039701,Prothrombin Complex Conc Human 1000 units Kit 1 Each Vial,36.62,20.15,1.9,32.23,63
NDC,63833061502,antihemophilic factor/VWF in units of FVIII Recon Soln 1 Each Vial,31.44,17.3,1.25,27.67,63
NDC,63833061502,antihemophilic factor/VWF in units of VWF Recon Soln 1 Each Vial,31.44,17.3,1.25,27.67,63
NDC,63833082502,C1 esterase inhibitor (Human) 500 units Kit 1 Each Box,17950.76,9872.92,62.22,15527.41,63
NDC,64067021601,methoxsalen 20 mcg/mL Solution 10 mL Vial,2864.5,1575.48,859.35,2477.79,38
NDC,64253022233,heparin (porcine) lock flush 10 units/mL 3 mL Solution 3 mL Syringe,34.8,19.14,10.44,30.1,38
NDC,64253022235,heparin (porcine) lock flush 10 units/mL 5 mL Solution 5 mL Syringe,34.8,19.14,0.02,30.1,48
NDC,64253033335,heparin lock 100 units/mL Solution 5 mL Syringe,35.32,19.43,0.02,30.55,48
NDC,64370053202,Vinorelbine Tartrate 50 MG/5ML Solution 5 mL Vial,429.5,236.23,5.58,371.52,48
NDC,64380015102,testosterone 25 MG/2.5GM (1%) Gel 2.5 g Box,21.6,11.88,6.48,18.68,38
NDC,64380016002,megestrol 40 MG/ML Suspension 480 mL Bottle,245.6,135.08,73.68,212.44,38
NDC,64380017202,OLANZapine zydis 5 MG TABLET DISPERSIBLE 30 Each Box,9.57,5.27,2.87,8.28,38
NDC,64380017302,OLANZapine zydis 10 MG TABLET DISPERSIBLE 30 Each Box,10.77,5.93,3.23,9.32,38
NDC,64380017401,OLANZapine zydis 15 MG TABLET DISPERSIBLE 1 Each Blister,12.56,6.91,3.77,10.86,38
NDC,64380021201,methIMAzole 5 MG Tab 100 Each Bottle,8.79,4.84,2.64,7.6,38
NDC,64380072406,calcitriol 0.5 MCG Cap 100 Each Bottle,9.4,5.17,2.82,8.13,38
NDC,64380072506,mycophenolate mofetil 500 MG Tab 100 Each Bottle,9.32,5.13,0.13,8.06,48
NDC,64380074206,busPIRone 10 MG Tab 100 Each Bottle,8.18,4.5,2.45,7.08,38
NDC,64406000801,natalizumab 300 MG/15ML Conc 15 mL Vial,35868.4,19727.62,20.5,31026.17,63
NDC,64406002201,tocilizumab-bavi 200 MG/10ML Solution 10 mL Vial,6009.0,3304.95,5.15,5197.79,63
NDC,64406002301,tocilizumab-bavi 400 MG/20ML Solution 20 mL Vial,9334.0,5133.7,5.15,8073.91,63
NDC,64406002401,tocilizumab-bavi 80 MG/4ML Solution 4 mL Vial,2412.6,1326.93,723.78,2086.9,38
NDC,64406005801,nusinersen 12 MG/5ML Solution 5 mL Vial,599840.74,329912.41,1280.25,518862.24,63
NDC,64597030160,Dextromethorphan-quiNIDine 20-10 MG Cap 60 Each Bottle,67.95,37.38,20.39,58.78,38
NDC,64764013001,ADAMTS13 recombinant-krhn 500 units Kit 1 Each Vial,49.6,27.28,14.88,240.23,63
NDC,64764013501,ADAMTS13 recombinant-krhn 1500 units Kit 1 Each Vial,49.6,27.28,14.88,240.23,63
NDC,64764030020,vedolizumab 60 mg/mL Recon Soln 1 Each Vial,39321.62,21626.9,18.6,34013.2,63
NDC,64764073030,vortioxetine 10 MG Tab 30 Each Bottle,52.27,28.75,15.68,45.21,38
NDC,64764080028,maribavir 200 MG Tab 28 Each Bottle,554.58,305.02,166.37,479.71,38
NDC,64842012021,futibatinib (12 mg daily dose) 4 mg Tablet Therapy Pack 21 Each Box,671.86,369.53,201.56,581.16,48
NDC,64842012028,futibatinib (16 mg daily dose) 4 mg Tablet Therapy Pack 28 Each Box,505.14,277.83,151.54,436.95,48
NDC,64842012035,futibatinib (20 mg daily dose) 4 mg Tablet Therapy Pack 35 Each Box,405.11,222.82,121.53,350.42,48
NDC,64875000101,miFEPRIStone 200 MG Tab 1 Each Box,108.2,59.51,32.46,93.59,38
NDC,64980012950,FLORANEX (lactobacillus acidophilus) Tab 50 Each Bottle,8.66,4.77,2.6,7.49,38
NDC,64980029001,perphenazine 2 MG Tab 100 Each Bottle,8.9,4.9,2.67,7.7,38
NDC,64980033990,magnesium oxide 400 mg Tab 1 Each Blister,4.47,2.46,1.34,3.87,38
NDC,64980056601,dapsone 100 MG Tab 100 Each Bottle,11.65,6.41,3.5,10.08,38
NDC,64980056703,dapsone 25 MG Tab 30 Each Bottle,9.95,5.48,2.99,8.61,38
NDC,65162005827,sevelamer carbonate 800 MG Tab 270 Each Bottle,9.28,5.11,2.78,8.03,38
NDC,65162010110,gabapentin 100 MG Cap 100 Each Bottle,8.18,4.5,2.45,7.08,38
NDC,65162015004,estradiol 0.075 mg PATCH BIWEEKLY 1 Each Packet,50.03,27.52,15.01,43.28,38
NDC,65162022804,estradiol 0.1 mg PATCH BIWEEKLY 1 Each Packet,50.03,27.52,15.01,43.28,38
NDC,65162028103,paliperidone 3 MG Tablet Extended Release 24 Hour 30 Each Bottle,13.5,7.43,4.05,11.68,38
NDC,65162051210,salsalate 500 MG Tab 100 Each Bottle,8.99,4.95,2.7,7.78,38
NDC,65162055710,temazepam 30 MG Cap 100 Each Bottle,10.35,5.7,3.11,8.95,38
NDC,65162068110,phenazopyridine 100 MG Tab 100 Each Bottle,9.06,4.99,2.72,7.84,38
NDC,65162069179,ondansetron 4 MG/5ML Solution 5 mL Oral Syringe,16.25,8.94,4.88,14.06,38
NDC,65162069179,ondansetron 4 MG/5ML Solution 50 mL Bottle,90.5,49.78,27.15,78.28,38
NDC,65162078203,memantine HCl 7 MG CAPSULE SR 24 HR 30 Each Bottle,11.0,6.05,3.3,9.52,38
NDC,65162078303,memantine HCl 14 MG CAPSULE SR 24 HR 30 Each Bottle,11.0,6.05,3.3,9.52,38
NDC,65162078503,memantine HCl 28 MG CAPSULE SR 24 HR 30 Each Bottle,11.0,6.05,3.3,9.52,38
NDC,65162091446,tobramycin 300 MG/5ML Nebu Soln 5 mL Plas Cont,57.9,31.85,17.37,50.08,38
NDC,65174027030,technetium Tc-99m macro aggregated albumin Kit 10 millicurie,979.0,538.45,293.7,861.52,48
NDC,65174088000,sodium iodide I-131 Cap 1 millicurie,63.75,35.07,19.13,56.1,48
NDC,65219005609,potassium PHOSphate 3 MMOLE/ML Solution 50 mL Vial,655.98,360.79,196.79,567.42,38
NDC,65219005629,potassium PHOSphate 3 MMOLE/ML Solution 50 mL Vial,655.98,360.79,196.79,567.42,38
NDC,65219037110,Pegfilgrastim-fpgk 6 MG/0.6ML Solution Prefilled Syringe 0.6 mL Syringe,18071.05,9939.08,184.91,15631.46,63
NDC,65219053501,fat emulsion 20 % Emulsion 500 mL Flex Cont,273.0,150.15,81.9,236.15,38
NDC,65219059004,tocilizumab-aazg 80 MG/4ML Solution 4 mL Vial,2130.07,1171.54,3.53,1842.51,63
NDC,65219059210,tocilizumab-aazg 200 MG/10ML Solution 10 mL Vial,5302.68,2916.48,3.53,4586.82,63
NDC,65219059420,tocilizumab-aazg 400 MG/20ML Solution 20 mL Vial,10590.36,5824.7,3.53,9160.66,63
NDC,65250013309,BUPivacaine liposome 1.3 % Suspension 10 mL Vial,1317.97,724.89,1.25,1140.04,63
NDC,65250026604,BUPivacaine liposome 1.3 % Suspension 20 mL Vial,2167.87,1192.33,1.25,1875.21,63
NDC,65597040601,fam-trastuzumab deruxtecan-nxki 20 mg/mL Recon Soln 1 Each Vial,12639.43,6951.69,24.74,10933.11,63
NDC,65597050404,quizartinib dihydrochloride 17.7 MG Tab 14 Each Bottle,1407.25,773.99,422.18,1217.27,38
NDC,65597051104,quizartinib dihydrochloride 26.5 MG Tab 14 Each Bottle,1407.25,773.99,422.18,1217.27,38
NDC,65597080101,datopotamab deruxtecan-dlnk 20 mg/mL Recon Soln 1 Each Vial,21051.6,11578.38,6315.48,18209.63,38
NDC,65649020175,polyethylene glycol/electrolytes 100 g Recon Soln 1 Each Box,424.11,233.27,127.23,366.86,38
NDC,65649030303,rifAXIMin 550 MG Tab 60 Each Box,143.53,78.95,43.06,124.15,38
NDC,65649055102,methylnaltrexone 12 MG/0.6ML Solution 0.6 mL Vial,932.62,512.95,1.55,806.72,48
NDC,65757030001,naltrexone 380 MG Recon Susp 1 Each Vial,9142.84,5028.57,3.54,7908.56,63
NDC,65757040103,ARIPiprazole lauroxil ER 441 mg/1.6 mL Prefilled Syringe 1.6 mL Syringe,8606.4,4733.52,2.77,7444.54,63
NDC,65757040203,ARIPiprazole lauroxil ER 662 mg/2.4 mL Prefilled Syringe 2.4 mL Syringe,10040.9,5522.5,2.77,8685.38,63
NDC,65757040303,ARIPiprazole lauroxil ER 882 mg/3.2 mL Prefilled Syringe 3.2 mL Syringe,13374.36,7355.9,2.77,11568.82,63
NDC,65757040403,ARIPiprazole lauroxil ER 1064 mg/3.9 mL Prefilled Syringe 3.9 mL Syringe,16132.16,8872.69,2.77,13954.32,63
NDC,65862001130,sertraline 25 MG Tab 30 Each Bottle,8.31,4.58,2.49,7.19,38
NDC,65862001305,sertraline 100 MG Tab 500 Each Bottle,8.28,4.56,2.48,7.16,38
NDC,65862001501,amoxicillin 875 MG Tab 100 Each Bottle,9.16,5.04,2.75,7.92,38
NDC,65862001601,amoxicillin 250 MG Cap 100 Each Bottle,8.17,4.5,2.45,7.07,38
NDC,65862001701,amoxicillin 500 MG Cap 100 Each Bottle,8.3,4.57,2.49,7.18,38
NDC,65862004824,zidovudine 10 MG/ML Syrup 240 mL Bottle,126.8,69.74,38.04,109.68,38
NDC,65862007601,ciprofloxacin 250 MG Tab 100 Each Bottle,8.74,4.81,2.62,7.56,38
NDC,65862010701,zidovudine 100 MG Cap 100 Each Bottle,11.55,6.36,3.47,9.99,38
NDC,65862014636,SUMAtriptan 25 MG Tab 9 Each Box,9.1,5.01,2.73,7.87,38
NDC,65862014736,SUMAtriptan 50 MG Tab 9 Each Box,9.47,5.21,2.84,8.19,38
NDC,65862019405,FLUoxetine 40 MG Cap 500 Each Bottle,8.22,4.53,2.47,7.11,38
NDC,65862020290,losartan 50 MG Tab 90 Each Bottle,8.31,4.58,2.49,7.19,38
NDC,65862020390,losartan 100 MG Tab 90 Each Bottle,8.47,4.66,2.54,7.33,38
NDC,65862021150,minocycline 100 MG Cap 50 Each Bottle,8.67,4.77,2.6,7.5,38
NDC,65862029490,rosuvastatin 10 MG Tab 90 Each Bottle,8.22,4.53,2.47,7.11,38
NDC,65862041905,sulfamethoxazole/trimethoprim 400-80 mg Tab 500 Each Bottle,8.19,4.51,2.46,7.08,38
NDC,65862042130,tenofovir disoproxil fumarate 300 MG Tab 30 Each Bottle,13.0,7.15,3.9,11.25,38
NDC,65862044930,valACYclovir 1 g Tab 30 Each Bottle,10.89,5.99,3.27,9.42,38
NDC,65862045860,galantamine 4 MG Tab 60 Each Bottle,8.97,4.94,2.69,7.76,38
NDC,65862045960,galantamine 8 MG Tab 60 Each Bottle,10.47,5.76,3.14,9.06,38
NDC,65862050220,amoxicillin/clavulanate 500-125 mg Tab 20 Each Bottle,9.45,5.2,2.84,8.17,38
NDC,65862050320,amoxicillin/clavulanate 875-125 mg Tab 20 Each Bottle,9.2,5.06,2.76,7.96,38
NDC,65862052890,venlafaxine HCl 75 MG CAPSULE SR 24 HR 90 Each Bottle,8.77,4.83,2.63,7.59,38
NDC,65862053401,amoxicillin/clavulanate 400-57 mg/5ml Recon Susp 10.9 mL Oral Syringe,13.25,7.29,3.98,11.46,38
NDC,65862053401,amoxicillin/clavulanate 400-57 mg/5ml Recon Susp 100 mL Bottle,56.18,30.9,16.85,48.6,38
NDC,65862053750,levoFLOXacin 500 MG Tab 50 Each Bottle,9.25,5.09,2.78,8.0,38
NDC,65862053820,levoFLOXacin 750 MG Tab 20 Each Bottle,9.18,5.05,2.75,7.94,38
NDC,65862059601,clindamycin palmitate hydrochloride 75 MG/5ML Recon Soln 100 mL Bottle,163.1,89.71,48.93,141.08,38
NDC,65862069790,venlafaxine HCl 150 MG CAPSULE SR 24 HR 90 Each Bottle,8.92,4.91,2.68,7.72,38
NDC,65862069960,cefUROxime 250 MG Tab 60 Each Bottle,8.58,4.72,2.57,7.42,38
NDC,65862070901,raloxifene 60 MG Tab 100 Each Bottle,10.47,5.76,3.14,9.06,38
NDC,65862078201,methenamine hippurate 1 g Tab 100 Each Bottle,9.4,5.17,2.82,8.13,38
NDC,65862083130,cinacalcet 30 MG Tab 30 Each Bottle,9.65,5.31,2.9,8.35,38
NDC,65862093008,sevelamer carbonate 0.8 g Pack 1 Each Packet,12.67,6.97,3.8,10.96,38
NDC,65862093190,sevelamer carbonate 2.4 g Pack 90 Each Box,12.67,6.97,3.8,10.96,38
NDC,66215030200,iloprost 10 mcg/mL Solution 1 mL Glass Cont,364.83,200.66,109.45,1072.71,48
NDC,66215030300,iloprost 20 mcg/mL Solution 1 mL Glass Cont,364.83,200.66,109.45,1072.71,48
NDC,66215040201,epoprostenol 1.5 mg Recon Soln 1 Each Vial,346.56,190.61,14.12,299.77,48
NDC,66215040301,epoprostenol 0.5 mg Recon Soln 1 Each Vial,180.78,99.43,14.12,156.37,48
NDC,66215050115,macitentan 10 MG Tab 15 Each Box,1041.4,572.77,312.42,900.81,38
NDC,66215060206,selexipag 200 MCG Tab 60 Each Bottle,618.93,340.42,185.68,535.37,38
NDC,66215060806,Selexipag 800 MCG Tab 60 Each Bottle,959.77,527.88,287.93,830.2,38
NDC,66288110001,CEFAZOLIN IV,792.6,435.93,0.69,685.6,48
NDC,66302010101,treprostinil 1 mg/mL Solution 3 mL Vial,1046.39,575.52,48.04,905.13,63
NDC,66302010201,treprostinil 2.5 mg/mL Solution 3 mL Vial,2593.47,1426.41,48.04,2243.35,63
NDC,66302010501,treprostinil 5 mg/mL Solution 3 mL Vial,5171.95,2844.58,48.04,4473.74,63
NDC,66302011001,treprostinil 10 mg/mL Solution 3 mL Syringe,10328.89,5680.89,48.04,8934.49,63
NDC,66302011001,treprostinil 10 mg/mL Solution 3 mL Vial,10328.89,5680.89,48.04,8934.49,63
NDC,66302030001,treprostinil diolamine 0.125 MG Tab CR 100 Each Bottle,26.04,14.33,7.81,22.52,38
NDC,66302030201,treprostinil diolamine 0.25 MG Tab CR 100 Each Bottle,46.08,25.35,13.82,39.86,38
NDC,66302031001,treprostinil diolamine 1 MG Tab CR 100 Each Bottle,147.52,81.14,44.26,127.6,38
NDC,66312017616,"lidocaine/EPINEPHrine 2%-1:100,000 Solution 1.7 mL Cartridge",37.04,20.38,11.11,32.04,38
NDC,66553000401,calcium carbonate 500 MG Chew Tab 500 Each Box,8.18,4.5,2.45,7.08,38
NDC,66658011303,palifermin 5.16 mg Recon Soln 1 Each Vial,15123.44,8317.9,29.19,13081.78,63
NDC,66658023401,anakinra 100 MG/0.67ML Solution Prefilled Syringe 0.67 mL Syringe,1152.67,633.97,345.8,997.06,48
NDC,66658023407,anakinra 100 MG/0.67ML Solution Prefilled Syringe 0.67 mL Syringe,1152.69,633.98,345.81,997.08,48
NDC,66689002301,HYDROcodone/acetaminophen 7.5-325 mg/15 mL Solution 15 mL Cup,20.65,11.36,6.2,17.86,38
NDC,66689030708,mycophenolate mofetil 200 MG/ML Recon Susp 160 mL Bottle,1364.44,750.45,0.13,1180.24,48
NDC,66689030708,mycophenolate mofetil 200 MG/ML Recon Susp 2.5 mL Oral Syringe,64.25,35.34,0.13,55.58,48
NDC,66689030708,mycophenolate mofetil 200 MG/ML Recon Susp 5 mL Oral Syringe,122.51,67.39,0.13,105.97,48
NDC,66689033008,aminocaproic acid 0.25 GM/ML Solution 236.5 mL Bottle,2136.92,1175.31,641.08,1848.44,38
NDC,66689040101,oxyCODONE 1 mg/ml Solution 5 mL Cup,23.49,12.92,7.05,20.32,38
NDC,66689040101,oxyCODONE 5 mg/5 mL Solution 5 mL Cup,23.49,12.92,7.05,20.32,38
NDC,66733094823,cetuximab 100 MG/50ML Solution 50 mL Vial,3679.68,2023.83,66.2,3182.92,63
NDC,66733095823,Cetuximab 200 MG/100ML Solution 100 mL Vial,7334.35,4033.9,66.2,6344.21,63
NDC,66758005002,DOCEtaxel 80 MG/8ML Solution 8 mL Vial,970.0,533.5,0.62,839.05,48
NDC,66758007138,ciprofloxacin 0.3 % Ointment 3.5 g Tube,825.55,454.06,247.67,714.1,38
NDC,66794015602,"baclofen 1,000 mcg/mL (20000 mcg/20 mL) Solution 20 mL Vial",2796.54,1538.1,149.26,2419.01,63
NDC,66794015702,baclofen 2000 mcg/mL (40 mg/20 mL) Solution 20 mL Vial,5578.08,3067.95,149.26,4825.04,63
NDC,66794021963,linezolid 600 MG/300ML Solution 300 mL Flex Cont,114.5,62.98,2.56,99.04,48
NDC,66887000301,collagenase clostridium histolyticum 0.9 MG Recon Soln 1 Each Vial,29863.68,16425.03,63.16,25832.08,63
NDC,66887000410,testosterone 75 MG PELLET 10 Each Box,599.19,329.56,179.76,518.3,38
NDC,66993014130,aliskiren 150 MG Tab 30 Each Bottle,22.81,12.55,6.84,19.73,38
NDC,66993043185,prazosin 1 MG Cap 90 Each Bottle,9.0,4.95,2.7,7.79,38
NDC,66993045630,dapagliflozin 5 MG Tab 30 Each Bottle,40.06,22.04,12.02,34.65,38
NDC,66993045730,dapagliflozin 10 MG Tab 30 Each Bottle,40.06,22.04,12.02,34.65,38
NDC,67066000501,secretin 16 mcg Recon Soln 1 Each Vial,3584.4,1971.42,36.55,3100.51,63
NDC,67157010150,ascorbic acid 500 MG/ML Solution 50 mL Vial,1476.24,811.94,442.87,1276.95,38
NDC,67253065110,propylthiouracil 50 MG Tab 100 Each Bottle,9.25,5.09,2.78,8.0,38
NDC,67308010101,aminolevulinic acid 20 % Recon Soln 1 Each,1189.66,654.32,339.37,2658.62,63
NDC,67386013051,eptinezumab-jjmr 100 MG/ML Solution 1 mL Vial,10211.01,5616.06,16.59,8832.52,63
NDC,67457015318,amiodarone 900 MG/18ML Solution 18 mL Vial,117.23,64.48,0.33,101.4,48
NDC,67457015399,amiodarone 450 MG/9ML Solution 9 mL Vial,79.18,43.55,0.33,68.49,48
NDC,67457016202,sodium tetradecyl sulfate 1 % Solution 2 mL Vial,483.76,266.07,145.13,418.45,38
NDC,67457017750,dimethyl sulfoxide 50 % Solution 50 mL Vial,3955.65,2175.61,614.23,5014.58,63
NDC,67457019501,melphalan 5 mg/mL Injection 1 Each Vial,2380.0,1309.0,95.9,2058.7,63
NDC,67457019501,melphalan Recon Soln 1 Each Vial,2380.0,1309.0,95.9,2058.7,63
NDC,67457019805,remifentanil Recon Soln 1 Each Vial,953.02,524.17,285.91,824.36,38
NDC,67457020725,dexrazoxane 10 mg/mL Recon Soln 1 Each Vial,1496.0,822.8,63.06,1294.04,63
NDC,67457020850,dexrazoxane 500 MG Recon Soln 1 Each Vial,2976.95,1637.33,63.06,2575.06,63
NDC,67457021720,methadone 10 MG/ML Solution 20 mL Vial,3298.74,1814.31,17.74,2853.41,48
NDC,67457022005,isosulfan blue 1 % Solution 5 mL Vial,6571.63,3614.4,7.64,5684.46,63
NDC,67457025102,dexmedeTOMIDine 100 MCG/ML Solution 2 mL Vial,129.46,71.21,38.84,111.98,38
NDC,67457029200,naloxone 0.4 MG/ML Solution 1 mL Vial,64.0,35.2,0.35,82.18,134
NDC,67457031625,decitabine 5 mg/mL Recon Soln 1 Each Vial,1886.5,1037.58,2.0,1631.82,48
NDC,67457032325,moxifloxacin 400 mg/250 mL Solution 250 mL Flex Cont,240.0,132.0,7.43,207.6,48
NDC,67457035959,fluPHENAZine decanoate 25 MG/ML Solution 5 mL Vial,668.4,367.62,8.07,578.17,48
NDC,67457042010,dexAMETHasone 100 MG/10ML Solution 10 mL Vial,55.0,30.25,0.1,47.58,48
NDC,67457042300,dexAMETHasone 4 MG/ML Solution 1 mL Vial,36.24,19.94,0.1,31.35,48
NDC,67457042312,dexAMETHasone 4 MG/ML Solution 1 mL Vial,22.77,12.530000000000001,0.1,31.32,86
NDC,67457043650,DOXOrubicin 2 mg/mL Injection 1 Each Vial,1266.24,696.44,2.85,1095.3,48
NDC,67457045010,cladribine 10 MG/10ML Solution 10 mL Vial,1675.0,921.25,9.68,1448.88,63
NDC,67457047322,tobramycin sulfate 80 MG/2ML Solution 2 mL Vial,45.84,25.22,1.69,39.65,48
NDC,67457052433,ibandronate 3 MG/3ML Solution 3 mL Syringe,1338.01,735.91,21.77,1157.38,48
NDC,67457052810,leucovorin 20 mg /mL Recon Soln 1 Each Vial,124.0,68.2,3.57,107.26,48
NDC,67457053035,leucovorin 20 mg/mL Recon Soln 1 Each Vial,119.07,65.49,3.57,103.0,48
NDC,67457053208,DOCEtaxel 80 MG/8ML Solution 8 mL Vial,782.0,430.1,0.62,676.43,48
NDC,67457053316,DOCEtaxel 160 MG/16ML Solution 16 mL Vial,1534.0,843.7,0.62,1326.91,48
NDC,67457054620,clofarabine 1 MG/ML Solution 20 mL Vial,10911.13,6001.13,4.19,9438.13,63
NDC,67457083306,Pegfilgrastim-jmdb 6 MG/0.6ML Solution Prefilled Syringe 0.6 mL Syringe,8777.5,4827.63,99.13,7592.54,63
NDC,67457084744,trastuzumab-dkst 21 mg/mL Recon Soln 1 Each Vial,11307.72,6219.25,40.29,9781.18,63
NDC,67457085500,adenosine 10 mcg/mL 6 MG/2ML Solution 2 mL Vial,67.0,36.85,0.28,57.96,48
NDC,67457085500,adenosine 6 MG/2ML Solution 2 mL Vial,67.0,36.85,0.28,57.96,48
NDC,67457085500,n,67.0,36.85,0.28,57.96,48
NDC,67457085730,adenosine diagnostic 3 MG/ML Solution 30 mL Vial,1073.35,590.35,0.28,928.45,48
NDC,67457099115,trastuzumab-dkst 21 mg/ml Recon Soln 1 Each Vial,4257.3,2341.52,40.29,3682.56,63
NDC,67618011128,docusate sodium 50 MG Cap 28 Each Bottle,3.9,2.15,1.17,3.37,38
NDC,67618015004,povidone-iodine 10 % Solution 118 mL Bottle,26.2,14.41,7.86,22.66,38
NDC,67684190101,ethyl esters of iodized fatty acids of poppy seed oil 480 MG/ML Oil 10 mL Ampule,7104.12,3907.27,2131.24,6145.06,38
NDC,67871047906,ethanolamine 5 % Solution 2 mL Ampule,2392.81,1316.05,717.84,2069.78,38
NDC,67877012440,silver sulfADIAZINE 1% Cream 400 g Jar,233.4,128.37,70.02,201.89,38
NDC,67877014601,temazepam 15 mg Cap 100 Each Bottle,10.23,5.63,3.07,8.85,38
NDC,67877014701,temazepam 30 MG Cap 100 Each Bottle,10.3,5.67,3.09,8.91,38
NDC,67877019790,amLODIPine 2.5 MG Tab 90 Each Bottle,8.06,4.44,2.42,6.97,38
NDC,67877021560,cefUROxime 250 MG Tab 60 Each Bottle,8.58,4.72,2.57,7.42,38
NDC,67877028660,riluzole 50 MG Tab 60 Each Bottle,9.0,4.95,2.7,7.79,38
NDC,67877041933,linezolid 600 MG Tab 1 Each Blister,17.5,9.63,5.25,15.14,38
NDC,67877042612,mycophenolic acid 180 MG Tablet Delayed Response 120 Each Bottle,8.61,4.74,0.41,7.45,48
NDC,67877042712,mycophenolic acid 360 MG Tablet Delayed Response 120 Each Bottle,9.22,5.08,0.41,7.98,48
NDC,67877045430,itraconazole 100 MG Cap 30 Each Bottle,12.0,6.6,3.6,10.38,38
NDC,67877049160,ticagrelor 90 MG Tab 60 Each Bottle,9.32,5.13,2.8,8.06,38
NDC,67877053714,temozolomide 5 MG Cap 14 Each Bottle,14.77,8.13,0.23,12.78,48
NDC,67877053807,temozolomide 20 MG Cap 5 Each Bottle,22.15,12.19,0.23,19.16,48
NDC,67877053907,temozolomide 100 MG Cap 5 Each Bottle,85.88,47.24,0.23,74.29,48
NDC,67877063602,tolvaptan 30 MG Tab 10 Each Bottle,1158.26,637.05,347.48,1001.89,38
NDC,67877069601,chlorTHALidone 25 MG Tab 100 Each Bottle,8.61,4.74,2.58,7.45,38
NDC,67877071831,everolimus 0.25 MG Tab 60 Each Box,19.5,10.73,1.99,16.87,48
NDC,67877071931,everolimus 0.5 MG Tab 60 Each Box,28.13,15.48,1.99,24.33,48
NDC,67877072131,everolimus 1 MG Tab 60 Each Box,86.9,47.8,1.99,75.17,48
NDC,67877073360,lacosamide 50 MG Tab 60 Each Bottle,10.27,5.65,3.08,8.88,38
NDC,67877073460,lacosamide 100 MG Tab 60 Each Bottle,10.5,5.78,3.15,9.08,38
NDC,67877073560,lacosamide 150 MG Tab 60 Each Bottle,10.71,5.9,3.21,9.26,38
NDC,67877073660,lacosamide 200 MG Tab 60 Each Bottle,10.93,6.02,3.28,9.45,38
NDC,67919003001,ceftolozane-tazobactam 1.5 (1-0.5) g Recon Soln 1 Each Vial,956.54,526.1,7.0,827.41,63
NDC,67919004001,tedizolid 200 MG Recon Soln 1 Each Vial,1676.8,922.24,1.56,1450.43,63
NDC,67919004104,tedizolid 200 MG Tab 30 Each Bottle,1121.19,616.66,336.36,969.83,38
NDC,67919004105,tedizolid 200 MG Tab 6 Each Box,1121.19,616.66,336.36,969.83,38
NDC,67979051143,testosterone undecanoate 750 MG/3ML Solution 3 mL Vial,8714.42,4792.94,1.66,7537.97,63
NDC,68001015103,carvedilol 12.5 MG Tab 500 Each Bottle,8.16,4.49,2.45,7.06,38
NDC,68001015600,venlafaxine 100 MG Tab 100 Each Bottle,9.25,5.09,2.78,8.0,38
NDC,68001015700,venlafaxine 25 MG Tab 100 Each Bottle,9.06,4.99,2.72,7.84,38
NDC,68001018100,QUEtiapine 400 MG Tab 100 Each Bottle,8.69,4.78,2.61,7.52,38
NDC,68001018200,QUEtiapine 200 MG Tab 100 Each Bottle,9.19,5.06,2.76,7.95,38
NDC,68001018300,QUEtiapine 300 MG Tab 100 Each Bottle,8.53,4.7,2.56,7.38,38
NDC,68001018500,QUEtiapine 25 MG Tab 100 Each Bottle,8.4,4.62,2.52,7.27,38
NDC,68001018500,QUEtiapine 6.25 mg quarter tablet Tab 0.25 tablet Package,8.1,4.46,2.43,7.01,38
NDC,68001023700,cloNIDine 0.1 MG Tab 100 Each Bottle,8.14,4.48,2.44,7.04,38
NDC,68001023800,cloNIDine 0.2 MG Tab 100 Each Bottle,8.19,4.51,2.46,7.08,38
NDC,68001024200,zonisamide 25 MG Cap 100 Each Bottle,8.69,4.78,2.61,7.52,38
NDC,68001024616,ondansetron ODT 4 MG TABLET DISPERSIBLE 1 Each Blister,9.07,4.99,0.01,7.85,48
NDC,68001024617,ondansetron ODT 4 MG TABLET DISPERSIBLE 30 Each Box,9.07,4.99,0.01,7.85,48
NDC,68001024716,ondansetron ODT 8 MG TABLET DISPERSIBLE 1 Each Blister,10.39,5.72,0.01,8.99,48
NDC,68001025104,fluconazole 50 MG Tab 30 Each Bottle,10.36,5.7,3.11,8.96,38
NDC,68001027900,diclofenac sodium 25 MG Tablet Delayed Response 100 Each Bottle,10.2,5.61,3.06,8.82,38
NDC,68001028006,diclofenac sodium 50 MG Tablet Delayed Response 60 Each Bottle,8.91,4.91,2.67,7.71,38
NDC,68001030800,buPROPion 75 MG Tab 100 Each Bottle,9.65,5.31,2.9,8.35,38
NDC,68001032700,triamterene/hydrochlorothiazide 37.5-25 mg Tab 100 Each Bottle,8.91,4.91,2.67,7.71,38
NDC,68001032800,triamterene/hydrochlorothiazide 75-50 mg Tab 100 Each Bottle,8.93,4.92,2.68,7.72,38
NDC,68001033203,lisinopril 2.5 MG Tab 500 Each Bottle,8.08,4.45,2.42,6.99,38
NDC,68001035600,metoprolol succinate 25 MG Tablet Extended Release 24 Hour 100 Each Bottle,8.83,4.86,2.65,7.64,38
NDC,68001035600,metoprolol succinate XL 6.25 mg quarter tablet Tablet Extended Release 24 Hour 0.25 tablet Package,8.21,4.52,2.46,7.1,38
NDC,68001036206,cefdinir 300 MG Cap 60 Each Bottle,10.63,5.85,3.19,9.19,38
NDC,68001038300,labetalol 300 MG Tab 100 Each Bottle,9.24,5.09,2.77,7.99,38
NDC,68001039700,famotidine 20 MG Tab 100 Each Bottle,8.46,4.66,2.54,7.32,38
NDC,68001040000,FLUoxetine 20 MG Cap 100 Each Bottle,8.22,4.53,2.47,7.11,38
NDC,68001040506,levETIRAcetam 1000 MG Tab 60 Each Bottle,8.97,4.94,2.69,7.76,38
NDC,68001042704,trospium chloride 60 MG CAPSULE SR 24 HR 30 Each Bottle,20.55,11.31,6.17,17.78,38
NDC,68001045006,ziprasidone 20 MG Cap 60 Each Bottle,9.73,5.36,2.92,8.42,38
NDC,68001045106,ziprasidone 40 MG Cap 60 Each Bottle,9.73,5.36,2.92,8.42,38
NDC,68001045206,ziprasidone 60 MG Cap 60 Each Bottle,9.81,5.4,2.94,8.49,38
NDC,68001045306,ziprasidone 80 MG Cap 60 Each Bottle,9.81,5.4,2.94,8.49,38
NDC,68001047200,divalproex 125 MG Tablet Delayed Response 100 Each Bottle,8.59,4.73,2.58,7.43,38
NDC,68001047547,clotrimazole 1 % Cream 28.4 g Tube,35.9,19.75,10.77,31.05,38
NDC,68001047646,hydrocortisone 1 % Cream 30 g Tube,27.35,15.05,8.21,23.66,38
NDC,68001048145,miconazole 2 % Cream 28.4 g Tube,28.35,15.6,8.51,24.52,38
NDC,68001048346,neomycin/bacitracin/polymyxin 3.5-400-5000 Ointment 14.2 g Tube,31.93,17.57,9.58,27.62,38
NDC,68001050200,metoprolol succinate 100 MG Tablet Extended Release 24 Hour 100 Each Bottle,9.21,5.07,2.76,7.97,38
NDC,68001053146,bacitracin zinc 500 UNIT/GM Ointment 28.4 g Tube,36.3,19.97,10.89,31.4,38
NDC,68001057400,desmopressin 0.1 mg Tab 100 Each Bottle,9.2,5.06,2.76,7.96,38
NDC,68001058500,glimepiride 2 MG Tab 100 Each Bottle,8.62,4.75,2.59,7.46,38
NDC,68001059100,escitalopram 5 MG Tab 100 Each Bottle,8.33,4.59,2.5,7.21,38
NDC,68001059705,sildenafil 20 MG Tab 90 Each Bottle,10.94,6.02,3.28,9.46,38
NDC,68001060600,nitrofurantoin monohydrate/macrocrystals 100 MG Cap 100 Each Bottle,11.69,6.43,3.51,10.11,38
NDC,68001061305,buPROPion HCl 150 MG Tablet Extended Release 24 Hour 90 Each Bottle,8.6,4.73,2.58,7.44,38
NDC,68084002701,warfarin 2.5 mg Tab 100 Each Box,9.06,4.99,2.72,7.84,38
NDC,68084004711,PARoxetine 40 MG Tab 1 Each Blister,9.34,5.14,2.8,8.08,38
NDC,68084007511,tretinoin 10 MG Cap 1 Each Blister,71.07,39.09,21.32,61.48,38
NDC,68084008201,isosorbide dinitrate 10 MG Tab 100 Each Box,9.79,5.39,2.94,8.47,38
NDC,68084008301,isosorbide dinitrate 20 MG Tab 100 Each Box,9.73,5.36,2.92,8.42,38
NDC,68084009411,carbidopa/levodopa 25-250 mg Tab 1 Each Blister,9.65,5.31,2.9,8.35,38
NDC,68084009901,atorvastatin 40 MG Tab 100 Each Box,9.49,5.22,2.85,8.21,38
NDC,68084009911,atorvastatin 40 MG Tab 1 Each Blister,9.49,5.22,2.85,8.21,38
NDC,68084011911,mirtazapine 15 MG Tab 1 Each Blister,8.79,4.84,2.64,7.6,38
NDC,68084012001,mirtazapine 30 MG Tab 100 Each Box,9.11,5.02,2.73,7.88,38
NDC,68084012111,mirtazapine 45 MG Tab 1 Each Blister,9.32,5.13,2.8,8.06,38
NDC,68084015811,morphine sulfate 30 MG Tab CR 1 Each Blister,11.96,6.58,3.59,10.35,38
NDC,68084020311,primidone 250 MG Tab 1 Each Blister,9.61,5.29,2.88,8.31,38
NDC,68084020511,minoxidil 10 MG Tab 1 Each Blister,8.92,4.91,2.68,7.72,38
NDC,68084021411,benzonatate 100 MG Cap 1 Each Blister,9.52,5.24,2.86,8.23,38
NDC,68084024811,loratadine 10 MG Tab 1 Each Blister,8.96,4.93,2.69,7.75,38
NDC,68084027011,risperiDONE 0.25 MG Tab 1 Each Blister,8.76,4.82,2.63,7.58,38
NDC,68084027111,risperiDONE 0.5 MG Tab 1 Each Blister,8.89,4.89,2.67,7.69,38
NDC,68084027211,risperiDONE 1 MG Tab 1 Each Blister,9.39,5.17,2.82,8.12,38
NDC,68084027411,risperiDONE 3 MG Tab 1 Each Blister,8.53,4.7,2.56,7.38,38
NDC,68084027711,risperiDONE 4 MG Tab 1 Each Blister,8.53,4.7,2.56,7.38,38
NDC,68084028211,carbidopa/levodopa 50-200 mg Tab CR 1 Each Blister,9.18,5.05,2.75,7.94,38
NDC,68084028411,hydroxyurea 500 MG Cap 1 Each Blister,9.76,5.37,2.93,8.44,38
NDC,68084028811,fludrocortisone 100 mcg Tab 1 Each Blister,9.52,5.24,2.86,8.23,38
NDC,68084029911,tamsulosin 0.4 MG Cap 1 Each Blister,8.77,4.83,2.63,7.59,38
NDC,68084031001,divalproex sodium 250 MG Tablet Extended Release 24 Hour 100 Each Box,11.41,6.28,3.42,9.87,38
NDC,68084031011,divalproex sodium 250 MG Tablet Extended Release 24 Hour 1 Each Blister,11.41,6.28,3.42,9.87,38
NDC,68084031311,divalproex 125 MG Capsule Delayed Release Sprinkle 1 Each Blister,9.52,5.24,2.86,8.23,38
NDC,68084032701,glimepiride 4 MG Tab 100 Each Box,9.3,5.12,2.79,8.04,38
NDC,68084034211,topiramate 25 MG Tab 1 Each Blister,8.98,4.94,2.69,7.77,38
NDC,68084034411,topiramate 100 MG Tab 1 Each Blister,9.57,5.27,2.87,8.28,38
NDC,68084034611,losartan 25 MG Tab 1 Each Blister,8.54,4.7,2.56,7.39,38
NDC,68084038911,benztropine 2 MG Tab 1 Each Blister,8.68,4.78,2.6,7.51,38
NDC,68084041111,indomethacin 75 MG Cap CR 1 Each Blister,14.2,7.81,4.26,12.28,38
NDC,68084041511,divalproex sodium 500 MG Tablet Extended Release 24 Hour 1 Each Blister,13.57,7.47,4.07,11.74,38
NDC,68084051211,simvastatin 20 MG Tab 1 Each Blister,8.79,4.84,2.64,7.6,38
NDC,68084052901,OLANZapine 20 MG Tab 100 Each Box,9.85,5.42,2.96,8.52,38
NDC,68084052911,OLANZapine 20 MG Tab 1 Each Blister,9.85,5.42,2.96,8.52,38
NDC,68084057201,guaiFENesin 600 MG TABLET SR 12 HR 100 Each Box,9.51,5.24,2.85,8.23,38
NDC,68084057211,guaiFENesin 600 MG TABLET SR 12 HR 1 Each Blister,9.51,5.24,2.85,8.23,38
NDC,68084059095,atorvastatin 80 MG Tab 1 Each Blister,9.03,4.97,2.71,7.81,38
NDC,68084059111,isosorbide mononitrate 30 MG Tablet Extended Release 24 Hour 1 Each Blister,8.58,4.72,2.57,7.42,38
NDC,68084061711,escitalopram 10 MG Tab 1 Each Blister,8.79,4.84,2.64,7.6,38
NDC,68084061811,escitalopram 20 MG Tab 1 Each Blister,9.05,4.98,2.72,7.83,38
NDC,68084065511,lithium carbonate 450 MG Tab CR 1 Each Blister,8.68,4.78,2.6,7.51,38
NDC,68084072311,OLANZapine 5 MG Tab 1 Each Blister,9.65,5.31,2.9,8.35,38
NDC,68084072811,fluconazole 100 MG Tab 1 Each Blister,12.61,6.94,3.78,10.91,38
NDC,68084073501,fluconazole 200 MG Tab 100 Each Box,15.08,8.3,4.52,13.04,38
NDC,68084073511,fluconazole 200 MG Tab 1 Each Blister,15.08,8.3,4.52,13.04,38
NDC,68084075225,clopidogrel 300 mg Tab 30 Each Box,44.52,24.49,13.36,38.51,38
NDC,68084075311,cyclobenzaprine  5 MG Tab 1 Each Blister,9.12,5.02,2.74,7.89,38
NDC,68084078895,glimepiride 1 MG Tab 1 Each Blister,9.52,5.24,2.86,8.23,38
NDC,68084080801,traMADol 50 MG Tab 100 Each Bottle,10.33,5.69,3.1,8.94,38
NDC,68084085411,carvedilol 6.25 MG Tab 1 Each Blister,8.39,4.62,2.52,7.26,38
NDC,68084087511,montelukast 10 MG Tab 1 Each Blister,9.65,5.31,2.9,8.35,38
NDC,68084087995,cycloSPORINE 25 mg Cap 1 Each Blister,19.69,10.83,0.71,17.03,48
NDC,68084088201,levETIRAcetam 750 MG Tab 100 Each Box,9.29,5.11,2.79,8.04,38
NDC,68084088211,levETIRAcetam 750 MG Tab 1 Each Blister,9.29,5.11,2.79,8.04,38
NDC,68084089511,HYDROcodone/acetaminophen 5-325 MG Tab 1 Each Blister,11.19,6.16,3.36,9.68,38
NDC,68084092195,cycloSPORINE 100 mg Cap 1 Each Blister,45.04,24.78,1.89,38.96,48
NDC,68084092895,pilocarpine 5 MG Tab 1 Each Blister,13.81,7.6,4.14,11.95,38
NDC,68094000159,morphine 10 mg/5 mL Solution 5 mL Cup,13.4,7.37,4.02,11.59,38
NDC,68094006359,megestrol 40 MG/ML Suspension 10 mL Cup,9.54,5.25,2.86,8.25,38
NDC,68094010120,phentolamine Recon Soln 1 Each Vial,2281.92,1255.06,338.83,2946.44,63
NDC,68094017462,megestrol 40 MG/ML Suspension 20 mL Cup,38.43,21.14,11.53,33.24,38
NDC,68180011216,levETIRAcetam 250 MG Tab 120 Each Bottle,8.89,4.89,2.67,7.69,38
NDC,68180024101,levoFLOXacin 500 MG Tab 100 Each Bottle,9.27,5.1,2.78,8.02,38
NDC,68180028101,ethambutol 400 MG Tab 100 Each Bottle,10.81,5.95,3.24,9.35,38
NDC,68180029509,DULoxetine HCl 30 MG Cap DR Particles 90 Each Bottle,8.99,4.95,2.7,7.78,38
NDC,68180042201,moxifloxacin 0.5 % Solution 3 mL Bottle,72.5,39.88,21.75,62.71,38
NDC,68180067406,lurasidone 120 MG Tab 30 Each Bottle,9.5,5.23,2.85,8.22,38
NDC,68180067511,oseltamivir 30 MG Cap 10 Each Box,14.8,8.14,4.44,12.8,38
NDC,68180067711,oseltamivir 75 MG Cap 10 Each Box,14.8,8.14,4.44,12.8,38
NDC,68180072205,cefdinir 125 MG/5ML Recon Susp 100 mL Bottle,90.5,49.78,27.15,78.28,38
NDC,68180081942,lanthanum carbonate 500 MG Chew Tab 45 Each Bottle,21.0,11.55,6.3,18.17,38
NDC,68180082046,lanthanum carbonate 750 MG Chew Tab 15 Each Bottle,21.0,11.55,6.3,18.17,38
NDC,68180082110,lanthanum carbonate 1000 MG Chew Tab 10 Each Bottle,21.0,11.55,6.3,18.17,38
NDC,68180082147,lanthanum carbonate 1000 MG Chew Tab 10 Each Bottle,21.0,11.55,6.3,18.17,38
NDC,68180085211,levonorgestrel 1.5 MG Tab 1 Each Box,42.45,23.35,12.74,36.72,38
NDC,68180086306,azithromycin 600 MG Tab 30 Each Bottle,20.82,11.46,6.25,18.01,38
NDC,68180096609,levothyroxine 50 MCG Tab 90 Each Bottle,8.48,4.67,2.54,7.34,38
NDC,68382000301,azaTHIOprine 50 MG Tab 100 Each Bottle,9.12,5.02,1.02,14.45,48
NDC,68382000514,topiramate sprinkle 25 MG CAPSULE SPRINKLE 60 Each Bottle,10.98,6.04,3.29,9.5,38
NDC,68382001014,lamoTRIgine 200 MG Tab 60 Each Bottle,8.91,4.91,2.67,7.71,38
NDC,68382001901,venlafaxine 37.5 MG Tab 100 Each Bottle,9.09,5.0,2.73,7.86,38
NDC,68382002101,venlafaxine 75 MG Tab 100 Each Bottle,9.19,5.06,2.76,7.95,38
NDC,68382003416,venlafaxine HCl 37.5 MG CAPSULE SR 24 HR 90 Each Bottle,8.94,4.92,2.68,7.73,38
NDC,68382004101,promethazine 25 MG Tab 100 Each Bottle,8.28,4.56,0.24,7.16,48
NDC,68382009601,hydroxychloroquine 200 MG Tab 100 Each Bottle,9.06,4.99,2.72,7.84,38
NDC,68382009816,PARoxetine 20 MG Tab 90 Each Bottle,8.46,4.66,2.54,7.32,38
NDC,68382009916,PARoxetine 30 MG Tab 90 Each Bottle,8.59,4.73,2.58,7.43,38
NDC,68382012305,amLODIPine 10 MG Tab 500 Each Bottle,8.13,4.48,2.44,7.03,38
NDC,68382014114,topiramate 200 MG Tab 60 Each Bottle,8.5,4.68,2.55,7.35,38
NDC,68382039501,ribavirin Recon Soln 1 Each Vial,110890.0,60989.5,33267.0,95919.85,38
NDC,68382039504,ribavirin Recon Soln 1 Each Vial,110890.0,60989.5,33267.0,95919.85,38
NDC,68382044614,bosentan 62.5 MG Tab 60 Each Bottle,58.34,32.09,17.5,50.46,38
NDC,68382044714,bosentan 125 MG Tab 60 Each Bottle,58.34,32.09,17.5,50.46,38
NDC,68382051201,amantadine 100 MG Cap 100 Each Bottle,9.42,5.19,2.83,8.15,38
NDC,68382056928,acamprosate calcium 333 MG Tablet Delayed Response 180 Each Bottle,11.22,6.18,3.37,9.71,38
NDC,68382070718,doxycycline monohydrate 100 MG Cap 50 Each Bottle,9.52,5.24,2.86,8.23,38
NDC,68382072001,budesonide 3 MG Cap DR Particles 100 Each Bottle,13.68,7.53,4.1,11.83,38
NDC,68382079801,labetalol 100 MG Tab 100 Each Bottle,8.66,4.77,2.6,7.49,38
NDC,68382080601,traZODone 100 MG Tab 100 Each Bottle,8.29,4.56,2.49,7.17,38
NDC,68382086010,benztropine mesylate 1 MG/ML Solution 2 mL Vial,297.0,163.35,14.5,256.91,48
NDC,68382096906,roflumilast 500 MCG Tab 30 Each Bottle,9.6,5.28,2.88,8.3,38
NDC,68382099710,arsenic trioxide 10 MG/10ML Solution 10 mL Vial,1811.54,996.35,4.01,1566.98,63
NDC,68462013801,OXcarbazepine 300 MG Tab 100 Each Bottle,8.65,4.76,2.6,7.48,38
NDC,68462018022,mupirocin 2 % Ointment 22 g Tube,51.49,28.32,15.45,44.54,38
NDC,68462025301,rOPINIRole 0.25 MG Tab 100 Each Bottle,8.4,4.62,2.52,7.27,38
NDC,68462025401,rOPINIRole 0.5 MG Tab 100 Each Bottle,8.4,4.62,2.52,7.27,38
NDC,68462025501,rOPINIRole 1 MG Tab 100 Each Bottle,8.4,4.62,2.52,7.27,38
NDC,68462025601,rOPINIRole 2 MG Tab 100 Each Bottle,8.4,4.62,2.52,7.27,38
NDC,68462029201,verapamil HCl 120 MG Tab CR 100 Each Bottle,8.81,4.85,2.64,7.62,38
NDC,68462030450,norethindrone acetate 5 MG Tab 50 Each Bottle,8.8,4.84,2.64,7.61,38
NDC,68462038001,theophylline 400 MG Tablet Extended Release 24 Hour 100 Each Bottle,11.01,6.06,3.3,9.52,38
NDC,68462039601,omeprazole 20 MG CAPSULE DELAYED RELEASE 100 Each Bottle,8.37,4.61,2.51,7.24,38
NDC,68462041827,lidocaine 5 % Ointment 50 g Jar,197.0,108.35,59.1,170.41,38
NDC,68462057230,voriconazole 50 MG Tab 30 Each Bottle,13.5,7.43,4.05,11.68,38
NDC,68462057330,voriconazole 200 MG Tab 30 Each Bottle,26.25,14.44,7.88,22.71,38
NDC,68462058340,aprepitant 40 MG Cap 1 Each Blister,216.08,118.85,2.46,186.91,48
NDC,68462063925,nitroglycerin 0.4 MG SL Tab 25 Each Bottle,8.34,4.59,2.5,7.21,38
NDC,68462068201,sirolimus 0.5 MG Tab 100 Each Bottle,19.0,10.45,0.91,16.44,48
NDC,68462068401,sirolimus 2 MG Tab 100 Each Bottle,26.25,14.44,0.91,22.71,48
NDC,68516460101,antihemophilic factor/VWF in units of FVIII 10 units/mL Recon Soln 1 Each Vial,29.95,16.48,1.03,26.36,63
NDC,68516460101,antihemophilic factor/VWF in units of FVIII Recon Soln 1 Each Vial,29.95,16.48,1.03,26.36,63
NDC,68516460501,antihemophilic factor/VWF in units of FVIII 10 units/mL Recon Soln 1 Each Vial,30.38,16.71,1.03,26.73,63
NDC,68516460702,Antihemophilic Factor-VWF 1000 units Recon Soln 1 Each Vial,30.38,16.71,9.11,26.73,38
NDC,68547011110,sulbactam/durlobactam 200 mg/mL Recon Soln 3 Each Box,913.2,502.26,273.96,789.92,48
NDC,68611019002,fluocinolone acetonide 0.19 MG Implant 1 Each Box,38099.8,20954.89,423.87,32956.33,63
NDC,68682000610,dilTIAZem 30 MG Tab 100 Each Bottle,9.5,5.23,2.85,8.22,38
NDC,68682010110,pentoxifylline 400 MG Tab CR 100 Each Bottle,9.19,5.06,2.76,7.95,38
NDC,68682010150,pentoxifylline 400 MG Tab CR 500 Each Bottle,9.16,5.04,2.75,7.92,38
NDC,68682029905,loteprednol etabonate 0.5 % Suspension 5 mL Bottle,651.13,358.13,195.34,563.23,38
NDC,68682046410,brinzolamide 1 % Suspension 10 mL Bottle,935.71,514.65,280.71,809.39,38
NDC,68682071201,enalapril 10 MG Tab 100 Each Bottle,8.75,4.82,2.63,7.57,38
NDC,68682073205,fluorescein-benoxinate Solution 5 mL Bottle,132.0,72.6,39.6,114.18,38
NDC,68727071201,lurbinectedin 4 mg/8 mL Recon Soln 1 Each Vial,33266.0,18296.3,175.92,28775.09,63
NDC,68727074501,DAUNOrubicin-cytarabine liposomal 44-100 MG Recon Susp 1 Each Vial,44161.75,24288.97,213.28,38199.91,63
NDC,68727080001,deFIBrotide 200 MG/2.5ML Solution 2.5 mL Vial,6376.2,3506.91,1912.86,5515.41,48
NDC,68803067205,trypan blue 0.15 % Solution Prefilled Syringe 0.5 mL Syringe,1266.94,696.82,380.08,1095.9,38
NDC,68875010201,teduglutide 5 MG Kit 1 Each Box,196959.3,108327.62,59087.79,170369.79,48
NDC,68992301001,tacrolimus 1 MG Tablet Extended Release 24 Hour 100 Each Bottle,24.77,13.63,1.55,21.43,48
NDC,68992304003,tacrolimus 4 MG Tablet Extended Release 24 Hour 30 Each Bottle,71.74,39.46,1.55,62.06,48
NDC,68992307501,tacrolimus 0.75 MG Tablet Extended Release 24 Hour 100 Each Bottle,20.08,11.05,1.55,17.37,48
NDC,69097015103,lamoTRIgine 150 MG Tab 60 Each Bottle,8.34,4.59,2.5,7.21,38
NDC,69097024402,darunavir 800 MG Tab 30 Each Bottle,17.48,9.62,5.24,15.12,38
NDC,69097024803,darunavir 600 MG Tab 60 Each Bottle,12.24,6.74,3.67,10.59,38
NDC,69097051607,cycloPHOSphamide 25 MG Cap 100 Each Bottle,16.0,8.8,0.72,13.84,48
NDC,69097051707,cycloPHOSphamide 50 MG Cap 100 Each Bottle,20.85,11.47,0.72,18.04,48
NDC,69097053302,tenofovir disoproxil fumarate 300 MG Tab 30 Each Bottle,9.88,5.44,2.96,8.55,38
NDC,69097068105,pregabalin 100 mg Cap 90 Each Bottle,10.2,5.61,3.06,8.82,38
NDC,69097068305,pregabalin 200 mg Cap 90 Each Bottle,10.22,5.63,3.07,8.84,38
NDC,69097082103,gemfibrozil 600 MG Tab 60 Each Bottle,8.57,4.72,2.57,7.41,38
NDC,69097095805,pregabalin 150 mg Cap 90 Each Bottle,10.21,5.62,3.06,8.83,38
NDC,69097096205,pregabalin 300 mg Cap 90 Each Bottle,10.25,5.64,3.08,8.87,38
NDC,69194035801,brilliant blue green 0.25 MG Recon Soln 1 Each Vial,4082.5,2245.38,1224.75,3531.36,38
NDC,69238105601,chlorproMAZINE 25 MG Tab 100 Each Bottle,9.56,5.26,2.87,8.27,48
NDC,69238145902,potassium chloride 20 MEQ/15ML (10%) Solution 473 mL Bottle,198.43,109.14,59.53,171.64,38
NDC,69238168001,fluPHENAZine 5 MG Tab 100 Each Bottle,11.35,6.25,3.41,9.82,38
NDC,69238183001,levothyroxine 25 MCG Tab 100 Each Bottle,8.74,4.81,2.62,7.56,38
NDC,69238183301,levothyroxine 88 MCG Tab 100 Each Bottle,8.94,4.92,2.68,7.73,38
NDC,69238183601,levothyroxine 125 MCG Tab 100 Each Bottle,9.11,5.02,2.73,7.88,38
NDC,69238207901,propranolol 40 MG Tab 100 Each Bottle,8.84,4.87,2.65,7.65,38
NDC,69292072225,flurbiprofen 0.03 % Solution 2.5 mL Bottle,146.0,80.3,43.8,126.29,38
NDC,69315011701,furosemide 40 MG Tab 100 Each Bottle,8.14,4.48,2.44,7.04,38
NDC,69315013401,imipramine 25 MG Tab 100 Each Bottle,8.79,4.84,2.64,7.6,38
NDC,69315018210,"oxyBUTYnin 5 MG Tab 1,000 Each Bottle",8.33,4.59,2.5,7.21,38
NDC,69315021101,NIFEdipine 10 MG Cap 100 Each Bottle,9.57,5.27,2.87,8.28,38
NDC,69315021201,NIFEdipine 20 MG Cap 100 Each Bottle,12.53,6.9,3.76,10.84,38
NDC,69367016304,phenazopyridine 200 MG Tab 100 Each Bottle,10.6,5.83,3.18,9.17,38
NDC,69367026601,felodipine 10 MG Tablet Extended Release 24 Hour 100 Each Bottle,8.8,4.84,2.64,7.61,38
NDC,69367028302,ergocalciferol 8000 UNIT/ML Solution 60 mL Bottle,105.22,57.88,31.57,91.02,38
NDC,69374031525,norepinephrine 16mg in NaCl 0.9 % 250 mL 64 mcg/mL Solution 250 mL Flex Cont,157.5,86.63,47.25,136.24,38
NDC,69374053650,methacholine 16 mg/mL Solution 1 Syringe Syringe,69.8,38.39,1.39,60.38,48
NDC,69374053703,methacholine 0.0625 mg/mL Solution 1 Syringe Syringe,69.8,38.39,1.39,60.38,48
NDC,69374053803,methacholine 0.25 mg/mL Solution 1 Syringe Syringe,69.8,38.39,1.39,60.38,48
NDC,69374053903,methacholine 1 mg/mL Solution 1 Syringe Syringe,69.8,38.39,1.39,60.38,48
NDC,69374054003,methacholine 4 mg/mL Solution 1 Syringe Syringe,69.8,38.39,1.39,60.38,48
NDC,69374091310,calcium chloride 10 % Solution 10 mL Syringe,98.0,53.9,29.4,84.77,48
NDC,69374091910,succinylcholine 20 mg/mL Solution 10 mL Syringe,148.5,81.68,44.55,128.45,48
NDC,69374098505,lidocaine 10 MG/ML Solution Prefilled Syringe 5 mL Syringe,67.0,36.85,20.1,57.96,38
NDC,69452015120,ergocalciferol 1.25 mg Cap 100 Each Bottle,5.01,2.76,1.5,4.33,38
NDC,69452016013,deferasirox 250 MG TABLET SOLUBLE 30 Each Bottle,40.2,22.11,12.06,34.77,38
NDC,69452020907,niMODipine 30 MG Cap 1 Each Package,15.62,8.6,4.69,13.51,38
NDC,69452020920,niMODipine 30 MG Cap 100 Each Box,15.62,8.6,4.69,13.51,38
NDC,69452034213,modafinil 100 MG Tab 30 Each Bottle,10.75,5.92,3.23,9.3,38
NDC,69452034313,modafinil 200 MG Tab 30 Each Bottle,11.25,6.19,3.38,9.73,38
NDC,69452034660,SUMAtriptan 100 MG Tab 1 Each Blister,8.67,4.77,2.6,7.5,38
NDC,69452038998,magnesium citrate Solution 296 mL Bottle,10.66,5.87,3.2,9.22,38
NDC,69468015104,uridine triacetate 10 g Pack 4 Each Box,10118.6,5565.23,3035.58,8752.59,48
NDC,69468015120,uridine triacetate 10 g Pack 20 Each Box,10118.6,5565.23,3035.58,8752.59,48
NDC,69488000140,gallium Ga-68 dotatate Kit 0.1 millicurie,94.27,51.85,28.28,82.96,63
NDC,69488000301,lutetium Lu-177 dotatate 370 MBQ/ML Solution 1 millicurie,832.0,457.6,249.6,732.16,63
NDC,69488001061,lutetium Lu-177 vipivotide tetraxetan 1000 MBQ/ML Solution 1 millicurie,660.25,363.14,198.08,581.02,63
NDC,69488001761,gallium Ga-68 gozetotide 25 MCG Kit 7 millicurie,17314.0,9522.7,381.01,15236.32,63
NDC,69536005015,phenylephrine 0.5 % Solution 15 mL Bottle,33.28,18.31,9.98,28.79,38
NDC,69543025204,guaiFENesin/codeine 100-10 MG/5ML Solution 118 mL Bottle,36.85,20.27,11.06,31.88,38
NDC,69616027230,perampanel 2 MG Tab 30 Each Bottle,49.4,27.17,14.82,42.73,38
NDC,69616027830,perampanel 8 MG Tab 30 Each Bottle,89.8,49.39,26.94,77.68,38
NDC,69616028230,perampanel 12 MG Tab 30 Each Bottle,89.8,49.39,26.94,77.68,38
NDC,69618000858,multivitamin and mineral 15 mL Liquid 236 mL Bottle,24.18,13.3,7.25,20.92,38
NDC,69618001501,aspirin 325 MG Tablet Delayed Response 100 Each Bottle,4.07,2.24,1.22,3.52,38
NDC,69618006401,senna 8.6 MG Tab 100 Each Bottle,4.07,2.24,1.22,3.52,38
NDC,69618007059,ferrous sulfate 75 (15 Fe) MG/ML Solution 50 mL Bottle,16.75,9.22,5.03,14.49,38
NDC,69794010201,burosumab-twza 10 mg/mL Solution 1 mL Vial,19161.24,10538.69,403.31,16574.47,63
NDC,69794020301,burosumab-twza 20 mg/mL Solution 1 mL Vial,36516.93,20084.32,403.31,31587.14,63
NDC,69794030401,burosumab-twza 30 mg/mL Solution 1 mL Vial,54767.88,30122.34,403.31,47374.22,63
NDC,69853010201,andexanet alfa - coagulation factor Xa inactivated-zhzo 200 MG Recon Soln 1 Each Vial,10510.0,5780.5,113.17,9091.15,63
NDC,69911086402,"coagulation factor IX recombinant, albumin fusion protein 250 units Recon Soln 1 Each Box",46.61,25.64,4.47,41.02,63
NDC,69918073501,isoproterenol 0.2 MG/ML Solution 5 mL Vial,771.0,424.05,231.3,666.92,38
NDC,69918090110,desmopressin 4 MCG/ML Solution 10 mL Vial,2148.0,1181.4,3.52,1858.02,63
NDC,69932000101,fluciclovine F-18 9-221 MCI/ML Solution 1 millicurie,1252.0,688.6,268.42,1101.76,63
NDC,69945006820,technetium Tc-99m tagged red blood cells Kit 20 millicurie,344.32,189.38,103.3,303.0,48
NDC,69945006820,technetium Tc-99m tagged red blood cells Kit 30 millicurie,509.0,279.95,152.7,447.92,48
NDC,69945009620,technetium Tc-99m mertiatide Kit 15 millicurie,1146.25,630.44,343.88,1008.7,48
NDC,70004004007,atropine 0.4 MG/ML Solution 2.5 mL Syringe,93.95,51.68,0.1,81.27,48
NDC,70004004025,atropine 0.4 MG/ML Solution 3 mL Syringe,88.32,48.58,0.1,76.4,48
NDC,70004010316,morphine 5 mg/mL Solution 30 mL Syringe,342.8,188.54,102.84,296.52,38
NDC,70004020006,fentaNYL 0.05 MG/ML Solution 2 mL Syringe,101.4,55.77,0.73,87.71,48
NDC,70004020232,fentaNYL 10 mcg/mL Solution 100 mL Flex Cont,488.0,268.4,146.4,422.12,38
NDC,70004043430,ketamine 100 mg in NaCl 0.9 % 50 mL 100 MG/50 ML Solution 50 mL,129.8,71.39,38.94,112.28,38
NDC,70010004301,methylphenidate HCl 20 MG Tab CR 100 Each Bottle,11.4,6.27,3.42,9.86,38
NDC,70010078612,methylergonovine 0.2 MG Tab 12 Each Bottle,43.87,24.13,13.16,37.95,38
NDC,70020191001,ixabepilone 2 mg/mL Recon Soln 1 Each Vial,9090.52,4999.79,117.14,7863.3,63
NDC,70020191101,ixabepilone 2 mg/mL Recon Soln 1 Each Vial,24794.09,13636.75,117.14,21446.89,63
NDC,70069005101,dorzolamide/timolol 2-0.5 % Solution 10 mL Bottle,90.0,49.5,27.0,77.85,38
NDC,70069012101,tropicamide 1 % Solution 15 mL Bottle,49.77,27.38,14.93,43.05,38
NDC,70069018101,pilocarpine 1 % Solution 15 mL Bottle,256.12,140.87,76.84,221.54,38
NDC,70069023101,brimonidine 0.2 % Solution 5 mL Bottle,41.39,22.77,12.42,35.8,38
NDC,70069027125,verapamil 2.5 MG/ML Solution 2 mL Vial,95.0,52.25,28.5,82.18,38
NDC,70069069201,zinc sulfate 3 MG/ML Solution 10 mL Vial,265.92,146.26,79.78,230.02,38
NDC,70092109236,fentaNYL 10 mcg/mL Solution 100 mL Flex Cont,298.0,163.9,89.4,257.77,38
NDC,70092113544,lidocaine-racepinephrine-tetracaine 3 Gel 3 mL Syringe,73.16,40.24,21.95,63.28,38
NDC,70092129349,HYDROmorphone 1 mg/mL Solution Prefilled Syringe 30 mL Syringe,343.7,189.04,103.11,297.3,38
NDC,70092138036,morphine 100 mg in 0.9% NaCl 100 mL 1 mg/mL Solution 100 mL Flex Cont,211.0,116.05,63.3,182.52,38
NDC,70092154635,HYDROmorphone (1 mg/mL) Solution 50 mL Flex Cont,204.25,112.34,61.28,176.68,38
NDC,70092156646,lidocaine (PF) 1 % Solution 10 mL Syringe,88.38,48.61,26.51,76.45,38
NDC,70092166343,"lidocaine 1% - EPINEPHrine 1:100,000 buffered in sod bicarbonate injection 1 %-1:100000 Solution Prefilled Syringe 3 mL Syringe",100.48,55.27,30.14,86.92,38
NDC,70092933375,ROPivacaine 0.2 % Solution 100 mL Cartridge,501.45,275.79999999999995,0.05,496.42,96
NDC,70100042402,indocyanine green 25 MG Recon Soln 1 Each Vial,1115.25,613.39,334.58,964.69,38
NDC,70114010101,Pegfilgrastim-cbqv 6 MG/0.6ML Solution Prefilled Syringe 0.6 mL Syringe,17545.0,9649.75,106.33,15176.43,63
NDC,70114013001,pegfilgrastim-cbqv 6 MG/0.6ML Solution Prefilled Syringe 0.6 mL Syringe,17545.0,9649.75,106.33,15176.43,63
NDC,70114034001,toripalimab-tpzi 240 mg/6 mL Solution 6 mL Vial,38118.11,20964.97,33.76,32972.17,63
NDC,70114044001,ranibizumab-eqrn 0.3 MG/0.05ML Solution 0.05 mL Vial,4421.4,2431.77,86.16,3824.51,63
NDC,70114044101,ranibizumab-eqrn 0.5 MG/0.05ML Solution 0.05 mL Vial,7359.0,4047.45,86.16,6365.54,63
NDC,70121100201,eptifibatide 20 MG/10ML Solution 10 mL Vial,615.0,338.25,21.75,531.98,48
NDC,70121156807,filgrastim-ayow 300 mcg/0.5mL Solution Prefilled Syringe 0.5 mL Syringe,873.6,480.48,0.38,755.66,63
NDC,70121157007,filgrastim-ayow 480 mcg/0.8mL Solution Prefilled Syringe 0.8 mL Syringe,1388.76,763.82,0.38,1201.28,63
NDC,70121157405,methylPREDNISolone acetate 80 MG/ML Suspension 1 mL Vial,126.08,69.35,0.11,109.06,63
NDC,70121162701,pegfilgrastim-pbbk 6 MG/0.6ML Solution Prefilled Syringe 0.6 mL Syringe,10510.0,5780.5,137.97,9091.15,63
NDC,70121163001,thiotepa 10 mg/ml Recon Soln 1 Each Vial,1440.0,792.0,10.54,1245.6,63
NDC,70121163101,thiotepa 100 MG Recon Soln 1 Each Vial,8125.0,4468.75,10.54,7028.13,63
NDC,70121175401,bevacizumab-maly 100 MG/4ML Solution 4 mL Vial,3258.7,1792.29,37.82,2818.78,63
NDC,70121175501,bevacizumab-maly 400 MG/16ML Solution 16 mL Vial,12379.92,6808.96,37.82,10708.63,63
NDC,70257005151,hepatitis B immune globulin Solution 5 mL Vial,4820.68,2651.38,56.62,4169.89,63
NDC,70257053251,cytomegalovirus immune globulin 5 % Solution 50 mL Vial,9501.99,5226.1,1557.59,12213.72,63
NDC,70257056001,baclofen 500 mcg/mL (10 mg/20 mL) Solution 20 mL Ampule,1291.02,710.07,149.26,1186.79,63
NDC,70257056211,baclofen 0.05 MG/ML Solution 1 mL Ampule,212.82,117.06,34.97,453.6,48
NDC,70257056301,baclofen 2000 mcg/mL (40 mg/20 mL) Solution 20 mL Ampule,5118.76,2815.32,149.26,4427.73,63
NDC,70257056302,baclofen 2000 mcg/mL (40 mg/20 mL) Solution 20 mL Ampule,5118.76,2815.32,149.26,4427.73,63
NDC,70257056302,baclofen 2000 mcg/mL (80 mg/40 mL) Solution 20 mL Ampule,5118.76,2815.32,149.26,4427.73,63
NDC,70377010211,aminocaproic acid 500 MG Tab 30 Each Bottle,37.5,20.63,11.25,32.44,38
NDC,70408023932,nitrofurantoin 25 MG/5ML Suspension 240 mL Bottle,3861.6,2123.88,1158.48,3340.28,38
NDC,70408064434,theophylline 80 MG/15ML Elixir 473 mL Bottle,953.47,524.41,286.04,824.75,38
NDC,70621010101,aminolevulinic acid 10 % Gel 2 g Tube,1099.0,604.45,1.48,950.64,63
NDC,70655008806,fluconazole 400 mg/200 mL Solution 200 mL Flex Cont,67.0,36.85,2.05,57.96,48
NDC,70700011985,norgestimate/ethinyl estradiol 0.25-35 mg-mcg Tab 28 Each Disp Pack,8.85,4.87,2.66,7.66,38
NDC,70700016201,progesterone micronized 100 MG Cap 100 Each Bottle,9.32,5.13,2.8,8.06,38
NDC,70700016725,glycopyrrolate 0.2 MG/ML Solution 5 mL Vial,91.24,50.19,0.46,78.92,63
NDC,70700016725,glycopyrrolate 1 MG/5ML Solution 5 mL Vial,91.24,50.19,0.46,78.92,63
NDC,70700018922,fluorouracil 5 GM/100ML Solution 100 mL Vial,309.18,170.05,1.91,267.44,48
NDC,70700026899,fosfomycin tromethamine 3 g Pack 1 Each Sachet,197.77,108.78,59.33,171.07,38
NDC,70710111001,cyproheptadine 4 MG Tab 100 Each Bottle,9.46,5.21,2.84,8.18,38
NDC,70710115201,isosorbide dinitrate 40 MG Tab 100 Each Bottle,42.06,23.14,12.62,36.38,38
NDC,70710115703,leflunomide 10 MG Tab 30 Each Bottle,10.28,5.66,3.08,8.89,38
NDC,70710115803,leflunomide 20 MG Tab 30 Each Bottle,10.28,5.66,3.08,8.89,38
NDC,70710116506,oseltamivir 6 MG/ML Recon Susp 60 mL Bottle,217.6,119.68,65.28,188.22,38
NDC,70710147801,fomepizole 1 gm/mL Solution 1.5 mL Vial,8115.0,4463.25,5.29,7019.48,63
NDC,70710152509,carmustine 3.3 mg/mL Recon Soln 1 Each Vial,3400.0,1870.0,219.22,2941.0,63
NDC,70710153101,DOXOrubicin liposome 2 MG/ML Suspension 25 mL Vial,5671.94,3119.57,108.47,4906.23,63
NDC,70710160901,baclofen 5 MG Tab 100 Each Bottle,8.53,4.7,2.56,7.38,38
NDC,70710185207,indomethacin 50 MG Suppos 30 Each Box,830.14,456.58,249.04,718.07,38
NDC,70720095036,goserelin 3.6 MG Implant 1 Each Syringe,4756.3,2615.97,603.65,4955.51,63
NDC,70720095130,goserelin 10.8 MG Implant 1 Each Box,12576.09,6916.85,603.65,10878.32,63
NDC,70756062925,phenylephrine 2.5 % Solution 2 mL Bottle,133.75,73.57,40.13,115.69,38
NDC,70756064935,phenylephrine 2.5 % Solution 15 mL Bottle,307.5,169.13,92.25,265.99,38
NDC,70756072011,acetaZOLAMIDE 125 MG Tab 100 Each Bottle,8.86,4.88,2.66,7.66,38
NDC,70801000301,triamcinolone acetonide 32 MG Suspension Reconstituted ER 1 Each Vial,3377.47,1857.61,15.45,2921.51,63
NDC,70842010101,delafloxacin 450 MG Tab 20 Each Bottle,196.28,107.96,58.88,169.78,38
NDC,70842010203,delafloxacin 300 MG Recon Soln 1 Each Vial,781.26,429.7,234.38,675.79,48
NDC,70842012006,meropenem/vaborbactam 2 (1-1) g Recon Soln 1 Each Vial,1216.5,669.08,1.81,1052.27,63
NDC,70842016010,minocycline HCl 100 MG Recon Soln 1 Each Vial,1410.9,776.0,2.23,1220.43,63
NDC,70842024001,rezafungin 200 MG Recon Soln 1 Each Vial,4921.81,2707.0,8.96,4257.37,63
NDC,70860020120,oxaliplatin 100 MG/20ML Solution 20 mL Vial,500.0,275.0,0.06,432.5,48
NDC,70860021174,fulvestrant 250 MG/5ML Solution Prefilled Syringe 5 mL Syringe,500.0,275.0,5.72,432.5,63
NDC,70860021803,cycloPHOSphamide 200 mg/mL Solution 2.5 mL Vial,1751.38,963.26,0.78,1514.94,63
NDC,70860021805,cycloPHOSphamide 200 mg/mL Solution 5 mL Vial,3321.25,1826.69,0.78,2872.88,63
NDC,70860040641,bumetanide 0.25 MG/ML Solution 10 mL Vial,43.53,23.95,0.37,37.65,63
NDC,70860080282,zoledronic acid 5 mg/100 mL Solution 100 mL Bag,450.2,247.61,4.82,389.42,48
NDC,70954004110,rifabutin 150 MG Cap 100 Each Bottle,40.01,22.01,12.0,34.61,38
NDC,70954014810,pyRIDostigmine 60 MG/5ML Solution 473 mL Bottle,1807.71,994.25,542.31,1563.67,38
NDC,70954024010,carBAMazepine 100 MG/5ML Suspension 450 mL Bottle,241.15,132.64,72.35,208.59,38
NDC,70954044310,miSOPROStol 100 MCG Tab 60 Each Bottle,8.99,4.95,2.7,7.78,38
NDC,70954044410,miSOPROStol 200 MCG Tab 60 Each Bottle,9.9,5.45,2.97,8.56,38
NDC,70954048810,lacosamide 10 MG/ML Solution 200 mL Bottle,233.0,128.15,69.9,201.55,38
NDC,70954049210,levOCARNitine 330 MG Tab 90 Each Box,9.63,5.3,2.89,8.33,38
NDC,70954054110,trimethoprim 100 MG Tab 100 Each Bottle,12.59,6.93,3.78,10.89,38
NDC,70954056410,estradiol 0.5 MG Tab 100 Each Bottle,8.24,4.54,2.47,7.13,38
NDC,70954056510,estradiol 1 MG Tab 100 Each Bottle,8.29,4.56,2.49,7.17,38
NDC,71019009702,calcium gluconate 2 g/100 mL Solution 2 g Flex Cont,34.12,18.77,10.24,29.51,38
NDC,71104097801,antihemophilic factor Fc-VWF-XTEN-ehtl recombinant 250 units Recon Soln 1 Each Vial,46.33,25.49,3.99,40.77,63
NDC,71258002200,F-18 piflufolastat 9 MCI Solution Prefilled Syringe 1 Each Syringe,16616.56,9139.11,332.44,14622.57,63
NDC,71266651901,phenol 6 % Solution 10 mL Vial,550.74,302.91,165.22,476.39,38
NDC,71266800601,bevacizumab 25 mg/mL Solution 0.12 mL Syringe,1345.7,740.14,1.58,1164.03,63
NDC,71266860401,moxifloxacin 0.16 % Solution Prefilled Syringe 1 mL Syringe,91.44,50.3,27.43,79.1,48
NDC,71266908101,ketamine 1000 mg in NaCl 100 mL 1000 MG/100 ML Solution 100 mL Flex Cont,418.0,229.9,125.4,361.57,38
NDC,71269025010,niacin 250 MG Tab CR 100 Each Bottle,8.26,4.55,2.48,7.14,38
NDC,71287011901,axicabtagene ciloleucel Suspension 1 Each Package,2310000.0,1270500.0,420299.42,3598266.24,63
NDC,71287021901,brexucabtagene autoleucel 200000000 CELLS Suspension 1 Each Flex Cont,2120000.0,1166000.0,419041.03,3305610.0,63
NDC,71288001615,DAPTOmycin 5 mg/mL Recon Soln 1 Each Vial,195.0,107.25,0.04,168.68,48
NDC,71288001615,DAPTOmycin 500 mg Recon Soln 1 Each Vial,195.0,107.25,0.04,168.68,48
NDC,71288003120,ampicillin/sulbactam 1.5 (1-0.5) g Recon Soln 1 Each Vial,60.91,33.51,1.41,52.69,48
NDC,71288003220,ampicillin/sulbactam 3 (2-1) g Recon Soln 1 Each Vial,82.19,45.21,1.41,71.09,48
NDC,71288011530,azaCITIDine 100 MG Recon Susp 1 Each Vial,241.5,132.83,0.25,208.9,48
NDC,71288016610,PEMEtrexed 25 mg/ml Recon Soln 1 Each Vial,171.0,94.05,4.36,147.92,63
NDC,71288016750,PEMEtrexed 25 mg/ml Recon Soln 1 Each Vial,735.0,404.25,4.36,635.78,63
NDC,71288020185,regadenoson 0.4 MG/5ML Solution 5 mL Syringe,150.0,82.5,3.28,129.75,48
NDC,71288020302,furosemide 10 MG/ML Solution 2 mL Vial,38.0,20.9,0.1,32.87,48
NDC,71288020310,furosemide 10 MG/ML Solution 10 mL Vial,46.0,25.3,0.1,39.79,96
NDC,71288030301,cyanocobalamin 1000 MCG/ML Solution 1 mL Vial,44.24,24.34,1.1,38.27,48
NDC,71288040310,heparin 5000 UNIT/ML Solution 10 mL Vial,97.48,53.62,0.17,84.32,48
NDC,71288080320,mycophenolate mofetil Recon Soln 1 Each Vial,450.0,247.5,0.35,389.25,48
NDC,71336100001,patisiran sodium 10 MG/5ML Solution 5 mL Vial,40133.5,22073.43,84.85,34715.48,63
NDC,71336100301,vutrisiran 25 MG/0.5ML Solution Prefilled Syringe 0.5 mL Syringe,486685.0,267676.75,4222.39,420982.53,63
NDC,71399004101,simethicone 40 MG/0.6ML Suspension 30 mL Bottle,27.67,15.22,8.3,23.93,38
NDC,71399004903,lidocaine 4 % Cream 30 g Tube,61.69,33.93,18.51,53.36,76
NDC,71399012001,hydrocortisone 1 % Lotion 120 mL Bottle,38.06,20.94,11.42,32.92,38
NDC,71399012204,vitamins A & D Ointment 113 g Tube,33.84,18.62,10.15,29.27,38
NDC,71399282901,dibucaine 1 % Ointment 28 g Tube,31.17,17.15,9.35,26.96,38
NDC,71399685403,menthol-methyl salicylate Cream 85 g Tube,31.31,17.23,9.39,27.08,38
NDC,71399685403,muscle rub 10-15 % Cream 85 g Tube,31.31,17.23,9.39,27.08,38
NDC,71399740105,cholecalciferol 400 UNIT/ML Liquid 50 mL Bottle,30.5,16.78,9.15,26.38,38
NDC,71449000211,lidocaine (PF) 1 % Solution 5 mL Syringe,81.0,44.55,24.3,70.07,38
NDC,71456000101,sodium bicarbonate 1 mEq/mL Solution 10 mL Vial,30.0,16.5,9.0,25.95,38
NDC,71837584305,sargramostim (GM-CSF) 250 mcg Recon Soln 1 Each Vial,1680.67,924.37,50.37,1453.78,63
NDC,71839010401,fosaprepitant (EMEND) 150 mg in NaCl 0.9% 150 mL 150 mg Solution 150 mL Flex Cont,295.8,162.69,0.11,255.87,48
NDC,71839010401,fosaprepitant 150 MG Recon Soln 1 Each Vial,183.0,100.65,0.11,158.3,48
NDC,71863020205,phenylephrine 0.1 mg/mL Solution 5 mL Ampule,62.5,34.38,0.14,54.06,48
NDC,71879013601,fluocinolone Acetonide 0.18 MG Implant 1 Each Box,38360.2,21098.11,451.53,33181.57,63
NDC,72078003401,remifentanil Recon Soln 1 Each Vial,481.51,264.84,144.45,416.51,38
NDC,72140063377,mineral oil/petrolatum Ointment 85 g Tube,44.99,24.75,13.5,38.92,38
NDC,72140085731,soap & cleaners Bar 1 Each Box,25.6,14.08,7.68,22.14,38
NDC,72187010103,elacestrant hydrochloride 86 MG Tab 30 Each Bottle,665.91,366.26,199.77,576.01,38
NDC,72187010203,elacestrant hydrochloride 345 MG Tab 30 Each Bottle,1987.73,1093.26,596.32,1719.39,38
NDC,72187040101,tagraxofusp-erzs 1000 MCG/ML Solution 1 mL Vial,138417.27,76129.5,290.97,119730.94,63
NDC,72205000130,moxifloxacin 400 MG Tab 30 Each Bottle,15.82,8.71,4.75,13.68,38
NDC,72205003101,decitabine 5 mg/mL Recon Soln 1 Each Vial,960.6,528.33,2.0,830.92,48
NDC,72205004060,dofetilide 250 MCG Cap 60 Each Bottle,9.1,5.01,2.73,7.87,38
NDC,72205004160,dofetilide 500 MCG Cap 60 Each Bottle,9.1,5.01,2.73,7.87,38
NDC,72205004601,thiotepa 100 MG Recon Soln 1 Each Vial,18295.0,10062.25,10.54,15825.18,63
NDC,72205008430,tiaGABine 2 MG Tab 30 Each Bottle,23.14,12.73,6.94,20.02,38
NDC,72205008530,tiaGABine 4 MG Tab 30 Each Bottle,23.14,12.73,6.94,20.02,38
NDC,72205024901,plerixafor 24 MG/1.2ML Solution 1.2 mL Vial,5936.05,3264.83,25.33,5134.68,63
NDC,72266016010,ziprasidone Recon Soln 1 Each Vial,211.74,116.46,6.17,183.16,48
NDC,72266016301,tobramycin Recon Soln 1 Each Vial,477.0,262.35,1.69,412.61,48
NDC,72266020401,prochlorperazine 10 MG/2ML Solution 2 mL Vial,59.43,32.69,2.54,51.41,48
NDC,72266025201,CISplatin 50 MG/50ML Solution 50 mL Vial,147.5,81.13,2.31,127.59,48
NDC,72266025301,CISplatin 100 MG/100ML Solution 100 mL Vial,218.0,119.9,2.31,188.57,48
NDC,72485062513,ciprofloxacin/dexamethasone 0.3-0.1 % Suspension 7.5 mL Bottle,389.96,214.48,116.99,337.32,38
NDC,72493010303,mitoMYcin 80 (2 x 40) MG Recon Soln 1 Each Box,100383.0,55210.65,267.34,86831.3,63
NDC,72578005601,felbamate 400 MG Tab 100 Each Bottle,11.19,6.16,3.36,9.68,38
NDC,72578005701,felbamate 600 MG Tab 100 Each Bottle,12.43,6.84,3.73,10.75,38
NDC,72578008201,acyclovir 5 % Ointment 15 g Tube,192.01,105.61,57.6,166.09,38
NDC,72606001101,bevacizumab-adcd 100 MG/4ML Solution 4 mL Vial,3073.3,1690.32,39.96,2658.4,63
NDC,72606001201,bevacizumab-adcd 400 MG/16ML Solution 16 mL Vial,11671.28,6419.21,39.96,10095.66,63
NDC,72611076110,vancomycin 10 mg/mL Recon Soln 1 Each Vial,47.5,26.13,0.15,41.09,48
NDC,72611076110,vancomycin 500 mg Recon Soln 1 Each Vial,47.5,26.13,0.15,41.09,48
NDC,72627240101,edetate disodium 150 MG/ML Solution 30 mL Vial,1230.0,676.5,0.28,1063.95,48
NDC,72694095401,pegaspargase 750 UNIT/ML Solution 5 mL Vial,109957.12,60476.42,23242.75,191862.41,63
NDC,72819015205,mitoMYcin 0.2 mg/mL Recon Soln 1 Each Vial,463.29,254.81,20.35,400.75,63
NDC,72819015205,mitoMYcin 0.4 mg/mL Recon Soln 1 Each Vial,463.29,254.81,20.35,400.75,63
NDC,72819015205,mitoMYcin Recon Soln 1 Each Vial,463.29,254.81,20.35,400.75,63
NDC,72874000101,fluoroestradiol F-18 4-100 MCI/ML Solution 1 Each Vial,13855.0,7620.25,498.67,12192.4,63
NDC,72888003905,amiodarone 200 MG Tab 500 Each Bottle,8.52,4.69,2.56,7.37,38
NDC,72893000101,melphalan HCl (PG Free) 5 MG/ML Recon Soln 1 Each Vial,7220.5,3971.28,15.45,6245.73,63
NDC,72893000301,PRALAtrexate 20 MG/ML Solution 1 mL Vial,30395.14,16717.33,320.92,26291.8,63
NDC,72893000501,PRALAtrexate 40 MG/2ML Solution 2 mL Vial,60775.28,33426.41,320.92,52570.62,63
NDC,73153090108,lisocabtagene maraleucel CD8 Suspension 1 Each Vial,2236135.0,1229874.25,443454.86,3656040.71,63
NDC,73177010102,ketamine 50 mg/5 mL Solution Prefilled Syringe 5 mL Syringe,99.3,54.62,29.79,85.89,38
NDC,73177010227,fentaNYL 10 mcg/mL Solution 100 mL Flex Cont,320.0,176.0,96.0,276.8,38
NDC,73177010316,fentaNYL 50 mcg/mL Solution 30 mL Syringe,283.4,155.87,85.02,245.14,38
NDC,73177010516,morphine 1 mg/mL Solution 30 mL Syringe,199.4,109.67,59.82,172.48,38
NDC,73177011803,lidocaine (PF) 1 % Solution 10 mL Syringe,101.9,56.05,30.57,88.14,38
NDC,73177015627,ketamine 1000 mg in NaCl 100 mL 1000 MG/100 ML Solution 100 mL Flex Cont,379.0,208.45,113.7,327.84,38
NDC,73302045601,ulipristal acetate 30 MG Tab 1 Each Box,98.0,53.9,29.4,84.77,38
NDC,73462010101,trilaciclib Dihydrochloride 15 mg/mL Recon Soln 1 Each Vial,7182.66,3950.47,4.61,6213.0,63
NDC,73475304105,efgartigimod alfa-fcab 400 mg/20 mL Solution 20 mL Vial,26009.6,14305.28,27.86,22498.3,63
NDC,73475310203,efgartigimod alfa-hyaluronidase-qvfc 1008-11200 mg-UT/5.6 mL Solution 5.6 mL Vial,67581.53,37169.85,28.42,58458.02,63
NDC,73535020801,tafasitamab-cxix 40 mg/mL Recon Soln 1 Each Vial,6306.42,3468.54,12.0,5455.05,63
NDC,73594931001,ferric derisomaltose 1000 MG/10ML Solution 10 mL Vial,14759.18,8117.55,17.84,12766.69,63
NDC,73650031610,teplizumab-mzwv 2 MG/2ML Solution 2 mL Vial,59099.91,32504.96,31.97,51121.42,63
NDC,73657002001,melphalan flufenamide 0.5 mg/mL Recon Soln 1 Each Vial,38965.0,21430.75,11689.5,33704.73,38
NDC,73776000111,lifileucel 72000000000 CELLS Suspension 1 Each Flex Cont,2575000.0,1416250.0,772500.0,2266000.0,48
NDC,74300000071,zinc oxide 40 % Paste 113 g Tube,42.15,23.19,12.65,36.46,38
NDC,74676590200,triptorelin pamoate 3.75 MG Recon Susp 1 Each Vial,4949.25,2722.09,413.24,4281.1,63
NDC,74676590400,triptorelin pamoate 11.25 MG Recon Susp 1 Each Vial,11523.33,6337.84,413.24,9967.68,63
NDC,74676590601,triptorelin pamoate 22.5 MG Recon Susp 1 Each Vial,23036.67,12670.17,413.24,19926.72,63
NDC,75834015801,verapamil HCl 180 MG Tab CR 100 Each Bottle,8.8,4.84,2.64,7.61,38
NDC,75834015901,verapamil HCl 240 MG Tab CR 100 Each Bottle,8.77,4.83,2.63,7.59,38
NDC,75834028030,potassium iodide 1 GM/ML Solution 30 mL Bottle,903.32,496.83,271.0,781.37,38
NDC,75907002311,cloNIDine 0.1 mg/24hr/patch PATCH WEEKLY 1 Each Package,41.81,23.0,12.54,36.17,38
NDC,75907006905,nortriptyline 10 MG Cap 500 Each Bottle,8.63,4.75,2.59,7.46,38
NDC,75987008010,Pegloticase 8 MG/ML Solution 1 mL Vial,126104.29,69357.36,3048.08,109080.21,63
NDC,75987013015,teprotumumab-trbw 500 MG Recon Soln 1 Each Vial,73556.75,40456.22,298.03,63626.59,63
NDC,75987015001,inebilizumab-cdon 100 MG/10ML Solution 10 mL Vial,196357.9,107996.85,415.9,169849.58,63
NDC,76075010101,carfilzomib 60 MG Recon Soln 1 Each Vial,15229.92,8376.46,44.62,13173.88,63
NDC,76075010201,carfilzomib 30 MG Recon Soln 1 Each Vial,7983.7,4391.04,44.62,6905.9,63
NDC,76075010301,carfilzomib 2 mg/mL Recon Soln 1 Each Vial,2677.89,1472.84,44.62,2316.37,63
NDC,76128015575,porfimer Recon Soln 1 Each Vial,97966.6,53881.63,20802.53,84741.11,63
NDC,76204080001,levalbuterol hydrochloride 0.63 MG/3ML Nebu Soln 3 mL Plas Cont,11.8,6.49,3.54,10.21,38
NDC,76204090001,levalbuterol hydrochloride 1.25 MG/3ML Nebu Soln 3 mL Box,11.8,6.49,3.54,10.21,38
NDC,76310001701,amifostine 500 MG Recon Soln 1 Each Vial,5800.6,3190.33,698.99,5017.52,48
NDC,76310002201,aldesleukin Recon Soln 1 Each Vial,22776.03,12526.82,4551.67,19701.27,63
NDC,76310002425,foscarnet 6000 MG/250ML Solution 250 mL Glass Cont,2286.0,1257.3,16.08,1977.39,63
NDC,76329124001,phytonadione 1 MG/0.5ML Solution 0.5 mL Syringe,180.75,99.42,1.9,156.35,86
NDC,76329301305,lidocaine 2 % Gel 10 mL Syringe,28.12,15.47,8.44,24.32,38
NDC,76329331601,EPINEPHrine 1 mg/10 mL Solution Prefilled Syringe 10 mL Syringe,93.95,51.68,3.6,81.27,48
NDC,76329334001,atropine 1 MG/10ML Solution Prefilled Syringe 10 mL Syringe,94.43,51.94,0.1,81.68,48
NDC,76329336901,naloxone 1 MG/ML Liquid 2 mL Syringe,213.0,117.15,63.9,184.25,38
NDC,76329336901,naloxone 2 MG/2ML Solution Prefilled Syringe 2 mL Syringe,213.0,117.15,0.35,184.25,48
NDC,76329339001,lidocaine 20 MG/ML Solution 5 mL Syringe,87.72,48.25,26.32,75.88,38
NDC,76329339905,procainamide 100 MG/ML Solution 10 mL Vial,525.0,288.75,157.15,1311.66,63
NDC,76329630005,lidocaine 4 % Solution 4 mL Bottle,196.2,107.91,58.86,169.71,38
NDC,76385010201,primaquine phosphate 26.3 mg (=15 mg Base) Tab 100 Each Bottle,11.01,6.06,3.3,9.52,38
NDC,76385010617,ketotifen fumarate 0.035 % Solution 5 mL Bottle,50.8,27.94,15.24,43.94,38
NDC,76385011501,sotalol 60 mg half tablet Tab 0.5 tablet Package,8.62,4.75,2.59,7.46,38
NDC,76388063525,chlorambucil 2 MG Tab 25 Each Bottle,68.64,37.76,20.59,59.37,38
NDC,76388071325,busulfan 2 MG Tab 25 Each Bottle,69.24,38.09,20.77,89.26,63
NDC,76478050120,PENTobarbital 50 MG/ML Solution 20 mL Vial,6550.19,3602.61,57.97,5665.91,48
NDC,77333043025,lactase 3000 units Tab 1 Each Blister,4.93,2.72,1.48,4.26,38
NDC,77333081225,simethicone 80 MG Chew Tab 1 Each Blister,8.78,4.83,2.63,7.59,38
NDC,77333082725,sodium bicarbonate 650 MG Tab 1 Each Blister,8.67,4.77,2.6,7.5,38
NDC,77333094010,pyridoxine 50 MG Tab 100 Each Box,4.0,2.2,1.2,3.46,38
NDC,78206011801,betamethasone (as acetate-sod phos) 6 (3-3) MG/ML Suspension 5 mL Vial,276.96,152.33,6.44,239.57,48
NDC,78206011801,betamethasone (as acetate-sod phos) 6 (3-3) mg/mL Suspension 5 mL Vial,276.96,152.33,6.44,239.57,48
NDC,78206014501,etonogestrel 68 MG Implant 1 Each Box,6574.0,3615.7,1251.46,5686.51,48
NDC,78206014701,trastuzumab-dttb 21 mg/mL Recon Soln 1 Each Vial,5985.97,3292.29,19.0,5177.86,63
NDC,78206014801,trastuzumab-dttb 21 mg/mL Recon Soln 1 Each Vial,15968.87,8782.88,19.0,13813.07,63
NDC,78206016201,inFLIXimab-abda 100 MG Recon Soln 1 Each Vial,4083.31,2245.83,22.55,3532.06,63
NDC,79854090020,vitamin E 400 units Cap 100 Each Bottle,4.0,2.2,1.2,3.46,38
NDC,79952011001,loncastuximab tesirine-lpyl 10 mg/2 mL Recon Soln 1 Each Vial,113857.24,62621.49,182.13,98486.51,63
NDC,80446040101,Tebentafusp-tebn 100 MCG/0.5ML Solution 0.5 mL Vial,83983.0,46190.65,184.4,72645.3,63
NDC,80650601185,silicone oil 1000 Misc 8.5 mL Vial,2284.84,1256.67,685.45,1976.39,38
NDC,80681005200,i-vite Tab 120 Each Bottle,4.32,2.38,1.3,3.74,38
NDC,80681009000,niacin 500 MG Tab CR 100 Each Bottle,8.29,4.56,2.49,7.17,38
NDC,80681009700,thiamine 50 MG Tab 100 Each Bottle,8.09,4.45,2.43,7.0,38
NDC,80681010000,glucose 4 g Chew Tab 10 Each Tube,5.06,2.79,1.52,4.38,38
NDC,80681013500,zinc (as sulfate) 220 mg (50 mg elemental) Cap 100 Each Bottle,4.13,2.28,1.24,3.57,38
NDC,80681013801,calcium carbonate/vitamin D 600-200 mg-unit Tab 150 Each Bottle,4.09,2.25,1.23,3.54,38
NDC,80681014000,calcium citrate 950 MG Tab 100 Each Bottle,8.12,4.47,2.44,7.02,38
NDC,80681016500,cyanocobalamin 250 MCG Tab 130 Each Bottle,4.07,2.24,1.22,3.52,38
NDC,80681016900,cholecalciferol 1000 units Tab 100 Each Bottle,4.08,2.25,1.22,3.53,38
NDC,80681016900,vitamin D3 1000 units Tab 100 Each Bottle,4.08,2.25,1.22,3.53,38
NDC,80681017000,vitamin D3 2000 units Tab 100 Each Bottle,4.12,2.27,1.24,3.56,38
NDC,80777010201,Moderna 12+ COVID-19 mRNA 50 mcg/0.5 mL Suspension Prefilled Syringe 0.5 mL Syringe,412.04,226.63,123.61,356.41,53
NDC,80803015350,sirolimus protein-bound 100 mg Recon Susp 1 Each Vial,32726.97,17999.84,84.57,28308.83,63
NDC,81033022015,potassium chloride 20 MEQ/15ML (10%) Solution 15 mL Cup,19.53,10.75,5.86,16.89,38
NDC,81033022052,potassium chloride 20 MEQ/15ML (10%) Solution 15 mL Cup,19.53,10.75,5.86,16.89,38
NDC,81284031505,indigotindisulfonate sodium 8 mg/mL Solution 5 mL Ampule,2175.0,1196.25,9.96,1881.38,63
NDC,81284041110,dihydroergotamine 1 MG/ML Solution 1 mL Ampule,412.8,227.04,35.24,655.22,48
NDC,81284061100,tranexamic acid 1000 MG/10ML Solution 10 mL Vial,63.5,34.93,19.05,54.93,76
NDC,81284083105,PHYSostigmine 0.4 mg/mL Solution 5 mL Ampule,690.0,379.5,207.0,596.85,38
NDC,82584079225,lidocaine 3.5 % Gel 1 mL Tube,101.77,55.98,30.53,88.03,38
NDC,82705000201,epcoritamab-bysp 4 MG/0.8ML Solution 0.8 mL Vial,6083.94,3346.17,47.39,5262.61,63
NDC,82705000201,epcoritamab-bysp 4 MG/5ML Solution 5 mL Vial,7162.0,3939.1,47.39,6195.13,63
NDC,82705001001,epcoritamab-bysp 48 MG/0.8ML Solution 0.8 mL Vial,66259.36,36442.65,47.39,57314.35,63
NDC,82959011101,imetelstat sodium 188 MG Recon Soln 1 Each Vial,41755.13,22965.33,47.63,36118.19,63
NDC,82959011201,imetelstat sodium 47 MG Recon Soln 1 Each Vial,10964.06,6030.24,47.63,9483.91,63
NDC,83490030760,sodium chloride 7 % Nebu Soln 4 mL Plas Cont,8.91,4.91,2.67,7.71,38
NDC,83634050041,magnesium sulfate 2 GM/50ML Solution 50 mL Flex Cont,56.2,30.91,0.42,48.61,48
NDC,87651042067,cranberry-vitamin C-probiotic 250 MG Tab 50 Each Box,4.5,2.48,1.35,3.89,38
NDC,87701040729,thiamine 100 mg Tab 100 Each Bottle,4.13,2.28,1.24,3.57,38
NDC,87701040731,cyanocobalamin 500 MCG Tab 100 Each Bottle,8.08,4.45,2.42,6.99,38
NDC,87701040754,vitamin E 400 units Cap 100 Each Bottle,4.28,2.36,1.28,3.7,38
NDC,87701040813,melatonin 3 MG Tab 100 Each Bottle,8.09,4.45,2.43,7.0,38
NDC,87701040816,coenzyme Q-10 100 MG Cap 30 Each Bottle,4.84,2.67,1.45,4.19,38
NDC,88888000006,zolpidem 2.5 mg half tablet Tab 1 Each Package,10.18,5.6,3.05,8.81,38
NDC,89122072420,Sodium Hyaluronate 20 MG/2ML Solution Prefilled Syringe 2 mL Syringe,1041.0,572.55,62.7,900.47,48
NDC,89130202001,sodium hyaluronate 60 MG/3ML Prefilled Syringe 3 mL Syringe,6036.01,3319.81,5.75,5221.15,63
NDC,89130444401,Sodium Hyaluronate (Viscosup) 25 MG/2.5ML Solution Prefilled Syringe 2.5 mL Syringe,574.3,315.87,62.7,496.77,48
NDC,96974000002,MG PLUS PROTEIN 133 MG Tab 100 Each Bottle,8.22,4.53,2.47,7.11,38
NDC,99099879002,NaCl 0.9 % Solution 100 mL Cartridge,41.9,23.05,12.57,36.24,38
NDC,99207024005,calcium disodium versenate 1 GM/5ML Solution 5 mL Ampule,22628.95,12445.93,5223.82,43568.35,63
NDC,99915000256,arginine 10 % Solution 15 g Bag,225.0,123.75,67.5,194.63,38
NDC,9999-4470-10,loperamide 1 MG/7.5ML Solution 15 mL Oral Syringe,5.89,3.24,1.77,5.09,38
NDC,99990-4090-00,rifAMPin Solution 0.001 mg Syringe,8.03,4.42,2.41,6.95,38
NDC,99990261360,allopurinol 50 mg half tablet Tab 0.5 tablet Package,8.8,4.84,2.64,7.61,38
NDC,99990437001,acetaZOLAMIDE Suspension 1 mg Oral Syringe,8.01,4.41,2.4,6.93,38
NDC,99990443002,guaiFENesin/codeine 100-10 MG/5ML Solution 10 mL Oral Syringe,11.63,6.4,3.49,10.06,38
NDC,99990443003,guaiFENesin 100 MG/5ML Liquid 5 mL Oral Syringe,8.57,4.72,2.57,7.41,38
NDC,99990452000,metoclopramide 10 MG/10ML Solution 10 mL Oral Syringe,21.37,11.76,6.41,18.49,38
NDC,99990465004,acetaminophen/codeine 120-12 mg/5 mL Solution 12.5 mL Oral Syringe,13.66,7.52,4.1,11.82,38
NDC,99990470001,ketamine 10 mg/1 mL Solution 1 mL Oral Syringe,13.13,7.23,3.94,11.36,38
NDC,99990470005,ketamine 20 mg/2 mL Solution 2 mL Oral Syringe,18.8,10.34,5.64,16.26,38
NDC,99990479001,potassium chloride 20 MEQ/15ML (10%) Solution 15 mL Cup,48.36,26.6,14.51,41.83,38
NDC,99990488000,lidocaine viscous 2 % Solution 15 mL Oral Syringe,10.57,5.82,3.17,9.14,38
NDC,99990807001,"amikacin Solution 250,000 mcg",14.53,8.0,4.36,12.57,38
NDC,99990816000,linezolid Solution 300 mL Syringe,116.9,64.3,35.07,101.12,38
NDC,99990816001,"colistimethate Solution 150,000 mcg",203.06,111.69,60.92,175.65,38
NDC,99990870000,ketamine 50 mg/10 ml 50 mg/10 mL Injection 1 mL Syringe,51.62,28.4,15.49,44.65,38
NDC,99990882002,"epoetin alfa 20,000 units/mL Solution 1 mL Vial",2901.3,1595.72,5.55,2509.62,63
NDC,9999465013,morphine sulfate 2 mg/mL Solution 1 Each Oral Syringe,213.0,117.15,63.9,184.25,38
NDC,9999473920,carvedilol 1.5625 mg half tablet Tab 0.5 tablet Package,15.25,8.39,4.58,13.19,38
NDC,99997010101,treprostinil 1 mg/mL Solution 3 mL Syringe,1046.39,575.52,48.04,905.13,63
NDC,99997022402,amikacin 25 mg/0.5 mL Solution 0.5 mL Syringe,37.92,20.86,11.38,32.8,38
NDC,99997050155,PENTobarbital 50 MG/ML Solution 2 mL Syringe,281.18,154.65,57.97,243.22,48
NDC,9999711001,benzocaine 20% lidocaine 10% tetracaine 4% in mineral oil/petrolatum ointment Ointment 30 g Jar,291.4,160.27,87.42,252.06,38
NDC,99998005430,cefepime Recon Soln 1 Each Vial,74.84,41.17,22.45,64.74,38
NDC,99998010101,modafinil 50 mg half tablet Tab 0.5 tablet Package,39.01,21.46,11.7,33.74,38
NDC,99998022402,amikacin 400 mcg/0.1 mL Solution 0.1 mL Syringe,31.58,17.37,9.47,27.32,38
NDC,99998023416,hydrocodone/homatropine 5-1.5 mg/5 mL Solution 10 mL Plas Cont,15.52,8.54,4.66,13.42,38
NDC,99998037731,cefTAZidime 100 mg/0.5 mL Solution 1 Each Syringe,66.5,36.58,19.95,57.52,38
NDC,99998050155,PENTobarbital 50 MG/ML Solution 1 mL Syringe,164.18,90.3,49.25,142.02,48
NDC,99998050618,metoprolol tartrate 6.25 mg Tab 0.25 tablet Package,8.22,4.53,2.47,7.11,38
NDC,99998050860,rifAMPin 10mg/ml Suspension 30 mL Cup,8.99,4.95,2.7,7.78,38
NDC,99998054867,hydrocodone/chlorpheniramine 10-8 MG/5ML Suspension Extended Release 10 mL Plas Cont,25.82,14.21,7.75,22.33,38
NDC,99998240341,fentaNYL (10 mcg/mL) Solution 100 mL,494.0,271.7,148.2,427.31,38
NDC,99998248803,acetic acid 5 % Solution 100 mL Disp Pack,31.55,17.36,9.47,27.29,38
NDC,99998432249,vancomycin Solution 0.5 mL Syringe,86.21,47.42,25.86,74.57,38
NDC,99998490525,dexAMETHasone 5 mg/0.5 mL Solution 0.5 mL Syringe,8.69,4.78,2.61,7.52,38
NDC,9999865069,HYDROmorphone 5 mg/mL Solution 30 mL Syringe,418.0,229.9,125.4,361.57,38
NDC,9999865072,morphine 100 mg in 0.9% NaCl 100 mL 1 mg/mL Solution 100 mL Bag,364.0,200.2,109.2,314.86,38
NDC,9999865073,fentaNYL 10 mcg/mL Solution 100 mL Bag,420.0,231.0,126.0,363.3,38
NDC,99998999952,brilliant green Solution 1 mL Oral Syringe,13.0,7.15,3.9,11.25,38
NDC,99999-0070-00,tobramycin-impregnated polymethylmethacrylate 5.5% Beads 1 Device Package,855.0,470.25,256.5,739.58,38
NDC,99999-0070-01,tobramycin-impregnated polymethylmethacrylate 6.4 mm Beads 1 Device Package,1075.0,591.25,322.5,929.88,38
NDC,99999-0160-01,vancomycin-impregnated polymethylmethacrylate 11% Beads 1 Device Package,1075.0,591.25,322.5,929.88,38
NDC,99999-0160-02,vancomycin-impregnated polymethylmethacrylate 11% Beads 1 Device Package,855.0,470.25,256.5,739.58,38
NDC,99999-0970-08,elastomeric (ON-Q) pump 270 mL Device 270 mL Package,2310.0,1270.5,693.0,1998.15,38
NDC,99999002501,aspirin Solution 750 Each Vial,4.43,2.44,1.33,3.83,38
NDC,99999002910,hydrALAZINE 5 mg half tablet Tab 0.5 tablet Package,8.53,4.7,2.56,7.38,38
NDC,99999003001,inFLIXimab Recon Soln 1 Each Vial,6321.23,3476.68,26.21,5467.86,63
NDC,99999003760,lidocaine/nystatin/al & mag hydroxide Suspension 240 mL Plas Cont,189.46,104.21,56.84,163.88,38
NDC,99999004405,PARoxetine 5 mg half tablet Tab 0.5 tablet Package,14.86,8.18,4.46,12.85,38
NDC,99999005561,OR esmolol 10 MG/ML Solution 5 mL Syringe,42.95,23.63,12.89,37.15,38
NDC,99999010501,treprostinil 5 mg/mL Solution 3 mL Vial,5171.95,2844.58,48.04,4473.74,63
NDC,99999010793,zidovudine (neonatal) Solution 20 mL Vial,212.04,116.63,63.61,183.41,38
NDC,99999013801,candida albicans skin test Solution 0.1 mL Syringe,93.6,51.48,28.08,80.96,38
NDC,99999017302,gentamicin 100 mcg/0.1 mL Solution 0.1 mL Syringe,32.47,17.86,9.74,28.09,38
NDC,99999018005,prednisoLONE acetate 1 % Suspension 1 mL Package,10.0,5.5,3.0,8.65,38
NDC,99999020315,pilocarpine 1 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
NDC,99999022402,amikacin 200 mcg/0.1 mL Solution 0.1 mL Syringe,7.59,4.18,2.28,6.57,38
NDC,99999025020,OR atropine 0.4 MG/ML Solution 2 mL Syringe,47.55,26.16,14.27,41.13,38
NDC,99999028310,gentamicin 0.3 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
NDC,99999028520,diazePAM 2.5 mg half tablet Tab 1 Each Plas Cont,8.22,4.53,2.47,7.11,38
NDC,99999029515,itraconazole 10 MG/ML Solution 20 mL Oral Syringe,146.86,80.78,44.06,127.03,38
NDC,99999031304,sulfacetamide/prednisoLONE 10-0.2 % Ointment 3.5 g Tube,511.47,281.31,153.44,442.42,38
NDC,99999032703,hydrALAZINE 12.5 mg half tablet Tab 0.5 tablet Package,8.25,4.54,2.48,7.14,38
NDC,99999037731,cefTAZidime 2.25 mg/0.1 mL Solution 1 Each Syringe,66.5,36.58,19.95,57.52,38
NDC,99999043001,felbamate 200 mg half tablet Tab 0.5 tablet Package,47.67,26.22,14.3,41.23,38
NDC,99999043730,amphotericin 5 mcg/0.1 mL Solution 1 Each Syringe,30.04,16.53,9.01,25.98,38
NDC,99999045016,nitrofurantoin 25 MG/5ML Suspension 10 mL Oral Syringe,46.78,25.73,14.03,40.46,38
NDC,99999049983,mirtazapine 7.5 mg half tablet Tab 0.5 tablet Package,8.49,4.67,2.55,7.34,38
NDC,99999050155,PENTobarbital 50 MG/ML Solution 0.5 mL Syringe,92.09,50.65,27.63,79.66,48
NDC,99999050860,rifAMPin 10mg/ml Suspension 15 mL Oral Syringe,8.5,4.68,2.55,7.35,38
NDC,99999065625,ciprofloxacin 0.3 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
NDC,99999067989,lidocaine/dexAMETHasone/tetracycline/nystatin Suspension 15 mL Oral Syringe,14.58,8.02,4.37,12.61,38
NDC,99999070401,bethanechol 12.5 mg half tablet Tab 0.5 tablet Package,13.6,7.48,4.08,11.76,38
NDC,99999073006,proparacaine 0.5 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
NDC,99999079550,balanced salt Solution 500 mL Bottle,154.75,85.12,46.43,133.86,38
NDC,99999080103,flurbiprofen 0.03 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
NDC,99999082316,sulfamethoxazole/trimethoprim 200-40 mg/5 mL Suspension 10 mL Oral Syringe,14.24,7.84,4.27,12.32,38
NDC,99999090218,clindamycin 250 mcg/0.1 mL Solution 0.1 mL Syringe,30.57,16.82,9.17,26.44,38
NDC,99999091605,clindamycin 1 mg/0.1 mL Solution 0.1 mL Syringe,30.56,16.81,9.17,26.43,38
NDC,99999097008,elastomeric (ON-Q) pump 120 mL Device 120 mL Package,1500.0,825.0,450.0,1297.5,38
NDC,99999103116,glycerin 99.7% (sterile) Solution 15 mL Vial,7.24,3.99,2.17,6.26,38
NDC,99999113101,bismuth subgallate 12 G Powder 12 g Disp Pack,30.63,16.85,9.19,26.49,38
NDC,99999149825,ceFAZolin 2.25 mg/0.1 mL Solution 1 Each Syringe,43.0,23.65,12.9,37.2,38
NDC,99999167316,OR mineral oil (non-sterile) Solution 10 mL Oral Syringe,4.55,2.51,1.37,3.94,38
NDC,99999173721,pill box Misc 1 Each Pack,92.59,50.93,27.78,80.09,38
NDC,99999176230,morphine Solution 1 mL Syringe,51.19,28.16,15.36,44.28,38
NDC,99999239006,atorvastatin 5 mg half tablet Tab 0.5 tablet Package,8.28,4.56,2.48,7.16,38
NDC,99999261002,dextroamphetamine 2.5 mg half tablet Tab 0.5 tablet Package,11.69,6.43,3.51,10.11,38
NDC,99999266216,OR cherry Syrup 8 mL Oral Syringe,5.12,2.82,1.54,4.43,38
NDC,99999284004,OR absolute alcohol Solution 30 mL Vial,177.43,97.59,53.23,153.48,38
NDC,99999285548,niMODipine 30 mg/mL Solution 1 mL Plas Cont,26.93,14.82,8.08,23.29,38
NDC,99999384345,ertapenem Recon Soln 1 Each Flex Cont,243.9,134.15,73.17,210.97,38
NDC,99999433249,vancomycin 1 mg/0.1 mL Solution 1 Each Vial,92.54,50.9,27.76,80.05,38
NDC,99999447004,opium tincture 3 mg/0.3 mL Tincture 0.3 mL Oral Syringe,12.3,6.77,3.69,10.64,38
NDC,99999447005,opium tincture 6 mg/0.6 mL Tincture 0.6 mL Oral Syringe,15.59,8.58,4.68,13.49,38
NDC,99999447006,opium tincture 12 mg/1.2 mL Tincture 1.2 mL Oral Syringe,22.19,12.21,6.66,19.19,38
NDC,99999465014,morphine 20 MG/ML Solution 1 Each Oral Syringe,187.52,103.14,56.26,162.2,38
NDC,99999465017,morphine 0.4 mg/mL Solution 1 Each Oral Syringe,23.28,12.81,6.98,20.14,38
NDC,99999465059,LORazepam 1 mg/mL Solution 0.1 mL Oral Syringe,10.12,5.57,3.04,8.75,38
NDC,99999470007,ketamine 30 mg/3 mL Solution 3 mL Oral Syringe,21.39,11.77,6.42,18.5,38
NDC,99999479002,sodium bicarbonate 1 mEq/mL Solution 50 mL Bottle,40.18,22.1,12.05,34.76,38
NDC,99999490525,dexAMETHasone 400 mcg/0.1 mL Solution 0.1 mL Syringe,8.14,4.48,2.44,7.04,38
NDC,99999499011,sodium polystyrene 15 g Powder 15 g Bottle,22.85,12.57,6.86,19.77,38
NDC,99999500099,silicone oil 5000 Misc 10 mL Syringe,2249.3,1237.12,674.79,1945.64,38
NDC,99999590500,bromocriptine 1.25 mg half tablet Tab 0.5 Each Package,16.01,8.81,4.8,13.85,38
NDC,9999967079,pill crusher Misc 1 Each Package,38.59,21.23,11.58,33.38,38
NDC,99999694003,ganciclovir 2 mg/0.1 mL Solution 1 Each Syringe,368.4,202.62,110.52,318.67,38
NDC,99999700000,lidocaine 2% jelly plus double antibiotic ointment Ointment 60 mL Jar,126.26,69.45,37.88,109.21,38
NDC,99999700001,lidocaine 2% jelly plus double antibiotic ointment Ointment 120 mL Jar,212.34,116.79,63.7,183.67,38
NDC,99999709016,tobramycin 100 mcg/0.1 mL Solution 0.1 mL Syringe,32.43,17.84,9.73,28.05,38
NDC,99999800897,ethambutol Solution 0.1 mg Syringe,8.66,4.77,2.6,7.49,38
NDC,99999802009,ceftolozane-tazobactam Recon Soln 1 Each Vial,956.54,526.1,286.96,827.41,38
NDC,99999856220,ciprofloxacin Solution 20 mL Vial,98.0,53.9,29.4,84.77,38
NDC,99999907000,tobramycin 1.5% 1.5% Solution 10 mL Bottle,95.68,52.63,28.7,82.76,38
NDC,99999921003,methotrexate 200mcg/0.05 mL Solution 0.05 mL Syringe,30.47,16.76,9.14,26.36,38
NDC,99999999901,dilating eye Gel 1 Each Syringe,33.76,18.57,10.13,29.2,38
NDC,99999999952,BRILLIANT GREEN 5 ML 5 mL Vial,37.0,20.35,11.1,32.01,38
RC,0115,Hospice,,,431.0,680.0,9
RC,0118,Rehab - Rev Codes,,,3084.0,9354.0,14
RC,0120,HC DAILY SERVICE 01,3560.0,1958.0,2314.0,3079.4,440
RC,0120,HC DAILY SERVICE 01 BMT/HEM ONC,4612.0,2536.6,2997.8,3989.38,11
RC,0120,HC DAILY SERVICE 02,3560.0,1958.0,2314.0,3079.4,33
RC,0120,HC DAILY SERVICE MODIFIED CARE,3786.0,2082.3,2460.9,3274.89,33
RC,0125,Hospice,,,431.0,680.0,9
RC,0128,Rehab - Rev Codes,,,3084.0,9354.0,14
RC,0135,Hospice,,,431.0,680.0,9
RC,0138,Rehab - Rev Codes,,,3084.0,9354.0,14
RC,0145,Hospice,,,431.0,680.0,9
RC,0148,Rehab - Rev Codes,,,3084.0,9354.0,14
RC,0155,Hospice,,,431.0,680.0,9
RC,0158,Rehab - Rev Codes,,,3084.0,9354.0,14
RC,0171,HC DAILY SERVICE NURSERY,1055.0,580.25,685.75,912.58,22
RC,0172,HC DAILY SERVICE NURSERY INTERMEDIATE,2907.0,1598.85,1889.55,2514.56,11
RC,0200,HC DAILY SERVICE ICU,8650.0,4757.5,5622.5,7482.25,22
RC,0201,HC DAILY SERVICE SICU,8650.0,4757.5,5622.5,7482.25,33
RC,0202,HC DAILY SERVICE MICU,8650.0,4757.5,5622.5,7482.25,121
RC,0210,HC DAILY SERVICE CVICU,8650.0,4757.5,5622.5,7482.25,11
RC,0250,"0.45% NaCl with KCl 20 mEq solution 1000 mL 20-0.45 MEQ/L-% Solution 1,000 mL Flex Cont",148.0,81.4,44.4,128.02,38
RC,0250,0.9% NaCl (excel) 0.9 % Solution 250 mL Flex Cont,70.44,38.75,21.13,60.93,38
RC,0250,0.9% NaCl (excel) 0.9 % Solution 500 mL Flex Cont,77.38,42.56,23.21,66.93,38
RC,0250,0.9% NaCl (mini-bag plus) Solution 100 mL Flex Cont,68.8,37.84,20.64,59.51,38
RC,0250,0.9% NaCl (mini-bag plus) Solution 50 mL Flex Cont,68.5,37.68,20.55,59.25,38
RC,0250,0.9% NaCl (preservative free) 0.9% Solution 10 mL Vial,37.52,20.64,11.26,32.45,38
RC,0250,0.9% NaCl (preservative free) 0.9% Solution 50 mL Vial,51.63,28.4,15.49,44.66,38
RC,0250,0.9% NaCl 0.9 % Solution 10 mL Syringe,6.17,3.4,1.85,5.34,38
RC,0250,0.9% NaCl add-vantage Solution 100 mL Flex Cont,61.5,33.83,18.45,53.2,38
RC,0250,ALPRAZolam 0.125 mg half tablet Tab 0.5 tablet Package,8.05,4.43,2.42,6.96,38
RC,0250,ALPRAZolam 0.25 MG Tab 100 Each Bottle,10.08,5.55,3.02,8.72,38
RC,0250,ALPRAZolam 0.5 MG Tab 100 Each Bottle,10.12,5.57,3.04,8.75,38
RC,0250,ALPRAZolam 1 MG Tab 100 Each Bottle,10.15,5.59,3.05,8.78,38
RC,0250,ANTIBIOTIC LOCK THERAPY 1 Each Syringe,55.0,30.25,16.5,47.58,38
RC,0250,APO-varenicline 0.5 MG Tab 56 Each Bottle,26.04,14.33,7.81,22.52,38
RC,0250,APO-varenicline 1 MG Tab 56 Each Bottle,26.04,14.33,7.81,22.52,38
RC,0250,ARIPiprazole 10 MG Tab 30 Each Bottle,8.78,4.83,2.63,7.59,38
RC,0250,ARIPiprazole 15 MG Tab 30 Each Bottle,8.99,4.95,2.7,7.78,38
RC,0250,ARIPiprazole 2 MG Tab 30 Each Bottle,8.77,4.83,2.63,7.59,38
RC,0250,ARIPiprazole 2.5 mg half tablet Tab 0.5 tablet Package,9.23,5.08,2.77,7.98,38
RC,0250,ARIPiprazole 20 MG Tab 30 Each Bottle,8.93,4.92,2.68,7.72,38
RC,0250,ARIPiprazole 30 MG Tab 30 Each Bottle,8.93,4.92,2.68,7.72,38
RC,0250,ARIPiprazole 5 MG Tab 30 Each Bottle,8.78,4.83,2.63,7.59,38
RC,0250,BRILLIANT GREEN 5 ML 5 mL Vial,37.0,20.35,11.1,32.01,38
RC,0250,BUPivacaine 0.1 % fentaNYL 2 mcg/mL in 0.9 % NaCL 0.5-0.1-0.9 MG/250ML-% Solution 250 mL Bag,291.0,160.05,87.3,251.72,38
RC,0250,BUPivacaine 0.125 % Solution 100 mL Bag,72.5,39.88,21.75,62.71,38
RC,0250,BUPivacaine 0.125 % Solution 500 mL Bag,129.41,71.18,38.82,111.94,38
RC,0250,BUPivacaine 0.125 % Solution 700 mL Bag,163.17,89.75,48.95,141.14,38
RC,0250,BUPivacaine 0.125 % w/fentanyl 1 mcg/ml Solution 30 mL Syringe,64.71,35.6,19.41,55.97,38
RC,0250,BUPivacaine 0.125% Solution 10 mL Syringe,34.48,18.97,10.34,29.83,38
RC,0250,BUPivacaine 0.125% Solution 30 mL Syringe,43.23,23.78,12.97,37.39,38
RC,0250,BUPivacaine 0.25 % (PF) 0.25 % Solution 30 mL Vial,43.23,23.78,12.97,37.39,38
RC,0250,"BUPivacaine 0.25% w/EPINEPHrine 1:400,000 Solution 30 mL Vial",43.23,23.78,12.97,37.39,38
RC,0250,BUPivacaine 0.25% w/fentanyl 5 mcg/ml Solution 30 mL Syringe,64.71,35.6,19.41,55.97,38
RC,0250,BUPivacaine 0.5 % (PF) 0.5 % Solution 10 mL Vial,45.78,25.18,13.73,39.6,38
RC,0250,"BUPivacaine 0.5% w/EPINEPHrine 1:400,000 (PF) Solution 30 mL Vial",45.03,24.77,13.51,38.95,38
RC,0250,BUPivacaine 0.5% w/fentanyl 10 mcg/ml Solution 30 mL Syringe,64.71,35.6,19.41,55.97,38
RC,0250,BUPivacaine 0.5% w/fentanyl 5 mcg/ml Solution 30 mL Syringe,64.71,35.6,19.41,55.97,76
RC,0250,"BUPivacaine/EPINEPHrine (PRESERVATIVE FREE) 0.25%/1:200,000 Solution 30 mL Vial",98.59,54.23,29.58,85.28,38
RC,0250,"BUPivacaine/EPINEPHrine (PRESERVATIVE FREE) 0.5%/1:200,000 Solution 30 mL Vial",93.67,51.52,28.1,81.02,38
RC,0250,"BUPivacaine/epinephrine 0.5%/1:200,000 Solution 50 mL Vial",154.88,85.19,46.46,133.97,38
RC,0250,Bacteriostatic Water(Benz Alc) Solution 30 mL Vial,68.89,37.89,20.67,59.59,38
RC,0250,CARBOplatin Solution 5 mL Vial,68.78,37.83,20.63,59.49,38
RC,0250,D5W (excel) 5 % Solution 100 mL Flex Cont,47.5,26.13,14.25,41.09,38
RC,0250,D5W (excel) 5 % Solution 250 mL Flex Cont,56.25,30.94,16.88,48.66,38
RC,0250,D5W (excel) 5 % Solution 500 mL Flex Cont,82.0,45.1,24.6,70.93,38
RC,0250,DULoxetine HCl 20 MG Cap DR Particles 60 Each Bottle,8.99,4.95,2.7,7.78,38
RC,0250,DULoxetine HCl 30 MG Cap DR Particles 90 Each Bottle,8.99,4.95,2.7,7.78,38
RC,0250,DULoxetine HCl 60 MG Cap DR Particles 30 Each Bottle,8.99,4.95,2.7,7.78,38
RC,0250,Desflurane Solution 1 Each Package,7.7,4.24,2.31,6.66,38
RC,0250,Desflurane Solution 240 mL Bottle,160.32,88.18,48.1,138.68,38
RC,0250,Dextromethorphan-quiNIDine 20-10 MG Cap 60 Each Bottle,67.95,37.38,20.39,58.78,38
RC,0250,EPINEPHrine 0.15 MG/0.15 ML Injection 0.15 mL,32.52,17.89,9.76,28.13,38
RC,0250,EPINEPHrine 0.3 MG/0.3ML Injection 0.3 mL,35.04,19.28,10.51,30.31,38
RC,0250,EPINEPHrine 1 MG/ML Solution 20 mL Syringe,80.4,44.22,24.12,69.55,38
RC,0250,EPINEPHrine 16 mcg/mL Solution 250 mL Flex Cont,255.0,140.25,76.5,220.58,38
RC,0250,EPINEPHrine 50 mcg/mL Injection 2 mL Syringe,108.8,59.84,32.64,94.11,38
RC,0250,FLORANEX (lactobacillus acidophilus) Tab 50 Each Bottle,8.495000000000001,4.68,2.5,7.49,76
RC,0250,FLUoxetine 10 MG Cap 100 Each Bottle,8.18,4.5,2.45,7.08,38
RC,0250,FLUoxetine 20 MG Cap 100 Each Bottle,8.22,4.53,2.47,7.11,38
RC,0250,FLUoxetine 20 MG/5ML Solution 120 mL Bottle,214.0,117.7,64.2,185.11,38
RC,0250,FLUoxetine 40 MG Cap 500 Each Bottle,8.22,4.53,2.47,7.11,38
RC,0250,GENTEAL TEARS 0.1-0.2-0.3 % Solution 15 mL Bottle,43.15,23.74,12.95,37.32,38
RC,0250,HC COLONIC MARKERS (SITZ),63.5,34.93,19.05,54.93,76
RC,0250,HC MONITORED ANES CARE MEDS,436.0,239.8,130.8,377.14,38
RC,0250,"HTK custodial Solution 1,000 mL Bag",45.0,24.75,13.5,38.93,38
RC,0250,HYDROcodone/acetaminophen 10-325 MG Tab 1 Each Blister,11.55,6.36,3.47,9.99,38
RC,0250,HYDROcodone/acetaminophen 2.5-108 mg/5 mL Solution 5 mL Cup,28.49,15.67,8.55,24.64,38
RC,0250,HYDROcodone/acetaminophen 5-217 mg/10 mL Solution 10 mL Cup,31.17,17.15,9.35,26.96,38
RC,0250,HYDROcodone/acetaminophen 5-325 MG Tab 1 Each Blister,11.19,6.16,3.36,9.68,38
RC,0250,HYDROcodone/acetaminophen 7.5-325 MG Tab 1 Each Blister,11.53,6.35,3.46,9.97,38
RC,0250,HYDROcodone/acetaminophen 7.5-325 MG Tab 100 Each Box,11.52,6.34,3.46,9.96,38
RC,0250,HYDROcodone/acetaminophen 7.5-325 mg/15 mL Solution 15 mL Cup,20.65,11.36,6.2,17.86,38
RC,0250,HYDROmorphone (1 mg/mL) Solution 50 mL Flex Cont,204.25,112.34,61.28,176.68,38
RC,0250,HYDROmorphone 1 mg half tablet Tab 0.5 tablet Packet,10.59,5.83,3.18,9.16,38
RC,0250,HYDROmorphone 1 mg/mL Solution Prefilled Syringe 30 mL Syringe,273.05,150.18,60.72,297.3,76
RC,0250,HYDROmorphone 2 MG Tab 100 Each Box,10.42,5.74,3.13,9.01,38
RC,0250,HYDROmorphone 2 MG/ML Solution 1 mL Crtrdg-NDL,73.76,40.57,22.13,63.8,38
RC,0250,HYDROmorphone 4 MG Tab 100 Each Box,10.65,5.865,3.17,9.3,76
RC,0250,HYDROmorphone 5 mg/mL Solution 30 mL Syringe,418.0,229.9,125.4,361.57,76
RC,0250,IMPL IUD MIRENA,4090.37,2249.71,1227.11,3538.17,38
RC,0250,IMPL NEXPLANON 68MG  340B ONLY,1795.5,987.53,538.65,1553.11,38
RC,0250,Isavuconazonium Sulfate 186 MG Cap 14 Each Box,282.8,155.54,84.84,244.62,38
RC,0250,Isoflurane Solution 1 Each Package,23.85,13.12,7.16,20.63,38
RC,0250,Isoflurane Solution 100 mL Bottle,104.0,57.2,31.2,89.96,38
RC,0250,LORazepam (1 mg/mL) Injection 100 mL Bag,271.2,149.16,81.36,234.59,38
RC,0250,LORazepam 0.25 mg half tablet Tab 0.5 tablet Package,10.72,5.9,3.22,9.27,38
RC,0250,LORazepam 0.5 MG Tab 1 Each Blister,10.35,5.7,3.11,8.95,38
RC,0250,LORazepam 1 MG Tab 100 Each Box,10.23,5.63,3.07,8.85,38
RC,0250,LORazepam 1 mg/mL Solution 0.1 mL Oral Syringe,10.12,5.57,3.04,8.75,38
RC,0250,LORazepam 1 mg/mL Solution 20 mL Bottle,33.67,18.52,10.1,29.12,38
RC,0250,LORazepam 2 MG Tab 100 Each Box,10.27,5.65,3.08,8.88,38
RC,0250,LORazepam 2 MG/ML Conc 30 mL Bottle,75.28,41.41,22.58,65.12,38
RC,0250,LORazepam 2 MG/ML Solution 1 mL Crtrdg-NDL,76.64,42.16,22.99,66.29,38
RC,0250,Lidocaine (Anorectal) 5 % Gel 10 g Tube,39.6,21.78,11.88,34.25,38
RC,0250,Loratadine 5 MG/5ML Solution 120 mL Bottle,34.14,18.78,10.24,29.53,38
RC,0250,MG PLUS PROTEIN 133 MG Tab 100 Each Bottle,8.22,4.53,2.47,7.11,38
RC,0250,NIFEdipine 10 MG Cap 100 Each Bottle,9.57,5.27,2.87,8.28,38
RC,0250,NIFEdipine 20 MG Cap 100 Each Bottle,12.53,6.9,3.76,10.84,38
RC,0250,NIFEdipine 30 MG Tablet Extended Release 24 Hour 100 Each Bottle,8.83,4.86,2.65,7.64,38
RC,0250,NIFEdipine 60 MG Tablet Extended Release 24 Hour 100 Each Bottle,9.04,4.98,2.71,7.82,38
RC,0250,NIFEdipine 90 MG Tablet Extended Release 24 Hour 100 Each Bottle,8.68,4.78,2.6,7.51,38
RC,0250,"NaCl 0.9 % Solution 1,000 mL Plas Cont",75.0,41.25,22.5,64.88,38
RC,0250,"NaCl 0.9 % Solution 2,000 mL Bottle",138.0,75.9,41.4,119.37,38
RC,0250,NaCl 0.9 % Solution 250 mL Plas Cont,72.75,40.02,21.83,62.93,38
RC,0250,"NaCl 0.9 % Solution 3,000 mL Flex Cont",192.0,105.6,57.6,166.08,38
RC,0250,NaCl 0.9 % Solution 500 mL Plas Cont,70.5,38.78,21.15,60.98,38
RC,0250,NxStage RFP400 CRRT solution Solution 1 Each Bag,475.54,261.55,142.66,411.34,38
RC,0250,NxStage RFP401 CRRT solution Solution 1 Each Bag,460.0,253.0,138.0,397.9,38
RC,0250,NxStage RFP402 CRRT solution Solution 1 Each Bag,460.0,253.0,138.0,397.9,38
RC,0250,NxStage RFP453 CRRT solution Solution 1 Each Bag,460.0,253.0,138.0,397.9,38
RC,0250,NxStage RFP454 CRRT solution Solution 1 Each Bag,475.54,261.55,142.66,411.34,38
RC,0250,OLANZapine 10 MG Tab 30 Each Bottle,8.79,4.84,2.64,7.6,38
RC,0250,OLANZapine 15 MG Tab 30 Each Bottle,9.21,5.07,2.76,7.97,38
RC,0250,OLANZapine 2.5 MG Tab 30 Each Bottle,8.47,4.66,2.54,7.33,38
RC,0250,OLANZapine 20 MG Tab 1 Each Blister,9.85,5.42,2.96,8.52,38
RC,0250,OLANZapine 20 MG Tab 100 Each Box,9.85,5.42,2.96,8.52,38
RC,0250,OLANZapine 5 MG Tab 1 Each Blister,9.65,5.31,2.9,8.35,38
RC,0250,OLANZapine zydis 10 MG TABLET DISPERSIBLE 30 Each Box,10.77,5.93,3.23,9.32,38
RC,0250,OLANZapine zydis 15 MG TABLET DISPERSIBLE 1 Each Blister,12.56,6.91,3.77,10.86,38
RC,0250,OLANZapine zydis 5 MG TABLET DISPERSIBLE 30 Each Box,9.57,5.27,2.87,8.28,38
RC,0250,OR absolute alcohol Solution 30 mL Vial,177.43,97.59,53.23,153.48,38
RC,0250,OR atropine 0.4 MG/ML Solution 2 mL Syringe,47.55,26.16,14.27,41.13,38
RC,0250,OR cherry Syrup 8 mL Oral Syringe,5.12,2.82,1.54,4.43,38
RC,0250,OR esmolol 10 MG/ML Solution 5 mL Syringe,42.95,23.63,12.89,37.15,38
RC,0250,OR lidocaine 10 MG/ML Solution 2 mL Syringe,30.09,16.55,9.03,26.03,38
RC,0250,OR mineral oil (non-sterile) Solution 10 mL Oral Syringe,4.55,2.51,1.37,3.94,38
RC,0250,ORA-Plus Liquid 473 mL Bottle,82.75,45.52,24.83,71.58,38
RC,0250,ORA-SWEET Syrup 473 mL Bottle,17.5,9.63,5.25,15.14,38
RC,0250,OXcarbazepine 150 MG Tab 1 Each Blister,8.62,4.75,2.59,7.46,38
RC,0250,OXcarbazepine 150 MG Tab 100 Each Box,8.62,4.75,2.59,7.46,38
RC,0250,OXcarbazepine 300 MG Tab 100 Each Bottle,8.65,4.76,2.6,7.48,38
RC,0250,OXcarbazepine 300 MG/5ML Suspension 250 mL Bottle,502.0,276.1,150.6,434.23,38
RC,0250,PARoxetine 10 MG Tab 1 Each Blister,9.0,4.95,2.7,7.79,38
RC,0250,PARoxetine 20 MG Tab 90 Each Bottle,8.46,4.66,2.54,7.32,38
RC,0250,PARoxetine 30 MG Tab 90 Each Bottle,8.59,4.73,2.58,7.43,38
RC,0250,PARoxetine 40 MG Tab 1 Each Blister,9.34,5.14,2.8,8.08,38
RC,0250,PARoxetine 5 mg half tablet Tab 0.5 tablet Package,14.86,8.18,4.46,12.85,38
RC,0250,PH test Test 1 Each Roll,136.03,74.82,40.81,117.67,38
RC,0250,PHENobarbital 16.2 MG Tab 100 Each Bottle,10.23,5.63,3.07,8.85,38
RC,0250,PHENobarbital 20 mg/5 mL Elixir 10 mL Oral Syringe,13.65,7.51,4.1,11.81,38
RC,0250,PHENobarbital 20 mg/5 mL Elixir 473 mL Bottle,182.65,100.46,54.8,157.99,38
RC,0250,PHENobarbital 32.4 MG Tab 100 Each Bottle,10.8,5.945,3.11,9.71,76
RC,0250,PHENobarbital 64.8 MG Tab 100 Each Bottle,11.52,6.34,3.46,9.96,38
RC,0250,PHENobarbital 97.2 MG Tab 100 Each Bottle,12.135000000000002,6.68,3.64,10.5,76
RC,0250,PHYSostigmine 0.4 mg/mL Solution 5 mL Ampule,690.0,379.5,207.0,596.85,38
RC,0250,"PLASMA-LYTE A Solution 1,000 mL Flex Cont",288.0,158.4,86.4,249.12,38
RC,0250,Polysorbate 80 Liquid 500 mL Bottle,210.0,115.5,63.0,181.65,38
RC,0250,QUEtiapine 100 MG Tab 1 Each Blister,8.59,4.73,2.58,7.43,38
RC,0250,QUEtiapine 12.5 mg half tablet Tab 0.5 tablet Package,13.66,7.52,4.1,11.82,38
RC,0250,QUEtiapine 200 MG Tab 100 Each Bottle,9.19,5.06,2.76,7.95,38
RC,0250,QUEtiapine 25 MG Tab 100 Each Bottle,8.4,4.62,2.52,7.27,38
RC,0250,QUEtiapine 300 MG Tab 100 Each Bottle,8.53,4.7,2.56,7.38,38
RC,0250,QUEtiapine 400 MG Tab 100 Each Bottle,8.69,4.78,2.61,7.52,38
RC,0250,QUEtiapine 50 MG Tab 1 Each Blister,8.56,4.71,2.57,7.4,38
RC,0250,QUEtiapine 6.25 mg quarter tablet Tab 0.25 tablet Package,8.1,4.46,2.43,7.01,38
RC,0250,"ROPivacaine 0.2 % /EPINEPHrine 1:400,000 0.5%/1:400,000 Solution 20 mL Vial",92.76,51.02,27.83,80.24,38
RC,0250,"ROPivacaine 0.5% w/EPINEPHrine 1:400,000 Solution 30 mL Vial",145.97,80.29,43.79,126.26,38
RC,0250,"ROPivacaine 1% w/EPINEPHrine 1:400,000 Solution 20 mL Vial",167.55,92.16,50.27,144.93,38
RC,0250,SITagliptin 100 MG Tab 1 Each Blister,35.7,19.64,10.71,30.88,38
RC,0250,SITagliptin phosphate 25 MG Tab 30 Each Bottle,35.7,19.64,10.71,30.88,38
RC,0250,SUFentanil 250 MCG/5ML Solution 5 mL Ampule,180.0,99.0,54.0,155.7,38
RC,0250,SUFentanil 5 mcg/mL Solution 50 mL Bag,4602.0,2531.1,1380.6,3980.73,38
RC,0250,SUFentanil 50 MCG/ML Solution 1 mL Vial,151.2,83.16,45.36,130.79,38
RC,0250,SUMAtriptan 100 MG Tab 1 Each Blister,8.67,4.77,2.6,7.5,38
RC,0250,SUMAtriptan 25 MG Tab 9 Each Box,9.1,5.01,2.73,7.87,38
RC,0250,SUMAtriptan 50 MG Tab 9 Each Box,9.47,5.21,2.84,8.19,38
RC,0250,Saline Bacteriostatic 0.9 % Solution 30 mL Vial,42.33,23.29,12.7,36.62,38
RC,0250,Selenious Acid 60 MCG/ML Solution 10 mL Vial,944.43,519.44,283.33,816.93,38
RC,0250,Selexipag 800 MCG Tab 60 Each Bottle,959.77,527.88,287.93,830.2,38
RC,0250,Sevoflurane Solution 1 Each Package,20.35,11.2,6.11,17.6,38
RC,0250,Sevoflurane Solution 250 mL Bottle,188.0,103.4,56.4,162.62,38
RC,0250,Sodium Glycerophosphate 1 mmol/mL Solution 20 mL Vial,104.5,57.48,31.35,90.39,38
RC,0250,Sorbitol 70 % Solution 30 mL Bottle,17.5,9.63,5.25,15.14,38
RC,0250,Sugammadex Sodium 200 MG/2ML Solution 2 mL Vial,750.16,412.59,225.05,648.89,38
RC,0250,Sugammadex Sodium 500 MG/5ML Solution 5 mL Vial,1361.49,748.82,408.45,1177.69,38
RC,0250,Tobramycin 0.3 % Ointment 3.5 g Tube,850.0,467.5,255.0,735.25,38
RC,0250,Urea 15 g Pack 1 Each Box,17.88,9.84,5.36,15.47,38
RC,0250,aMILoride 5 MG Tab 100 Each Bottle,8.74,4.81,2.62,7.56,38
RC,0250,abacavir 300 MG Tab 60 Each Bottle,14.5,7.98,4.35,12.54,38
RC,0250,acamprosate calcium 333 MG Tablet Delayed Response 180 Each Bottle,11.22,6.18,3.37,9.71,38
RC,0250,acebutolol 200 MG Cap 1 Each Blister,11.44,6.3,3.43,9.9,38
RC,0250,acetaZOLAMIDE 125 MG Tab 100 Each Bottle,8.86,4.88,2.66,7.66,38
RC,0250,acetaZOLAMIDE 250 MG Tab 1 Each Blister,17.47,9.61,5.24,15.11,38
RC,0250,acetaZOLAMIDE 500 MG CAPSULE SR 12 HR 1 Each Blister,21.27,11.7,6.38,18.4,38
RC,0250,acetaZOLAMIDE Suspension 1 mg Oral Syringe,8.01,4.41,2.4,6.93,38
RC,0250,acetaminophen 120 MG Suppos 1 Each Box,4.08,2.25,1.22,3.53,38
RC,0250,acetaminophen 160 MG Chew Tab 24 Each Box,4.37,2.41,1.31,3.78,38
RC,0250,acetaminophen 160 MG/5ML Liquid 473 mL Bottle,18.9,10.4,5.03,49.49,114
RC,0250,acetaminophen 160 MG/5ML Solution 15.6 mL Cup,9.9,5.45,2.97,8.56,38
RC,0250,acetaminophen 160 MG/5ML Solution 31.25 mL Cup,11.88,6.54,3.56,10.28,38
RC,0250,acetaminophen 160 MG/5ML Solution 473 mL Bottle,23.16,12.74,6.95,20.03,38
RC,0250,acetaminophen 325 MG Suppos 6 Each Box,6.56,3.61,1.97,5.67,38
RC,0250,"acetaminophen 325 MG Tab 1,000 Each Bottle",4.02,2.22,1.21,3.48,38
RC,0250,acetaminophen 325 MG Tab 100 Each Box,4.24,2.34,1.27,3.67,38
RC,0250,acetaminophen 325 MG/10.15ML Solution 10.15 mL Cup,12.18,6.7,3.65,10.54,38
RC,0250,acetaminophen 40 mg/1.25 mL Solution 1.25 mL Oral Syringe,8.03,4.42,2.41,6.95,38
RC,0250,"acetaminophen 500 MG Tab 1,000 Each Bottle",4.04,2.23,1.21,3.49,38
RC,0250,acetaminophen 500 MG Tab 100 Each Box,4.17,2.3,1.25,3.61,38
RC,0250,acetaminophen 500 MG Tab 500 Each Bottle,4.04,2.23,1.21,3.49,38
RC,0250,acetaminophen 500 mg/15.6 mL Solution 15.6 mL Cup,9.9,5.45,2.97,8.56,38
RC,0250,acetaminophen 500 mg/15.6 mL Solution 15.6 mL Oral Syringe,4.49,2.47,1.35,3.88,38
RC,0250,acetaminophen 650 MG Suppos 1 Each,5.49,3.02,1.65,4.75,38
RC,0250,acetaminophen 650 MG Suppos 100 Each Box,4.92,2.71,1.48,4.26,38
RC,0250,acetaminophen 650 MG/20.3ML Solution 20.3 mL Cup,13.559999999999999,7.465,3.73,12.72,76
RC,0250,acetaminophen 80 MG Suppos 6 Each Box,6.27,3.45,1.88,5.42,38
RC,0250,acetaminophen/codeine 120-12 mg/5 mL Solution 12.5 mL Oral Syringe,13.66,7.52,4.1,11.82,38
RC,0250,acetaminophen/codeine 120-12 mg/5 mL Solution 473 mL Bottle,30.1,16.56,9.03,26.04,38
RC,0250,acetaminophen/codeine 300-30 mg Tab 1 Each Blister,11.26,6.2,3.38,9.74,38
RC,0250,"acetic acid 0.25 % Solution 1,000 mL Plas Cont",75.0,41.25,22.5,64.88,38
RC,0250,acetic acid 2 % Solution 15 mL Bottle,118.02,64.92,35.41,102.09,38
RC,0250,acetic acid 5 % Solution 100 mL Disp Pack,31.55,17.36,9.47,27.29,38
RC,0250,acetic acid 5 % Solution 500 mL Bottle,77.75,42.77,23.33,67.25,38
RC,0250,acetic acid glacial 99 % Solution 500 mL Bottle,1231.5,677.33,369.45,1065.25,38
RC,0250,acetone Solution 480 mL Bottle,70.4,38.72,21.12,60.9,38
RC,0250,acetylcholine 20 MG Recon Soln 1 Each Vial,720.08,396.05,216.02,622.87,38
RC,0250,acetylcysteine 10% 10% Solution 15 mL Bottle,1750.0,962.5,502.5,1578.63,76
RC,0250,acetylcysteine 10% 10% Solution 5 mL Bottle,4525.0,2488.75,1357.5,3914.13,38
RC,0250,acetylcysteine 20 % Solution 2 mL Syringe,16.45,9.05,4.94,14.23,38
RC,0250,acetylcysteine 20 % Solution 30 mL Vial,83.41,45.88,25.02,72.15,38
RC,0250,acetylcysteine 5% 5% Solution 15 mL Bottle,160.6,88.33,48.18,138.92,38
RC,0250,activated charcoal AQ 50 g Liquid 240 mL Tube,70.57,38.82,21.17,61.04,38
RC,0250,acyclovir (neonatal) 5 mg/ml Solution 30 mL Syringe,353.4,194.37,106.02,305.69,38
RC,0250,acyclovir 200 MG Cap 100 Each Bottle,8.59,4.73,2.58,7.43,38
RC,0250,acyclovir 200 MG/5ML Suspension 10 mL Oral Syringe,29.59,16.28,8.88,25.6,38
RC,0250,acyclovir 200 MG/5ML Suspension 473 mL Bottle,271.79,149.49,81.54,235.1,38
RC,0250,acyclovir 200 MG/5ML Suspension 5 mL Oral Syringe,18.3,10.07,5.49,15.83,38
RC,0250,acyclovir 400 MG Tab 100 Each Bottle,8.42,4.64,2.53,7.28,38
RC,0250,acyclovir 5 % Ointment 15 g Tube,192.01,105.61,57.6,166.09,38
RC,0250,acyclovir 800 MG Tab 500 Each Bottle,8.7,4.79,2.61,7.53,38
RC,0250,albendazole 200 MG Tab 2 Each Bottle,77.0,42.35,23.1,66.61,38
RC,0250,albuterol (2.5 mg/3mL) 0.083% Nebu Soln 3 mL Plas Cont,8.96,4.9399999999999995,2.69,7.78,114
RC,0250,albuterol 0.5 % Nebu Soln 1 Each Box,9.65,5.31,2.9,8.35,38
RC,0250,albuterol 0.5% Nebu Soln 20 mL Bottle,151.9,83.55,45.57,131.39,38
RC,0250,albuterol 1.25 mg/3 mL Nebu Soln 3 mL Plas Cont,12.39,6.82,3.72,10.72,38
RC,0250,albuterol HFA 108 (90 Base) MCG/ACT Aero Soln 6.7 g Inhaler,107.49,59.12,32.25,92.98,38
RC,0250,aliskiren 150 MG Tab 30 Each Bottle,22.81,12.55,6.84,19.73,38
RC,0250,allopurinol 100 MG Tab 1 Each Blister,9.37,5.16,2.81,8.11,38
RC,0250,allopurinol 100 MG Tab 100 Each Box,9.09,5.0,2.73,7.86,38
RC,0250,allopurinol 150 mg half tablet Tab 0.5 tablet Package,8.71,4.8,2.61,7.53,38
RC,0250,allopurinol 300 MG Tab 1 Each Blister,9.21,5.07,2.76,7.97,38
RC,0250,allopurinol 50 mg half tablet Tab 0.5 tablet Package,8.8,4.84,2.64,7.61,38
RC,0250,alprostadil 20 MCG Kit 1 Each Box,3797.65,2088.71,1139.3,3284.97,38
RC,0250,alprostadil 500 MCG/ML Solution 1 mL Ampule,929.46,511.21,278.84,803.98,38
RC,0250,alteplase 12.5 mcg/0.1 mL Solution 1 Each Syringe,341.1,187.61,102.33,295.05,38
RC,0250,aluminum & magnesium hydroxide/simethicone 200-200-20 mg/ 5 ml Suspension 30 mL Cup,6.7,3.69,2.01,5.8,38
RC,0250,aluminum & magnesium hydroxide/simethicone 400-400-40 MG/5ML Suspension 355 mL Bottle,34.915,19.205,9.73,32.35,76
RC,0250,aluminum acetate Pack 12 Each Box,9.0,4.95,2.7,7.79,38
RC,0250,aluminum chloride 20 % Solution 37.5 mL Bottle,47.3,26.02,14.19,40.91,38
RC,0250,aluminum hydroxide 320 MG/5ML Suspension 473 mL Bottle,43.18,23.75,12.95,37.35,38
RC,0250,alvimopan 12 MG Cap 30 Each Box,403.01,221.66,120.9,348.6,38
RC,0250,amLODIPine 10 MG Tab 500 Each Bottle,8.13,4.48,2.44,7.03,38
RC,0250,amLODIPine 2.5 MG Tab 90 Each Bottle,8.06,4.44,2.42,6.97,38
RC,0250,amLODIPine 5 MG Tab 1 Each Blister,8.53,4.7,2.56,7.38,38
RC,0250,amantadine 100 MG Cap 100 Each Bottle,9.42,5.19,2.83,8.15,38
RC,0250,amantadine 50 MG/5ML Solution 10 mL Oral Syringe,15.06,8.29,4.52,13.03,38
RC,0250,amantadine 50 MG/5ML Solution 473 mL Bottle,96.97,53.34,29.09,83.88,38
RC,0250,amantadine 50 MG/5ML Solution 5 mL Oral Syringe,8.94,4.92,2.68,7.73,38
RC,0250,ambrisentan 10 MG Tab 30 Each Bottle,97.16,53.44,29.15,84.04,38
RC,0250,ambrisentan 5 MG Tab 30 Each Bottle,97.16,53.44,29.15,84.04,38
RC,0250,amikacin 200 mcg/0.1 mL Solution 0.1 mL Syringe,7.59,4.18,2.28,6.57,38
RC,0250,amikacin 25 mg/0.5 mL Solution 0.5 mL Syringe,37.92,20.86,11.38,32.8,38
RC,0250,amikacin 400 mcg/0.1 mL Solution 0.1 mL Syringe,31.58,17.37,9.47,27.32,38
RC,0250,"amikacin Solution 250,000 mcg",14.53,8.0,4.36,12.57,38
RC,0250,"amino acid (AMINOSYN II 10%) 10 % Solution 2,000 mL Plas Cont",351.0,193.05,105.3,303.62,38
RC,0250,"amino acid (TRAVASOL 10%) 10 % Solution 2,000 mL Plas Cont",351.0,193.05,105.3,303.62,38
RC,0250,aminocaproic acid 0.25 GM/ML Solution 236.5 mL Bottle,2136.92,1175.31,641.08,1848.44,38
RC,0250,aminocaproic acid 500 MG Tab 30 Each Bottle,37.5,20.63,11.25,32.44,38
RC,0250,aminolevulinic acid 1.5 g Recon Soln 1 Each Vial,7675.4,4221.47,2302.62,6639.22,38
RC,0250,amiodarone 100 MG Tab 30 Each Bottle,15.36,8.45,4.61,13.29,38
RC,0250,amiodarone 150 MG/100ML Solution 100 mL Plas Cont,193.5,106.43,58.05,167.38,38
RC,0250,amiodarone 150 mg in D5W 100 mL infusion 1.5 mg/mL Kit 100 mL Bag,380.63,209.35,114.19,329.24,38
RC,0250,amiodarone 200 MG Tab 500 Each Bottle,8.52,4.69,2.56,7.37,38
RC,0250,amitriptyline 10 MG Tab 100 Each Bottle,8.47,4.66,2.54,7.33,38
RC,0250,amitriptyline 100 MG Tab 100 Each Bottle,10.43,5.74,3.13,9.02,38
RC,0250,amitriptyline 12.5 mg half tablet Tab 0.5 tablet Package,8.89,4.89,2.67,7.69,38
RC,0250,amitriptyline 25 MG Tab 100 Each Bottle,8.94,4.92,2.68,7.73,38
RC,0250,amitriptyline 50 MG Tab 100 Each Bottle,8.72,4.8,2.62,7.54,38
RC,0250,ammonium lactate 12 % Lotion 226 g Bottle,66.6,36.63,19.98,57.61,38
RC,0250,amoxicillin 250 MG Cap 100 Each Bottle,8.17,4.5,2.45,7.07,38
RC,0250,amoxicillin 250 MG Chew Tab 100 Each Bottle,9.08,5.0,2.72,7.85,38
RC,0250,amoxicillin 400 MG/5ML Recon Susp 100 mL Bottle,29.45,16.2,8.84,25.47,38
RC,0250,amoxicillin 400 mg/5 mL Recon Susp 100 mL Bottle,64.0,35.2,19.2,55.36,38
RC,0250,amoxicillin 400 mg/5 mL Recon Susp 250 mg Oral Syringe,26.5,14.58,7.95,22.92,38
RC,0250,amoxicillin 500 MG Cap 100 Each Bottle,8.3,4.57,2.49,7.18,38
RC,0250,amoxicillin 875 MG Tab 100 Each Bottle,9.16,5.04,2.75,7.92,38
RC,0250,amoxicillin/clavulanate 250-125 mg Tab 30 Each Bottle,16.97,9.34,5.09,14.68,38
RC,0250,amoxicillin/clavulanate 250-62.5 mg/5 mL Recon Susp 10 mL Oral Syringe,27.31,15.03,8.19,23.62,38
RC,0250,amoxicillin/clavulanate 250-62.5 mg/5 mL Recon Susp 150 mL Bottle,540.25,297.14,162.08,467.32,38
RC,0250,amoxicillin/clavulanate 400-57 mg/5ml Recon Susp 10.9 mL Oral Syringe,13.25,7.29,3.98,11.46,38
RC,0250,amoxicillin/clavulanate 400-57 mg/5ml Recon Susp 100 mL Bottle,56.18,30.9,16.85,48.6,38
RC,0250,amoxicillin/clavulanate 500-125 mg Tab 20 Each Bottle,9.45,5.2,2.84,8.17,38
RC,0250,amoxicillin/clavulanate 875-125 mg Tab 20 Each Bottle,9.2,5.06,2.76,7.96,38
RC,0250,amoxicillin/clavulanate 875:125 Suspension 400 mg Oral Syringe,31.76,17.47,9.53,27.47,38
RC,0250,amphetamine/dextroamphetamine 10 MG CAPSULE SR 24 HR 100 Each Bottle,11.31,6.23,3.39,9.78,38
RC,0250,amphetamine/dextroamphetamine 20 MG CAPSULE SR 24 HR 100 Each Bottle,11.31,6.23,3.39,9.78,38
RC,0250,amphetamine/dextroamphetamine 30 MG CAPSULE SR 24 HR 100 Each Bottle,11.31,6.23,3.39,9.78,38
RC,0250,amphetamine/dextroamphetamine 5 MG Tab 100 Each Bottle,11.545,6.355,3.34,10.34,76
RC,0250,amphotericin 5 mcg/0.05 mL Solution 1 Each Syringe,30.04,16.53,9.01,25.98,38
RC,0250,amphotericin 5 mcg/0.1 mL Solution 1 Each Syringe,30.04,16.53,9.01,25.98,38
RC,0250,amphotericin B 0.15% Solution 10 mL Bottle,287.2,157.96,86.16,248.43,38
RC,0250,amphotericin B 0.3% Solution 5 mL Bottle,151.36,83.25,45.41,130.93,38
RC,0250,amphotericin B 1 mg/mL 1 mg/mL Solution 1 mL Oral Syringe,9.31,5.13,2.79,8.05,38
RC,0250,amphotericin B 50 MCG/5 ML Solution 5 mL Oral Syringe,8.07,4.44,2.42,6.98,38
RC,0250,amphotericin Nebu Soln 1 Each Vial,303.0,166.65,90.9,262.1,38
RC,0250,ampicillin Recon Soln 1 Each Vial,73.3,40.32,21.99,63.4,38
RC,0250,amyl nitrite 0.3 ML Solution 1 Each Ampule,12.24,6.74,3.67,10.59,38
RC,0250,anagrelide 0.5 MG Cap 100 Each Bottle,9.5,5.23,2.85,8.22,38
RC,0250,anagrelide 1 MG Cap 100 Each Bottle,12.37,6.81,3.71,10.7,38
RC,0250,anastrozole 1 MG Tab 30 Each Box,9.72,5.35,2.92,8.41,38
RC,0250,"anticoagulant citrate dextrose formula A Solution 1,000 mL Plas Cont",137.5,75.63,41.25,118.94,38
RC,0250,antithymocyte globulin (horse) (ATG) skin test Solution 0.2 mL Syringe,1108.24,609.54,332.47,958.63,38
RC,0250,apixaban 2.5 MG Tab 100 Each Box,33.29,18.31,9.99,28.8,38
RC,0250,apixaban 5 MG Tab 100 Each Box,33.29,18.31,9.99,28.8,38
RC,0250,apixaban 5 MG Tab 60 Each Bottle,33.28,18.31,9.98,28.79,38
RC,0250,apraclonidine 0.5 % Solution 5 mL Bottle,223.81,123.1,67.14,193.6,38
RC,0250,arginine 10 % Solution 15 g Bag,276.0,151.8,67.5,282.86,76
RC,0250,arginine 10 % Solution 300 mL Glass Cont,230.0,126.5,69.0,198.95,38
RC,0250,"arginine/lysine 5 % Solution 1,000 mL Flex Cont",1315.0,723.25,394.5,1137.48,38
RC,0250,artemether/lumefantrine 20-120 MG Tab 24 Each Bottle,21.16,11.64,6.35,18.3,38
RC,0250,ascorbic acid 250 MG Tab 100 Each Bottle,4.07,2.24,1.22,3.52,38
RC,0250,ascorbic acid 500 MG/ML Solution 50 mL Vial,1476.24,811.94,442.87,1276.95,38
RC,0250,ascorbic acid 500 mg Tab 100 Each Box,8.11,4.47,2.43,7.02,38
RC,0250,asenapine 10 MG SL Tab 60 Each Box,19.77,10.88,5.93,17.1,38
RC,0250,asenapine 2.5 MG SL Tab 10 Each Box,22.21,12.22,6.66,19.21,38
RC,0250,asenapine 5 MG SL Tab 10 Each Box,22.21,12.22,6.66,19.21,38
RC,0250,aspirin 0.0006 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
RC,0250,aspirin 0.0012 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
RC,0250,aspirin 0.0025 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
RC,0250,aspirin 0.005 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
RC,0250,aspirin 0.01 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
RC,0250,aspirin 0.02 mg Cap 1 capsule Packet,89.56,49.26,26.87,77.47,38
RC,0250,aspirin 0.04 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
RC,0250,aspirin 0.08 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
RC,0250,aspirin 0.15 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
RC,0250,aspirin 0.16 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
RC,0250,aspirin 0.3 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
RC,0250,aspirin 0.6 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
RC,0250,aspirin 1.2 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
RC,0250,aspirin 1.25 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
RC,0250,aspirin 10 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
RC,0250,aspirin 10 mg/mL Suspension 81 mL Bottle,13.0,7.15,3.9,11.25,38
RC,0250,aspirin 10.1 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
RC,0250,aspirin 165 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
RC,0250,aspirin 2.4 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
RC,0250,aspirin 2.5 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
RC,0250,aspirin 20 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
RC,0250,aspirin 20.25 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
RC,0250,aspirin 300 MG Suppos 12 Each Box,7.08,3.9,2.12,6.12,38
RC,0250,"aspirin 325 MG Tab 1,000 Each Bottle",4.03,2.22,1.21,3.49,38
RC,0250,aspirin 325 MG Tablet Delayed Response 100 Each Bottle,4.07,2.24,1.22,3.52,38
RC,0250,aspirin 40 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
RC,0250,aspirin 40.5 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
RC,0250,aspirin 5 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
RC,0250,aspirin 80 mg Cap 1 capsule Packet,35.05,19.28,10.52,30.32,38
RC,0250,"aspirin 81 MG Chew Tab 1,000 Each Bottle",4.04,2.23,1.21,3.49,38
RC,0250,aspirin 81 MG Chew Tab 30 Each Box,4.3,2.37,1.29,3.72,38
RC,0250,aspirin 81 MG Chew Tab 36 Each Bottle,4.1,2.26,1.23,3.55,38
RC,0250,aspirin 81 MG Tablet Delayed Response 250 Each Bottle,4.05,2.23,1.22,3.5,38
RC,0250,aspirin Cap 1 mg Package,8.23,4.53,2.47,7.12,38
RC,0250,aspirin Solution 750 Each Vial,4.43,2.44,1.33,3.83,38
RC,0250,aspirin/dipyridamole 25-200 MG CAPSULE SR 12 HR 60 Each Bottle,10.0,5.5,3.0,8.65,38
RC,0250,atazanavir sulfate 200 MG Cap 60 Each Bottle,15.91,8.76,4.77,13.76,38
RC,0250,atazanavir sulfate 300 MG Cap 30 Each Bottle,22.04,12.13,6.61,19.06,38
RC,0250,atenolol 100 MG Tab 100 Each Bottle,8.43,4.64,2.53,7.29,38
RC,0250,atenolol 12.5 mg half tablet Tab 0.5 tablet Package,8.06,4.44,2.42,6.97,38
RC,0250,atenolol 25 MG Tab 100 Each Bottle,8.21,4.52,2.46,7.1,38
RC,0250,atenolol 50 MG Tab 100 Each Bottle,8.23,4.53,2.47,7.12,38
RC,0250,atenolol Solution 25 mg Oral Syringe,25.15,13.84,7.55,21.75,38
RC,0250,atorvastatin 10 MG Tab 90 Each Bottle,8.56,4.71,2.57,7.4,38
RC,0250,"atorvastatin 20 MG Tab 1,000 Each Bottle",8.8,4.84,2.64,7.61,38
RC,0250,atorvastatin 40 MG Tab 1 Each Blister,9.49,5.22,2.85,8.21,38
RC,0250,atorvastatin 40 MG Tab 100 Each Box,9.49,5.22,2.85,8.21,38
RC,0250,atorvastatin 5 mg half tablet Tab 0.5 tablet Package,8.28,4.56,2.48,7.16,38
RC,0250,atorvastatin 80 MG Tab 1 Each Blister,9.03,4.97,2.71,7.81,38
RC,0250,atovaquone 750 MG/5ML Suspension 210 mL Bottle,1207.15,663.94,362.15,1044.18,38
RC,0250,atovaquone 750 MG/5ML Suspension 5 mL Oral Syringe,76.88,42.29,23.06,66.5,38
RC,0250,atracurium 50 MG/5ML Solution 5 mL Vial,74.25,40.84,22.28,64.23,38
RC,0250,atropine 1 % Solution 2 mL Bottle,147.3,81.02,44.19,127.41,38
RC,0250,atropine 1 % Solution 5 mL Bottle,175.3,96.42,52.59,151.63,38
RC,0250,azelastine hydrochloride 137 mcg/spray Solution 30 mL Bottle,96.13,52.88,28.84,83.15,38
RC,0250,azithromycin 200 MG/5ML Recon Susp 30 mL Bottle,85.48,47.02,25.64,73.94,38
RC,0250,azithromycin 250 MG Tab 50 Each Box,11.68,6.43,3.5,10.1,38
RC,0250,azithromycin 500 MG Tab 30 Each Bottle,21.48,11.82,6.44,18.58,38
RC,0250,azithromycin 600 MG Tab 30 Each Bottle,20.82,11.46,6.25,18.01,38
RC,0250,azithromycin Suspension 250 mg Oral Syringe,71.7,39.44,21.51,62.02,38
RC,0250,aztreonam Recon Soln 1 Each Vial,231.48,127.32,69.44,200.23,38
RC,0250,bacitracin 500 UNIT/GM Ointment 3.5 g Tube,366.26,201.45,109.88,316.81,38
RC,0250,bacitracin zinc 500 UNIT/GM Ointment 28.4 g Tube,36.3,19.97,10.89,31.4,38
RC,0250,bacitracin/polymyxin B 500-10000 UNIT/GM Ointment 14.2 g Tube,32.23,17.73,9.67,27.88,38
RC,0250,bacitracin/polymyxin B 500-10000 UNIT/GM Ointment 3.5 g Tube,100.23,55.13,30.07,86.7,38
RC,0250,baclofen 10 MG Tab 1 Each Blister,8.56,4.71,2.57,7.4,38
RC,0250,baclofen 2.5 mg half tablet Tab 0.5 tablet Package,8.25,4.54,2.48,7.14,38
RC,0250,baclofen 20 MG Tab 100 Each Bottle,8.76,4.82,2.63,7.58,38
RC,0250,baclofen 5 MG Tab 100 Each Bottle,8.53,4.7,2.56,7.38,38
RC,0250,baclofen 5 MG/ML Suspension 50 mL Bottle,50.5,27.78,15.15,43.68,38
RC,0250,balanced salt Solution 15 mL Bottle,64.26,35.35,19.28,55.58,38
RC,0250,balanced salt Solution 500 mL Bottle,154.75,85.12,46.43,133.86,38
RC,0250,balanced salt Solution 500 mL Glass Cont,154.75,85.12,46.43,133.86,76
RC,0250,balanced salt plus Solution 500 mL Glass Cont,351.38,193.26,105.41,303.94,38
RC,0250,baricitinib 1 MG Tab 30 Each Bottle,226.39,124.52,67.92,195.83,38
RC,0250,baricitinib 2 MG Tab 30 Each Bottle,226.39,124.52,67.92,195.83,38
RC,0250,barium sulfate 2 % Suspension 450 mL Bottle,21.37,11.76,6.41,18.49,38
RC,0250,barium sulfate Powder 6 g Bottle,259.34,142.64,77.8,224.33,38
RC,0250,bebtelovimab 175 mg/2 mL Solution 2 mL Vial,8830.0,4856.5,2649.0,7637.95,38
RC,0250,belladonna/opium 16.2-30 MG Suppos 12 Each Box,52.03,28.62,15.61,45.01,38
RC,0250,belladonna/opium 16.2-60 MG Suppos 1 Each Box,61.52,33.84,18.46,53.21,38
RC,0250,"belzer-mps Solution 1,000 mL Flex Cont",3326.0,1829.3,997.8,2876.99,38
RC,0250,benzocaine 20 % Gel 9 g Tube,20.0,11.0,6.0,17.3,38
RC,0250,benzocaine 20 % Solution 30 mL Bottle,46.15,25.39,13.85,39.92,38
RC,0250,benzocaine 20% lidocaine 10% tetracaine 4% in mineral oil/petrolatum ointment Ointment 30 g Jar,291.4,160.27,87.42,252.06,38
RC,0250,benzocaine-menthol 20-0.5 % Aerosol 85 g Can,40.23,22.13,12.07,34.8,38
RC,0250,benzocaine-menthol Lozenge 8 Each Package,8.29,4.56,2.49,7.17,38
RC,0250,benzocaine/docusate sodium 20-283 MG Enema 5 mL Box,14.15,7.79,4.25,12.24,38
RC,0250,benzoin compound Tincture 58 mL Bottle,34.62,19.05,10.39,29.95,38
RC,0250,benzonatate 100 MG Cap 1 Each Blister,9.52,5.24,2.86,8.23,38
RC,0250,benztropine 0.5 MG Tab 100 Each Bottle,8.46,4.66,2.54,7.32,38
RC,0250,benztropine 1 MG Tab 100 Each Bottle,8.53,4.7,2.56,7.38,38
RC,0250,benztropine 2 MG Tab 1 Each Blister,8.68,4.78,2.6,7.51,38
RC,0250,benzylpenicilloyl polylysine 0.25 ML Solution 0.25 mL Ampule,974.04,535.73,292.21,842.54,38
RC,0250,betamethasone dipropionate 0.05 % Cream 15 g Tube,133.4,73.37,40.02,115.39,38
RC,0250,betamethasone dipropionate 0.05 % Ointment 15 g Tube,157.5,86.63,47.25,136.24,38
RC,0250,betaxolol 0.5 % Solution 5 mL Bottle,180.69,99.38,54.21,156.3,38
RC,0250,bethanechol 10 MG Tab 100 Each Bottle,9.05,4.98,2.72,7.83,38
RC,0250,bethanechol 12.5 mg half tablet Tab 0.5 tablet Package,13.6,7.48,4.08,11.76,38
RC,0250,bethanechol 25 MG Tab 100 Each Bottle,9.51,5.24,2.85,8.23,38
RC,0250,bicalutamide 50 MG Tab 30 Each Bottle,9.65,5.31,2.9,8.35,38
RC,0250,bictegravir-emtricitabine-tenofovir AF 50-200-25 mg Tab 30 Each Bottle,342.29,188.26,102.69,296.08,38
RC,0250,bisacodyl 10 MG Suppos 12 Each Box,4.24,2.34,1.27,3.67,38
RC,0250,bisacodyl 10 MG Suppos 50 Each Box,3.92,2.16,1.18,3.39,38
RC,0250,bisacodyl 5 MG Tablet Delayed Response 100 Each Box,4.12,2.27,1.24,3.56,38
RC,0250,bismuth subgallate 12 G Powder 12 g Disp Pack,30.63,16.85,9.19,26.49,38
RC,0250,bismuth subgallate Powder 25 g Bottle,396.23,217.93,118.87,342.74,38
RC,0250,bismuth subsalicylate 262 MG Chew Tab 30 Each Box,4.36,2.4,1.31,3.77,38
RC,0250,bismuth subsalicylate 262 MG/15ML Suspension 237 mL Bottle,17.86,9.83,5.36,15.45,38
RC,0250,bisoprolol fumarate 2.5 mg half tablet Tab 0.5 tablet Package,8.33,4.59,2.5,7.21,38
RC,0250,bisoprolol fumarate 5 MG Tab 100 Each Bottle,8.66,4.77,2.6,7.49,38
RC,0250,boric acid topical Powder 170 g Bottle,34.37,18.91,10.31,29.73,38
RC,0250,bosentan 125 MG Tab 60 Each Bottle,58.34,32.09,17.5,50.46,38
RC,0250,bosentan 6.25 mg/mL Suspension 10 mL Oral Syringe,609.61,335.29,182.88,527.31,38
RC,0250,bosentan 6.25 mg/mL Suspension 20 mL Oral Syringe,315.42,173.49,94.63,272.84,38
RC,0250,bosentan 6.25 mg/mL Suspension 5 mL Oral Syringe,160.71,88.4,48.21,139.01,38
RC,0250,bosentan 62.5 MG Tab 60 Each Bottle,58.34,32.09,17.5,50.46,38
RC,0250,brexpiprazole 0.25 mg half tablet Tab 0.5 tablet Package,65.63,36.1,19.69,56.77,38
RC,0250,brexpiprazole 0.5 MG Tab 30 Each Bottle,126.26,69.45,37.88,109.21,38
RC,0250,brexpiprazole 1 mg half tablet Tab 0.5 tablet Package,65.63,36.1,19.69,56.77,38
RC,0250,brexpiprazole 2 MG Tab 30 Each Bottle,126.26,69.45,37.88,109.21,38
RC,0250,brilliant blue green 0.25 MG Recon Soln 1 Each Vial,4082.5,2245.38,1224.75,3531.36,38
RC,0250,brilliant green Solution 1 mL Oral Syringe,13.0,7.15,3.9,11.25,38
RC,0250,brimonidine 0.15 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
RC,0250,brimonidine 0.2 % Solution 5 mL Bottle,41.39,22.77,12.42,35.8,38
RC,0250,brinzolamide 1 % Suspension 10 mL Bottle,935.71,514.65,280.71,809.39,38
RC,0250,brivaracetam 10 MG/ML Solution 10 mL Oral Syringe,112.11,61.67,33.63,96.98,38
RC,0250,brivaracetam 10 MG/ML Solution 2.5 mL Oral Syringe,34.78,19.13,10.43,30.08,38
RC,0250,brivaracetam 10 MG/ML Solution 300 mL Bottle,3102.3,1706.27,930.69,2683.49,38
RC,0250,brivaracetam 100 MG Tab 100 Each Box,72.29,39.76,21.69,62.53,38
RC,0250,brivaracetam 50 MG Tab 100 Each Box,72.29,39.76,21.69,62.53,38
RC,0250,bromocriptine 1.25 mg half tablet Tab 0.5 Each Package,16.01,8.81,4.8,13.85,38
RC,0250,bromocriptine 2.5 MG Tab 100 Each Bottle,17.755000000000003,9.77,4.8,16.87,76
RC,0250,bromocriptine 5 MG Cap 30 Each Bottle,26.11,14.37,7.83,22.59,38
RC,0250,buPROPion 100 MG Tab 100 Each Bottle,9.14,5.03,2.74,7.91,38
RC,0250,buPROPion 50 mg half tablet Tab 0.5 tablet Package,8.0,4.4,2.4,6.92,38
RC,0250,buPROPion 75 MG Tab 100 Each Bottle,9.65,5.31,2.9,8.35,38
RC,0250,buPROPion HCl 100 MG TABLET SR 12 HR 60 Each Bottle,8.82,4.86,2.65,7.63,38
RC,0250,buPROPion HCl 150 MG TABLET SR 12 HR 250 Each Bottle,8.89,4.89,2.67,7.69,38
RC,0250,buPROPion HCl 150 MG Tablet Extended Release 24 Hour 90 Each Bottle,8.6,4.73,2.58,7.44,38
RC,0250,buPROPion HCl 300 MG Tablet Extended Release 24 Hour 30 Each Bottle,8.53,4.7,2.56,7.38,38
RC,0250,budesonide 0.25 MG/2ML Suspension 2 mL Plas Cont,30.72,16.9,9.22,26.57,38
RC,0250,budesonide 0.5 MG/2ML Suspension 2 mL Plas Cont,35.0,19.25,10.5,30.28,38
RC,0250,budesonide 3 MG Cap DR Particles 100 Each Bottle,13.68,7.53,4.1,11.83,38
RC,0250,bumetanide 0.5 MG Tab 100 Each Bottle,9.49,5.22,2.85,8.21,38
RC,0250,bumetanide 1 MG Tab 100 Each Bottle,9.12,5.02,2.74,7.89,38
RC,0250,bumetanide 2 MG Tab 1 Each Blister,12.22,6.73,3.67,10.57,38
RC,0250,bumetanide Solution 1 mg Package,4.75,2.62,1.43,4.11,38
RC,0250,bupivacaine 0.25% HYDROmorphone 10 mcg/mL in 0.9% NaCL 100 mL 100 mL Cartridge,177.0,97.35,53.1,153.11,38
RC,0250,buprenorphine 0.5 mg quarter tablet SL Tab 0.25 tablet Package,7.4,4.07,2.22,6.4,38
RC,0250,buprenorphine 1 mg half tablet SL Tab 0.5 tablet Package,7.8,4.29,2.34,6.75,38
RC,0250,buprenorphine 10 MCG/HR PATCH WEEKLY 4 Each Box,169.07,92.99,50.72,146.25,38
RC,0250,buprenorphine 15 MCG/HR PATCH WEEKLY 4 Each Box,240.35,132.2,72.11,207.9,38
RC,0250,buprenorphine 2 MG SL Tab 30 Each Bottle,11.2,6.16,3.36,9.69,38
RC,0250,buprenorphine 20 MCG/HR PATCH WEEKLY 4 Each Box,293.15,161.24,87.95,253.57,38
RC,0250,buprenorphine 5 MCG/HR PATCH WEEKLY 4 Each Box,115.38,63.46,34.61,99.8,38
RC,0250,buprenorphine 7.5 MCG/HR PATCH WEEKLY 4 Each Box,158.33,87.09,47.5,136.96,38
RC,0250,buprenorphine 8 MG SL Tab 30 Each Bottle,12.82,7.06,3.85,11.09,38
RC,0250,busPIRone 10 MG Tab 100 Each Bottle,8.18,4.5,2.45,7.08,38
RC,0250,busPIRone 2.5 mg half tablet Tab 0.5 tablet Package,8.08,4.45,2.42,6.99,38
RC,0250,busPIRone 5 MG Tab 100 Each Bottle,8.16,4.49,2.45,7.06,38
RC,0250,butalbital/acetaminophen/caffeine 50-325-40 mg Tab 100 Each Bottle,10.47,5.76,3.14,9.06,38
RC,0250,butalbital/aspirin/caffeine 50-325-40 MG Cap 100 Each Bottle,11.3,6.22,3.39,9.77,38
RC,0250,butamben/tetracaine/benzocaine 2-2-14 % Aerosol 20 g Bottle,385.35,211.95,115.61,333.33,38
RC,0250,butamben/tetracaine/benzocaine 2-2-14 % Aerosol 5 g Bottle,180.15,99.09,54.05,155.83,38
RC,0250,butorphanol 10 MG/ML Solution 2.5 mL Bottle,221.08,121.6,66.32,191.23,38
RC,0250,cadexomer iodine 0.9 % Gel 10 g Tube,94.83,52.16,28.45,82.03,76
RC,0250,caffeine 200 MG Tab 16 Each Box,4.41,2.43,1.32,3.81,38
RC,0250,caffeine citrate 20 MG/ML Solution 3 mL Vial,51.5,28.325,12.9,51.9,76
RC,0250,caffeine/sodium benzoate 125-125 MG/ML Solution 2 mL Vial,234.06,128.74,70.22,202.46,38
RC,0250,calamine 8-8 % Lotion 177 mL Bottle,24.96,13.73,7.49,21.59,38
RC,0250,calcitonin (salmon) 200 UNIT/ACT Solution 3.7 mL Bottle,258.33,142.09,77.5,223.46,38
RC,0250,calcitriol 0.25 MCG Cap 1 Each Blister,9.22,5.08,2.77,7.98,38
RC,0250,calcitriol 0.5 MCG Cap 100 Each Bottle,9.4,5.17,2.82,8.13,38
RC,0250,calcium acetate 667 MG Cap 200 Each Bottle,8.83,4.86,2.65,7.64,38
RC,0250,calcium carbonate 1250 MG/5ML Suspension 473 mL Bottle,40.78,22.43,12.23,35.27,38
RC,0250,calcium carbonate 1250 MG/5ML Suspension 5 mL Oral Syringe,8.3,4.57,2.49,7.18,38
RC,0250,calcium carbonate 500 MG Chew Tab 150 Each Bottle,4.07,2.24,1.22,3.52,38
RC,0250,calcium carbonate 500 MG Chew Tab 500 Each Box,8.18,4.5,2.45,7.08,38
RC,0250,calcium carbonate/vitamin D 600-200 mg-unit Tab 150 Each Bottle,4.09,2.25,1.23,3.54,38
RC,0250,calcium citrate 950 MG Tab 100 Each Bottle,8.12,4.47,2.44,7.02,38
RC,0250,calcium gluconate 2 g/100 mL Solution 2 g Flex Cont,69.285,38.11,10.24,90.35,76
RC,0250,calcium gluconate 2.5% 2.5 % Gel 25 g Tube,114.5,62.98,34.35,99.04,38
RC,0250,camphor/menthol 0.5-0.5 % Lotion 222 mL Bottle,39.43,21.69,11.83,34.11,38
RC,0250,candida albicans skin test Solution 0.1 mL Syringe,93.6,51.48,28.08,80.96,38
RC,0250,candida albicans skin test Solution 1 mL Vial,1753.8,964.59,526.14,1517.04,38
RC,0250,capsaicin 0.025 % Cream 60 g Tube,44.36,24.4,13.31,38.37,38
RC,0250,captopril 12.5 MG Tab 100 Each Bottle,10.04,5.53,3.01,8.68,38
RC,0250,captopril 25 MG Tab 100 Each Bottle,10.26,5.65,3.08,8.87,38
RC,0250,captopril 3.125 mg quarter tablet Tab 0.25 tablet Package,7.76,4.27,2.33,6.71,38
RC,0250,captopril 50 MG Tab 100 Each Bottle,11.2,6.16,3.36,9.69,38
RC,0250,captopril 6.25 mg half tablet Tab 0.5 tablet Package,8.52,4.69,2.56,7.37,38
RC,0250,carBAMazepine 100 MG Chew Tab 1 Each Blister,9.61,5.29,2.88,8.31,38
RC,0250,carBAMazepine 100 MG TABLET SR 12 HR 100 Each Bottle,9.49,5.22,2.85,8.21,38
RC,0250,carBAMazepine 100 MG/5ML Suspension 10 mL Cup,13.18,7.25,3.95,11.4,38
RC,0250,carBAMazepine 100 MG/5ML Suspension 40 mL Cup,28.72,15.8,8.62,24.84,38
RC,0250,carBAMazepine 100 MG/5ML Suspension 450 mL Bottle,241.15,132.64,72.35,208.59,38
RC,0250,carBAMazepine 200 MG TABLET SR 12 HR 100 Each Bottle,9.7,5.34,2.91,8.39,38
RC,0250,carBAMazepine 200 MG Tab 100 Each Box,9.69,5.33,2.91,8.38,38
RC,0250,carBAMazepine 400 MG TABLET SR 12 HR 100 Each Bottle,11.8,6.49,3.54,10.21,38
RC,0250,carBAMazepine 50 mg half tablet Chew Tab 0.5 tablet Package,7.79,4.29,2.34,6.74,38
RC,0250,carbachol 0.01 % Solution 1.5 mL Vial,182.65,100.46,54.8,157.99,38
RC,0250,carbamide peroxide 6.5 % Solution 15 mL Bottle,26.62,14.65,7.99,23.03,38
RC,0250,carbidopa-levodopa 25-100 mg Tab CR 1 Each Blister,9.25,5.09,2.78,8.0,38
RC,0250,carbidopa/levodopa 10-100 mg Tab 100 Each Bottle,8.73,4.81,2.62,7.55,38
RC,0250,carbidopa/levodopa 25-100 mg Tab 100 Each Box,9.2,5.06,2.76,7.96,38
RC,0250,carbidopa/levodopa 25-250 mg Tab 1 Each Blister,9.65,5.31,2.9,8.35,38
RC,0250,carbidopa/levodopa 50-200 mg Tab CR 1 Each Blister,9.18,5.05,2.75,7.94,38
RC,0250,carboprost 250 MCG/ML Solution 1 mL Vial,1737.55,955.66,521.27,1502.98,38
RC,0250,carboxymethylcellulose 1 % Gel 15 mL Bottle,50.4,27.72,15.12,43.6,38
RC,0250,carboxymethylcellulose sodium PF 1 % Gel 0.4 mL Plas Cont,3.51,1.94,1.05,3.04,38
RC,0250,carboxymethylcellulose/glycerin PF 0.5-0.9 % Solution 0.4 mL Plas Cont,3.48,1.92,1.04,3.01,38
RC,0250,"cardioplegic Solution 1,000 mL Flex Cont",507.0,278.85,152.1,438.56,38
RC,0250,"cardioplegic Solution 1,000 mL Plas Cont",795.0,437.25,238.5,687.68,38
RC,0250,cariprazine 1.5 MG Cap 10 Each Blister,115.21,63.37,34.56,99.66,38
RC,0250,cariprazine 3 MG Cap 10 Each Blister,115.21,63.37,34.56,99.66,38
RC,0250,carisoprodol 350 MG Tab 100 Each Bottle,10.27,5.654999999999999,3.07,8.91,76
RC,0250,carvedilol 1.5625 mg half tablet Tab 0.5 tablet Package,15.25,8.39,4.58,13.19,38
RC,0250,carvedilol 12.5 MG Tab 500 Each Bottle,8.16,4.49,2.45,7.06,38
RC,0250,carvedilol 25 MG Tab 100 Each Box,8.3,4.57,2.49,7.18,38
RC,0250,carvedilol 3.125 MG Tab 100 Each Box,8.3,4.57,2.49,7.18,38
RC,0250,carvedilol 6.25 MG Tab 1 Each Blister,8.39,4.62,2.52,7.26,38
RC,0250,casirivimab 300 MG/2.5ML Solution 11.1 mL Vial,30.09,16.55,9.03,26.03,38
RC,0250,ceFAZolin 2.25 mg/0.1 mL Solution 1 Each Syringe,43.0,23.65,12.9,37.2,38
RC,0250,ceFAZolin 5 % Solution 15 mL Bottle,31.27,17.2,9.38,27.05,38
RC,0250,ceFAZolin Solution 0.5 mL Syringe,41.43,22.79,12.43,35.84,38
RC,0250,ceFAZolin Solution 1 Each Syringe,41.43,22.79,12.43,35.84,38
RC,0250,cefOXitin Recon Soln 1 Each Vial,67.0,36.85,20.1,57.96,38
RC,0250,cefTAZidime 100 mg/0.5 mL Solution 1 Each Syringe,66.5,36.58,19.95,57.52,38
RC,0250,cefTAZidime 1g Nebu Soln 1 Each Vial,56.95,31.33,17.09,49.26,38
RC,0250,cefTAZidime 2.25 mg/0.05 mL Solution 0.5 mL Syringe,58.75,32.32,17.63,50.82,38
RC,0250,cefTAZidime 2.25 mg/0.1 mL Solution 1 Each Syringe,66.5,36.58,19.95,57.52,38
RC,0250,cefTAZidime 5 % Solution 10 mL Bottle,148.55,81.71,44.57,128.5,38
RC,0250,cefTAZidime Recon Soln 1 Each Vial,56.95,31.33,17.09,49.26,38
RC,0250,cefTRIAXone 2 g Recon Soln 1 Each Vial,80.81,44.45,24.24,69.9,38
RC,0250,cefTRIAXone Recon Soln 1 Each Vial,48.205,26.515,12.65,46.93,76
RC,0250,cefUROxime 250 MG Tab 60 Each Bottle,8.58,4.72,2.57,7.42,76
RC,0250,cefadroxil 500 MG Cap 100 Each Bottle,8.59,4.73,2.58,7.43,38
RC,0250,cefadroxil 500 MG Cap 50 Each Bottle,8.79,4.84,2.64,7.6,38
RC,0250,cefdinir 125 MG/5ML Recon Susp 100 mL Bottle,90.5,49.78,27.15,78.28,38
RC,0250,cefdinir 300 MG Cap 60 Each Bottle,10.63,5.85,3.19,9.19,38
RC,0250,cefepime Recon Soln 1 Each Vial,74.84,41.17,22.45,64.74,38
RC,0250,ceftolozane-tazobactam Recon Soln 1 Each Vial,956.54,526.1,286.96,827.41,38
RC,0250,celecoxib 100 MG Cap 1 Each Blister,11.35,6.25,3.41,9.82,38
RC,0250,celecoxib 200 MG Cap 1 Each Blister,13.07,7.19,3.92,11.31,38
RC,0250,cephALEXin 250 MG Cap 1 Each Blister,9.07,4.99,2.72,7.85,38
RC,0250,cephALEXin 250 MG/5ML Recon Susp 100 mL Bottle,83.9,46.15,25.17,72.57,38
RC,0250,cephALEXin 500 MG Cap 100 Each Bottle,8.72,4.8,2.62,7.54,38
RC,0250,cetaphil Lotion 473 mL Bottle,44.83,24.66,13.45,38.78,38
RC,0250,cetirizine 1 MG/ML Solution 118 mL Bottle,25.77,14.18,7.73,22.29,38
RC,0250,cetirizine 10 MG Tab 100 Each Bottle,8.44,4.65,2.53,7.3,38
RC,0250,cetirizine 5 MG Tab 100 Each Bottle,4.6,2.53,1.38,3.98,38
RC,0250,cevimeline 30 MG Cap 100 Each Bottle,14.75,8.12,4.43,12.76,38
RC,0250,cherry syrup Syrup 473 mL Bottle,69.98,38.49,20.99,60.53,38
RC,0250,chlorTHALidone 12.5 mg half tablet Tab 0.5 tablet Packet,8.45,4.65,2.54,7.31,38
RC,0250,chlorTHALidone 25 MG Tab 100 Each Bottle,8.61,4.74,2.58,7.45,38
RC,0250,chlorambucil 2 MG Tab 25 Each Bottle,68.64,37.76,20.59,59.37,38
RC,0250,chlordiazePOXIDE 10 mg capsule Cap 100 Each Bottle,10.37,5.71,3.11,8.97,38
RC,0250,chlordiazePOXIDE 25 mg capsule Cap 100 Each Bottle,10.42,5.74,3.13,9.01,38
RC,0250,chlordiazePOXIDE 5 mg capsule Cap 100 Each Bottle,10.48,5.77,3.14,9.07,38
RC,0250,chlordiazePOXIDE/clidinium 5-2.5 MG Cap 100 Each Bottle,9.4,5.17,2.82,8.13,38
RC,0250,chlorhexidine 0.12 % Solution 473 mL Bottle,38.21,21.02,11.46,33.05,38
RC,0250,cholecalciferol 1000 units Tab 100 Each Bottle,4.08,2.25,1.22,3.53,38
RC,0250,cholecalciferol 400 UNIT/ML Liquid 50 mL Bottle,30.5,16.78,9.15,26.38,38
RC,0250,cholecalciferol 400 units Tab 100 Each Bottle,8.05,4.43,2.42,6.96,38
RC,0250,cholestyramine 4 g Pack 1 Each Packet,10.0,5.5,3.0,8.65,38
RC,0250,choriogonadotropin alfa 250 MCG/0.5ML Solution Prefilled Syringe 0.5 mL Syringe,1374.94,756.22,412.48,1189.32,38
RC,0250,chromium chloride 40 MCG/10ML Solution 10 mL Vial,148.9,81.9,44.67,128.8,38
RC,0250,cilostazol 100 MG Tab 60 Each Bottle,9.2,5.06,2.76,7.96,38
RC,0250,cilostazol 50 MG Tab 60 Each Bottle,9.05,4.98,2.72,7.83,38
RC,0250,cinacalcet 30 MG Tab 30 Each Bottle,9.65,5.31,2.9,8.35,38
RC,0250,ciprofloxacin 0.3 % Ointment 3.5 g Tube,825.55,454.06,247.67,714.1,38
RC,0250,ciprofloxacin 0.3 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
RC,0250,ciprofloxacin 0.3 % Solution 5 mL Bottle,69.0,37.95,20.7,59.69,38
RC,0250,ciprofloxacin 250 MG Tab 100 Each Bottle,8.74,4.81,2.62,7.56,38
RC,0250,ciprofloxacin 500 MG Tab 100 Each Box,9.02,4.97,2.71,7.8,38
RC,0250,ciprofloxacin 500 MG/5ML (10%) Recon Susp 100 mL Bottle,463.9,255.15,139.17,401.27,38
RC,0250,ciprofloxacin 750 MG Tab 50 Each Bottle,8.61,4.74,2.58,7.45,38
RC,0250,ciprofloxacin Solution 20 mL Vial,98.0,53.9,29.4,84.77,38
RC,0250,ciprofloxacin/dexamethasone 0.3-0.1 % Suspension 7.5 mL Bottle,389.96,214.48,116.99,337.32,38
RC,0250,cisatracurium 10 MG/5ML Solution 5 mL Vial,74.0,40.7,22.2,64.01,38
RC,0250,cisatracurium 20 MG/10ML Solution 10 mL Vial,95.0,52.25,28.5,82.18,38
RC,0250,cisatracurium 200 MG/20ML Solution 20 mL Vial,1475.7,811.64,442.71,1276.48,38
RC,0250,citalopram 10 MG Tab 100 Each Bottle,8.19,4.51,2.46,7.08,38
RC,0250,citalopram 10 MG/5ML Solution 240 mL Bottle,222.63,122.45,66.79,192.57,38
RC,0250,citalopram 20 MG Tab 100 Each Bottle,8.17,4.5,2.45,7.07,38
RC,0250,citalopram 40 MG Tab 100 Each Bottle,8.19,4.51,2.46,7.08,38
RC,0250,citalopram 5 mg half tablet Tab 0.5 tablet Package,8.09,4.45,2.43,7.0,38
RC,0250,clarithromycin 500 MG Tab 60 Each Bottle,9.93,5.47,2.98,8.59,38
RC,0250,clarithromycin Suspension 125 mg Oral Syringe,656.88,361.29,197.06,568.2,38
RC,0250,clindamycin 1 mg/0.1 mL Solution 0.1 mL Syringe,30.56,16.81,9.17,26.43,38
RC,0250,clindamycin 250 mcg/0.1 mL Solution 0.1 mL Syringe,30.57,16.82,9.17,26.44,38
RC,0250,clindamycin hydrochloride 150 MG Cap 100 Each Bottle,8.48,4.67,2.54,7.34,38
RC,0250,clindamycin palmitate hydrochloride 75 MG/5ML Recon Soln 100 mL Bottle,163.1,89.71,48.93,141.08,38
RC,0250,clindamycin phosphate 1 % Solution 60 mL Bottle,188.84,103.87,56.65,163.35,38
RC,0250,clindamycin phosphate 2 % Cream 40 g Tube,353.91,194.66,106.17,306.13,38
RC,0250,cloBAZam 10 MG Tab 100 Each Bottle,11.65,6.41,3.5,10.08,38
RC,0250,cloBAZam 5 mg half tablet Tab 0.5 tablet Package,13.66,7.52,4.1,11.82,38
RC,0250,cloNIDine 0.05 mg half tablet Tab 0.5 tablet Package,8.07,4.44,2.42,6.98,38
RC,0250,cloNIDine 0.1 MG Tab 100 Each Bottle,8.14,4.48,2.44,7.04,38
RC,0250,cloNIDine 0.1 mg/24hr/patch PATCH WEEKLY 1 Each Package,41.81,23.0,12.54,36.17,38
RC,0250,cloNIDine 0.2 MG Tab 100 Each Bottle,8.19,4.51,2.46,7.08,38
RC,0250,cloNIDine 0.2 mg/24hr/patch PATCH WEEKLY 1 Each Box,112.07,61.64,33.62,96.94,38
RC,0250,cloNIDine 0.3 MG Tab 1 Each Blister,9.19,5.06,2.76,7.95,38
RC,0250,cloNIDine 0.3 mg/24hr/patch PATCH WEEKLY 4 Each Box,153.54,84.45,46.06,132.81,38
RC,0250,cloZAPine 100 MG Tab 1 Each Blister,12.01,6.61,3.6,10.39,38
RC,0250,cloZAPine 25 MG Tab 1 Each Blister,8.97,4.94,2.69,7.76,38
RC,0250,clobetasol propionate 0.05 % Cream 30 g Tube,54.97,30.24,16.49,47.55,38
RC,0250,clobetasol propionate 0.05 % Ointment 15 g Tube,104.0,57.2,31.2,89.96,38
RC,0250,clomiPRAMINE 25 MG Cap 30 Each Bottle,9.65,5.31,2.9,8.35,38
RC,0250,clomiPRAMINE 50 MG Cap 30 Each Bottle,30.92,17.01,9.28,26.75,38
RC,0250,clonazePAM 0.25 MG TABLET DISPERSIBLE 1 Each Blister,12.1,6.66,3.63,10.47,38
RC,0250,clonazePAM 0.25 mg half tablet Tab 0.5 tablet Package,10.83,5.96,3.25,9.37,38
RC,0250,clonazePAM 0.5 mg Tab 100 Each Bottle,10.07,5.54,3.02,8.71,38
RC,0250,clonazePAM 0.5 mg Tab 100 Each Box,10.28,5.66,3.08,8.89,38
RC,0250,clonazePAM 1 mg Tab 100 Each Bottle,10.11,5.57,3.03,8.75,38
RC,0250,clonazePAM 2 mg Tab 100 Each Bottle,10.16,5.59,3.05,8.79,38
RC,0250,clopidogrel 300 mg Tab 30 Each Box,44.52,24.49,13.36,38.51,38
RC,0250,clopidogrel 75 mg Tab 500 Each Bottle,8.55,4.71,2.57,7.4,38
RC,0250,clopidogrel Solution 1 Each Oral Syringe,23.4,12.87,7.02,20.24,38
RC,0250,clotrimazole 1 % Cream 28.4 g Tube,35.9,19.75,10.77,31.05,38
RC,0250,clotrimazole 10 MG Troche 70 Each Bottle,12.94,7.12,3.88,11.19,38
RC,0250,clotrimazole/betamethasone 1-0.05 % Cream 15 g Tube,79.01,43.46,23.7,68.34,38
RC,0250,co-enzyme Q-10 50 MG Cap 30 Each Bottle,8.67,4.77,2.6,7.5,38
RC,0250,cocaine 10 % Solution 10 mL Bottle,1330.0,731.5,399.0,1150.45,38
RC,0250,cocaine hydrochloride Powder 25 g Bottle,7810.28,4295.66,2343.08,6755.89,38
RC,0250,cocoa butter Misc 28.3 g Tube,26.93,14.82,8.08,23.29,38
RC,0250,codeine 15 MG Tab 100 Each Box,11.62,6.4,3.49,10.05,38
RC,0250,codeine 30 MG Tab 100 Each Box,11.93,6.57,3.58,10.32,38
RC,0250,coenzyme Q-10 100 MG Cap 30 Each Bottle,4.84,2.67,1.45,4.19,38
RC,0250,coenzyme Q-10 60 MG/ML Suspension 1 mL Oral Syringe,8.89,4.89,2.67,7.69,38
RC,0250,colchicine 0.3 mg half tablet Tab 0.5 tablet Package,7.92,4.36,2.38,6.85,38
RC,0250,colchicine 0.6 MG Tab 100 Each Bottle,8.68,4.78,2.6,7.51,38
RC,0250,colchicine/probenecid 0.5-500 MG Tab 100 Each Bottle,11.82,6.51,3.55,10.22,38
RC,0250,colistimethate 150 mg Recon Soln 1 Each Vial,183.0,100.65,54.9,158.3,38
RC,0250,"colistimethate Solution 150,000 mcg",203.06,111.69,60.92,175.65,38
RC,0250,collagenase 250 UNIT/GM Ointment 30 g Tube,962.38,529.31,288.71,832.46,76
RC,0250,copper 0.4 MG/ML Solution 10 mL Vial,172.2,94.71,51.66,148.95,38
RC,0250,cortisone 12.5 mg half tablet Tab 0.5 tablet Package,7.76,4.27,2.33,6.71,38
RC,0250,cottonseed oil Oil 474 mL Bottle,54.84,30.17,16.45,47.44,38
RC,0250,cranberry-vitamin C-probiotic 250 MG Tab 50 Each Box,4.5,2.48,1.35,3.89,38
RC,0250,cyanocobalamin 100 MCG Tab 1 Each Blister,8.59,4.73,2.58,7.43,38
RC,0250,cyanocobalamin 250 MCG Tab 130 Each Bottle,4.07,2.24,1.22,3.52,38
RC,0250,cyanocobalamin 500 MCG Tab 100 Each Bottle,8.08,4.45,2.42,6.99,38
RC,0250,cycloSPORINE 0.05 % Emulsion 1 Each Ampule,35.05,19.28,10.52,30.32,38
RC,0250,cycloSPORINE 0.05 % Emulsion 60 Each Plas Cont,19.6,10.78,5.88,16.95,38
RC,0250,cycloSPORINE 0.1 % Solution 15 mL Bottle,1825.0,1003.75,547.5,1578.63,38
RC,0250,cycloSPORINE 0.1 % Solution 5 mL Bottle,4525.0,2488.75,1357.5,3914.13,38
RC,0250,cyclobenzaprine  10 MG Tab 500 Each Bottle,8.07,4.44,2.42,6.98,38
RC,0250,cyclobenzaprine  2.5 mg half tablet Tab 0.5 tablet Package,8.56,4.71,2.57,7.4,38
RC,0250,cyclobenzaprine  5 MG Tab 1 Each Blister,9.12,5.02,2.74,7.89,38
RC,0250,cyclopentolate 1 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
RC,0250,cyclopentolate 1 % Solution 2 mL Bottle,61.83,34.01,18.55,53.48,38
RC,0250,cyclopentolate/phenylephrine 0.2-1 % Solution 2 mL Bottle,149.57,82.27,44.87,129.38,38
RC,0250,cyclopentolate/phenylephrine 0.2-1 % Solution 5 mL Bottle,226.38,124.51,67.91,195.82,38
RC,0250,cyproheptadine 2 mg half tablet Tab 0.5 tablet Package,8.7,4.79,2.61,7.53,38
RC,0250,cyproheptadine 4 MG Tab 100 Each Bottle,9.46,5.21,2.84,8.18,38
RC,0250,dabigatran 150 MG Cap 60 Each Box,16.92,9.31,5.08,14.64,38
RC,0250,danazol 50 MG Cap 100 Each Bottle,14.61,8.04,4.38,12.64,38
RC,0250,dantrolene 100 MG Cap 100 Each Bottle,11.92,6.56,3.58,10.31,38
RC,0250,dantrolene 25 MG Cap 100 Each Bottle,8.94,4.92,2.68,7.73,38
RC,0250,dantrolene 250 MG Recon Susp 1 Each Vial,13930.31,7661.68,4179.09,12049.72,38
RC,0250,dapagliflozin 10 MG Tab 30 Each Bottle,40.06,22.04,12.02,34.65,38
RC,0250,dapagliflozin 5 MG Tab 30 Each Bottle,40.06,22.04,12.02,34.65,38
RC,0250,dapsone 100 MG Tab 100 Each Bottle,11.65,6.41,3.5,10.08,38
RC,0250,dapsone 25 MG Tab 30 Each Bottle,9.95,5.48,2.99,8.61,38
RC,0250,darunavir 600 MG Tab 60 Each Bottle,12.24,6.74,3.67,10.59,38
RC,0250,darunavir 800 MG Tab 30 Each Bottle,17.48,9.62,5.24,15.12,38
RC,0250,darunavir-cobicistat 800-150 MG Tab 30 Each Bottle,202.34,111.29,60.7,175.02,38
RC,0250,dasatinib 20 MG Tab 60 Each Bottle,409.95,225.48,122.99,354.61,38
RC,0250,dasatinib 50 MG Tab 60 Each Bottle,207.48,114.12,62.24,179.47,38
RC,0250,deferasirox 180 MG Tab 30 Each Bottle,15.2,8.36,4.56,13.15,38
RC,0250,deferasirox 250 MG TABLET SOLUBLE 30 Each Bottle,40.2,22.11,12.06,34.77,38
RC,0250,deferasirox 360 MG Tab 30 Each Bottle,20.76,11.42,6.23,17.96,38
RC,0250,delafloxacin 450 MG Tab 20 Each Bottle,196.28,107.96,58.88,169.78,38
RC,0250,demeclocycline 150 MG Tab 100 Each Bottle,23.1,12.71,6.93,19.98,38
RC,0250,desmopressin 0.01 % Solution 5 mL Bottle,415.17,228.35,124.55,359.12,38
RC,0250,desmopressin 0.1 mg Tab 100 Each Bottle,9.2,5.06,2.76,7.96,38
RC,0250,desmopressin 0.2 mg Tab 1 Each Blister,16.41,9.03,4.92,14.19,38
RC,0250,desvenlafaxine succinate 100 MG Tablet Extended Release 24 Hour 30 Each Bottle,9.27,5.1,2.78,8.02,38
RC,0250,desvenlafaxine succinate 25 MG Tablet Extended Release 24 Hour 30 Each Bottle,9.93,5.47,2.98,8.59,38
RC,0250,desvenlafaxine succinate 50 MG Tablet Extended Release 24 Hour 90 Each Bottle,9.27,5.1,2.78,8.02,38
RC,0250,dexAMETHasone 0.33% and lidocaine 0.1% in ultrasound Gel 250 mL Jar,109.81,60.4,32.94,94.99,38
RC,0250,dexAMETHasone 4 MG/ML Solution 1 mL Vial,9.33,5.14,2.8,8.07,38
RC,0250,dexAMETHasone 400 mcg/0.1 mL Solution 0.1 mL Syringe,8.14,4.48,2.44,7.04,38
RC,0250,dexAMETHasone 5 mg/0.5 mL Solution 0.5 mL Syringe,8.69,4.78,2.61,7.52,38
RC,0250,dexmedeTOMIDine 100 MCG/ML Solution 2 mL Vial,129.46,71.21,38.84,111.98,38
RC,0250,dexmedeTOMIDine 200 mcg/50 mL Solution 50 mL Glass Cont,160.0,88.0,48.0,138.4,38
RC,0250,dexmedeTOMIDine 400 mcg/100 mL Solution 100 mL Glass Cont,270.0,148.5,81.0,233.55,38
RC,0250,dexmedeTOMIDine 80 mcg/20 mL Solution 20 mL Vial,152.6,83.93,45.78,132.0,38
RC,0250,dexmedetomidine HCl in NaCl 4 mcg/mL Solution Prefilled Syringe 5 mL Syringe,71.41,39.28,21.42,61.77,38
RC,0250,dextran-hypromellose PF 0.1-0.3 % Solution 28 Each Plas Cont,21.55,11.86,6.47,18.64,38
RC,0250,dextroamphetamine 2.5 mg half tablet Tab 0.5 tablet Package,11.69,6.43,3.51,10.11,38
RC,0250,dextroamphetamine 5 MG Tab 100 Each Bottle,11.615,6.395,3.32,10.51,76
RC,0250,dextromethorphan/guiafenesin 30-600 mg TABLET SR 12 HR 20 Each Box,4.84,2.67,1.45,4.19,38
RC,0250,"dextrose 10 % Solution 1,000 mL Flex Cont",162.0,89.1,48.6,140.13,76
RC,0250,"dextrose 5 % Solution 1,000 mL Flex Cont",134.0,73.7,40.2,115.91,38
RC,0250,dextrose 5 % Solution 100 mL Flex Cont,48.9,26.9,14.67,42.3,38
RC,0250,dextrose 5 % Solution 250 mL Flex Cont,59.75,32.87,17.93,51.68,38
RC,0250,dextrose 5 % Solution 500 mL Flex Cont,86.63,47.65,25.99,74.93,38
RC,0250,"dextrose 70% 70 % Solution 2,000 mL Plas Cont",150.0,82.5,45.0,129.75,38
RC,0250,diazePAM 1 mg half tablet Tab 0.5 tablet Package,10.08,5.55,3.02,8.72,38
RC,0250,diazePAM 10 MG Tab 100 Each Bottle,10.23,5.63,3.07,8.85,38
RC,0250,diazePAM 2 MG Tab 1 Each Blister,10.15,5.59,3.05,8.78,38
RC,0250,diazePAM 2.5 mg half tablet Tab 1 Each Plas Cont,8.22,4.53,2.47,7.11,38
RC,0250,diazePAM 5 MG Tab 1 Each Blister,10.18,5.6,3.05,8.81,38
RC,0250,diazePAM 5 MG Tab 100 Each Box,10.17,5.6,3.05,8.8,38
RC,0250,dibucaine 1 % Ointment 28 g Tube,31.17,17.15,9.35,26.96,38
RC,0250,diclofenac 1 % Gel 100 g Tube,63.05,34.68,18.92,54.54,38
RC,0250,diclofenac sodium 25 MG Tablet Delayed Response 100 Each Bottle,10.2,5.61,3.06,8.82,38
RC,0250,diclofenac sodium 50 MG Tablet Delayed Response 60 Each Bottle,8.91,4.91,2.67,7.71,38
RC,0250,dicloxacillin 250 MG Cap 100 Each Bottle,9.05,4.98,2.72,7.83,38
RC,0250,dicyclomine 10 MG Cap 100 Each Bottle,8.66,4.77,2.6,7.49,38
RC,0250,difluprednate 0.05 % Emulsion 5 mL Bottle,664.0,365.2,199.2,574.36,38
RC,0250,digoxin 0.05 MG/ML Solution 60 mL Bottle,426.94,234.82,128.08,369.3,38
RC,0250,digoxin 125 MCG Tab 100 Each Bottle,8.99,4.95,2.7,7.78,38
RC,0250,"digoxin 250 MCG Tab 1,000 Each Bottle",8.99,4.95,2.7,7.78,38
RC,0250,digoxin 62.5 mcg half tablet Tab 0.5 tablet Package,8.64,4.76,2.59,7.47,38
RC,0250,dilTIAZem 120 MG CAPSULE SR 24 HR 1 Each Blister,9.43,5.19,2.83,8.16,38
RC,0250,dilTIAZem 15 mg half tablet Tab 0.5 tablet Package,8.5,4.68,2.55,7.35,38
RC,0250,dilTIAZem 180 MG CAPSULE SR 24 HR 1 Each Blister,9.43,5.19,2.83,8.16,38
RC,0250,dilTIAZem 180 MG CAPSULE SR 24 HR 90 Each Bottle,9.81,5.4,2.94,8.49,38
RC,0250,dilTIAZem 240 MG CAPSULE SR 24 HR 1 Each Blister,8.84,4.87,2.65,7.65,38
RC,0250,dilTIAZem 30 MG Tab 100 Each Bottle,9.5,5.23,2.85,8.22,38
RC,0250,dilTIAZem 300 MG CAPSULE SR 24 HR 90 Each Bottle,9.18,5.05,2.75,7.94,38
RC,0250,dilTIAZem 60 MG Tab 1 Each Blister,8.52,4.69,2.56,7.37,38
RC,0250,dilTIAZem 90 MG Tab 100 Each Bottle,9.06,4.99,2.72,7.84,38
RC,0250,dilTIAZem HCl 120 mg CAPSULE SR 12 HR 100 Each Bottle,18.34,10.09,5.5,15.86,38
RC,0250,dilTIAZem HCl 60 mg CAPSULE SR 12 HR 100 Each Bottle,14.61,8.04,4.38,12.64,38
RC,0250,dilTIAZem HCl 90 MG CAPSULE SR 12 HR 1 Each Blister,18.67,10.27,5.6,16.15,38
RC,0250,dilating eye Gel 1 Each Syringe,33.76,18.57,10.13,29.2,38
RC,0250,dinoprostone 10 MG INSERT 1 Each Box,1325.43,728.99,397.63,1146.5,38
RC,0250,diphenhydrAMINE 12.5 MG/5ML Liquid 118 mL Bottle,13.56,7.46,4.07,11.73,38
RC,0250,diphenhydrAMINE 12.5 MG/5ML Liquid 5 mL Oral Syringe,4.11,2.27,1.23,3.56,38
RC,0250,diphenhydrAMINE 25 MG Cap 100 Each Box,8.14,4.48,2.44,7.04,38
RC,0250,diphenhydrAMINE/zinc acetate Cream 28.3 g Tube,32.58,17.92,9.77,28.18,38
RC,0250,"diphenoxylate/atropine 2.5-0.025 MG Tab 1,000 Each Bottle",11.03,6.07,3.31,9.54,38
RC,0250,diphenoxylate/atropine 2.5-0.025 MG Tab 100 Each Bottle,10.48,5.77,3.14,9.07,38
RC,0250,dipyridamole 25 MG Tab 100 Each Bottle,9.65,5.31,2.9,8.35,38
RC,0250,disopyramide 150 MG Cap 100 Each Bottle,13.74,7.56,4.12,11.89,38
RC,0250,divalproex 125 MG Capsule Delayed Release Sprinkle 1 Each Blister,9.52,5.24,2.86,8.23,38
RC,0250,divalproex 125 MG Tablet Delayed Response 100 Each Bottle,8.59,4.73,2.58,7.43,38
RC,0250,divalproex 250 MG Tablet Delayed Response 100 Each Box,8.66,4.77,2.6,7.49,38
RC,0250,divalproex 500 MG Tablet Delayed Response 100 Each Box,8.64,4.76,2.59,7.47,38
RC,0250,divalproex sodium 250 MG Tablet Extended Release 24 Hour 1 Each Blister,11.41,6.28,3.42,9.87,38
RC,0250,divalproex sodium 250 MG Tablet Extended Release 24 Hour 100 Each Box,11.41,6.28,3.42,9.87,38
RC,0250,divalproex sodium 500 MG Tablet Extended Release 24 Hour 1 Each Blister,13.57,7.47,4.07,11.74,38
RC,0250,docosanol 10 % Cream 2 g Pump Btl,66.76,36.72,20.03,57.75,38
RC,0250,docusate sodium 100 MG Cap 1 Each Blister,8.59,4.73,2.58,7.43,38
RC,0250,"docusate sodium 100 MG Cap 1,000 Each Bottle",8.04,4.43,2.41,6.95,38
RC,0250,docusate sodium 150 MG/15ML Liquid 10 mL Cup,14.11,7.77,4.23,12.21,38
RC,0250,docusate sodium 150 MG/15ML Liquid 473 mL Bottle,55.52,30.54,16.66,48.02,38
RC,0250,docusate sodium 150 MG/15ML Liquid 5 mL Oral Syringe,9.83,5.41,2.95,8.5,38
RC,0250,docusate sodium 283 mg Enema 5 mL Tube,14.15,7.79,4.25,12.24,38
RC,0250,docusate sodium 50 MG Cap 28 Each Bottle,3.9,2.15,1.17,3.37,38
RC,0250,dofetilide 125 MCG Cap 60 Each Bottle,11.8,6.49,3.54,10.21,38
RC,0250,dofetilide 250 MCG Cap 60 Each Bottle,9.1,5.01,2.73,7.87,38
RC,0250,dofetilide 500 MCG Cap 60 Each Bottle,9.1,5.01,2.73,7.87,38
RC,0250,dolutegravir 50 MG Tab 30 Each Bottle,191.01,105.06,57.3,165.22,38
RC,0250,dolutegravir 50 mg Tab 5 Each Bottle,935.06,514.29,280.52,808.83,38
RC,0250,donepezil 10 MG Tab 30 Each Bottle,8.55,4.71,2.57,7.4,38
RC,0250,donepezil 23 MG Tab 30 Each Bottle,13.8,7.59,4.14,11.94,38
RC,0250,donepezil 5 MG Tab 90 Each Bottle,8.525,4.695,2.55,7.4,76
RC,0250,dornase alfa 2.5 MG/2.5ML Solution 2.5 mL Plas Cont,326.05,179.33,97.82,282.03,38
RC,0250,dorzolamide 2 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
RC,0250,dorzolamide 2 % Solution 10 mL Bottle,138.97,76.44,41.69,120.21,38
RC,0250,dorzolamide/timolol 2-0.5 % Solution 10 mL Bottle,90.0,49.5,27.0,77.85,38
RC,0250,doxazosin 1 MG Tab 100 Each Bottle,9.4,5.17,2.82,8.13,38
RC,0250,doxazosin 2 MG Tab 100 Each Bottle,9.4,5.17,2.82,8.13,38
RC,0250,doxazosin 4 MG Tab 100 Each Bottle,8.87,4.88,2.66,7.67,38
RC,0250,doxepin 10 MG Cap 100 Each Box,8.6,4.73,2.58,7.44,38
RC,0250,doxepin 100 MG Cap 100 Each Bottle,11.44,6.3,3.43,9.9,38
RC,0250,doxepin 25 MG Cap 100 Each Bottle,8.85,4.87,2.66,7.66,38
RC,0250,doxepin 50 MG Cap 100 Each Bottle,9.65,5.31,2.9,8.35,38
RC,0250,doxycycline Recon Soln 1 Each Vial,172.98,95.14,51.89,149.63,38
RC,0250,doxycycline monohydrate 100 MG Cap 50 Each Bottle,9.52,5.24,2.86,8.23,38
RC,0250,doxycycline monohydrate 100 mg Cap 14 Each Bottle,9.52,5.24,2.86,8.23,38
RC,0250,dronedarone 400 MG Tab 60 Each Bottle,42.45,23.35,12.74,36.72,38
RC,0250,dry skin Cream 106 g Jar,20.0,11.0,6.0,17.3,38
RC,0250,ePHEDrine 5 MG/ML Solution 10 mL Vial,189.0,103.95,56.7,163.49,38
RC,0250,ePHEDrine 5 MG/ML Solution 5 mL Syringe,100.28,55.16,30.08,86.74,38
RC,0250,ePHEDrine 50 MG/ML Solution 1 mL Vial,189.24,104.09,56.77,163.69,38
RC,0250,ePHEDrine Sulfate (Pressors) 5 MG/ML Solution 10 mL Vial,189.0,103.95,56.7,163.49,38
RC,0250,edetate 2% Solution 10 mL,486.25,267.44,145.88,420.61,38
RC,0250,efavirenz 600 MG Tab 30 Each Bottle,15.0,8.25,4.5,12.98,38
RC,0250,elacestrant hydrochloride 345 MG Tab 30 Each Bottle,1987.73,1093.26,596.32,1719.39,38
RC,0250,elacestrant hydrochloride 86 MG Tab 30 Each Bottle,665.91,366.26,199.77,576.01,38
RC,0250,eltrombopag olamine 25 MG Tab 30 Each Bottle,564.84,310.67,149.57,545.91,76
RC,0250,eltrombopag olamine 50 MG Tab 30 Each Bottle,1018.135,559.98,269.46,984.42,76
RC,0250,elvitegravir-cobicistat-emtricitabine-tenofovir AF 150-150-200-10 MG Tab 30 Each Bottle,342.29,188.26,102.69,296.08,38
RC,0250,emollient Cream 113 g Tube,34.24,18.84,10.27,29.62,38
RC,0250,emollient Cream 453 g Jar,51.71,28.45,15.51,44.73,76
RC,0250,empagliflozin 10 mg Tab 30 Each Box,62.65,34.46,18.8,54.19,38
RC,0250,empagliflozin 25 mg Tab 30 Each Box,62.65,34.46,18.8,54.19,38
RC,0250,emtricitabine 200 MG Cap 30 Each Bottle,54.29,29.86,16.29,46.96,38
RC,0250,emtricitabine/tenofovir DF 200/300 mg Tab 5 Each Bottle,741.91,408.06,222.57,641.75,38
RC,0250,enalapril 10 MG Tab 100 Each Bottle,8.75,4.82,2.63,7.57,38
RC,0250,enalapril 2.5 MG Tab 100 Each Bottle,8.53,4.7,2.56,7.38,38
RC,0250,enalapril 20 MG Tab 100 Each Bottle,8.98,4.94,2.69,7.77,38
RC,0250,enalapril 5 MG Tab 100 Each Bottle,8.69,4.78,2.61,7.52,38
RC,0250,enalaprilat 1.25 MG/ML Solution 1 mL Vial,43.44,23.9,13.03,37.58,38
RC,0250,enalaprilat 1.25 MG/ML Solution 2 mL Vial,91.36,50.25,27.41,79.03,38
RC,0250,enalaprilat 1.25 mg/mL Injection 1 mL Vial,99.33,54.64,29.8,85.92,38
RC,0250,enalaprilat 1.25 mg/mL Injection 2 mL Vial,91.37,50.26,27.41,79.04,38
RC,0250,enalaprilat 1.25 mg/ml Injection 2 mL Vial,91.37,50.26,27.41,79.04,38
RC,0250,entacapone 100 mg half tablet Tab 0.5 tablet Package,16.41,9.03,4.92,14.19,38
RC,0250,entacapone 200 MG Tab 100 Each Bottle,16.48,9.07,4.94,14.26,38
RC,0250,entecavir 0.05 MG/ML Solution 210 mL Bottle,2889.25,1589.09,866.78,2499.2,38
RC,0250,entecavir 0.5 MG Tab 30 Each Bottle,11.0,6.05,3.3,9.52,38
RC,0250,entecavir 1 MG Tab 30 Each Bottle,11.0,6.05,3.3,9.52,38
RC,0250,eplerenone 25 mg Tab 30 Each Bottle,9.5,5.23,2.85,8.22,38
RC,0250,ergocalciferol 1.25 mg Cap 100 Each Bottle,5.01,2.76,1.5,4.33,38
RC,0250,ergocalciferol 8000 UNIT/ML Solution 60 mL Bottle,105.22,57.88,31.57,91.02,38
RC,0250,ertapenem Recon Soln 1 Each Flex Cont,243.9,134.15,73.17,210.97,38
RC,0250,erythromycin 5 MG/GM Ointment 1 g Tube,28.07,15.44,8.42,24.28,38
RC,0250,erythromycin 5 MG/GM Ointment 3.5 g Tube,73.2,40.26,21.96,63.32,38
RC,0250,erythromycin base 250 MG Tab 30 Each Bottle,23.86,13.13,7.16,20.64,38
RC,0250,erythromycin ethylsuccinate 200 mg/5 mL Recon Susp 100 mL Bottle,629.8,346.39,188.94,544.78,38
RC,0250,escitalopram 10 MG Tab 1 Each Blister,8.79,4.84,2.64,7.6,38
RC,0250,escitalopram 10 MG Tab 100 Each Box,8.5,4.68,2.55,7.35,38
RC,0250,escitalopram 20 MG Tab 1 Each Blister,9.05,4.98,2.72,7.83,38
RC,0250,escitalopram 5 MG Tab 100 Each Bottle,8.33,4.59,2.5,7.21,38
RC,0250,esketamine 28 MG/DEVICE Solution Therapy Pack 1 Each Box,1261.3049999999998,693.725,378.39,1091.03,76
RC,0250,esomeprazole magnesium 40 MG CAPSULE DELAYED RELEASE 30 Each Bottle,9.56,5.26,2.87,8.27,38
RC,0250,estradiol 0.05 mg PATCH BIWEEKLY 1 Each Box,30.49,16.77,9.15,26.37,38
RC,0250,estradiol 0.075 mg PATCH BIWEEKLY 1 Each Packet,50.03,27.52,15.01,43.28,38
RC,0250,estradiol 0.1 mg PATCH BIWEEKLY 1 Each Packet,50.03,27.52,15.01,43.28,38
RC,0250,estradiol 0.5 MG Tab 100 Each Bottle,8.24,4.54,2.47,7.13,38
RC,0250,estradiol 1 MG Tab 100 Each Bottle,8.29,4.56,2.49,7.17,38
RC,0250,estrogens (conjugated) 0.3 mg Tab 100 Each Bottle,25.09,13.8,7.53,21.7,38
RC,0250,estrogens (conjugated) 0.625 MG/GM Cream 30 g Tube,1392.58,765.92,417.77,1204.58,38
RC,0250,estrogens (conjugated) 0.625 mg Tab 100 Each Bottle,25.09,13.8,7.53,21.7,38
RC,0250,estrogens (conjugated) 1.25 MG Tab 100 Each Bottle,25.09,13.8,7.53,21.7,38
RC,0250,ethambutol 400 MG Tab 100 Each Bottle,10.81,5.95,3.24,9.35,38
RC,0250,ethambutol Solution 0.1 mg Syringe,8.66,4.77,2.6,7.49,38
RC,0250,ethanolamine 5 % Solution 2 mL Ampule,2392.81,1316.05,717.84,2069.78,38
RC,0250,ethyl alcohol 99 % Solution 5 mL Ampule,5388.0,2963.4,1616.4,4660.62,38
RC,0250,ethyl esters of iodized fatty acids of poppy seed oil 480 MG/ML Oil 10 mL Ampule,7104.12,3907.27,2131.24,6145.06,38
RC,0250,etomidate 2 MG/ML Solution 10 mL Vial,68.54,37.7,20.56,59.29,76
RC,0250,etravirine 200 MG Tab 60 Each Bottle,73.41,40.38,22.02,63.5,38
RC,0250,exemestane 25 MG Tab 30 Each Bottle,14.5,7.975,3.6,14.71,76
RC,0250,eye irrigating Solution 118 mL Bottle,20.0,11.0,6.0,17.3,38
RC,0250,ezetimibe 10 MG Tab 90 Each Bottle,8.9,4.9,2.67,7.7,38
RC,0250,famciclovir 250 MG Tab 30 Each Bottle,8.6,4.73,2.58,7.44,38
RC,0250,famciclovir 500 MG Tab 30 Each Bottle,10.5,5.78,3.15,9.08,38
RC,0250,famotidine 10 MG Tab 60 Each Bottle,8.24,4.54,2.47,7.13,38
RC,0250,famotidine 20 MG Tab 100 Each Bottle,8.46,4.66,2.54,7.32,38
RC,0250,famotidine 20 MG Tab 25 Each Box,8.57,4.72,2.57,7.41,38
RC,0250,fd & c blue #2 Powder 25 g Bottle,144.53,79.5,43.36,125.02,38
RC,0250,febuxostat 40 MG Tab 30 Each Bottle,12.3,6.77,3.69,10.64,38
RC,0250,febuxostat 80 MG Tab 30 Each Bottle,12.3,6.77,3.69,10.64,38
RC,0250,felbamate 200 mg half tablet Tab 0.5 tablet Package,47.67,26.22,14.3,41.23,38
RC,0250,felbamate 300 mg half tablet Tab 0.5 tablet Package,53.76,29.57,16.13,46.5,38
RC,0250,felbamate 400 MG Tab 100 Each Bottle,11.19,6.16,3.36,9.68,38
RC,0250,felbamate 600 MG Tab 100 Each Bottle,12.43,6.84,3.73,10.75,38
RC,0250,felbamate 600 MG/5ML Suspension 237 mL Bottle,1542.05,848.13,462.62,1333.87,38
RC,0250,felodipine 10 MG Tablet Extended Release 24 Hour 100 Each Bottle,8.8,4.84,2.64,7.61,38
RC,0250,felodipine 2.5 MG Tablet Extended Release 24 Hour 100 Each Bottle,9.754999999999999,5.37,2.78,8.87,76
RC,0250,felodipine 5 MG Tablet Extended Release 24 Hour 100 Each Bottle,8.63,4.75,2.59,7.46,38
RC,0250,fenofibrate 160 MG Tab 90 Each Bottle,9.28,5.11,2.78,8.03,38
RC,0250,fenofibrate 54 MG Tab 90 Each Bottle,8.73,4.81,2.62,7.55,38
RC,0250,fentaNYL (10 mcg/mL) Solution 100 mL,494.0,271.7,148.2,427.31,38
RC,0250,fentaNYL 0.05 MG/ML Solution 2 mL Ampule,53.22,29.28,15.97,46.04,38
RC,0250,fentaNYL 10 mcg/mL Solution 100 mL Bag,420.0,231.0,126.0,363.3,38
RC,0250,fentaNYL 10 mcg/mL Solution 100 mL Flex Cont,380.0,209.0,89.4,422.12,152
RC,0250,fentaNYL 10 mcg/mL Solution 250 mL Bag,314.0,172.7,94.2,271.61,38
RC,0250,fentaNYL 100 MCG Tab 28 Each Box,165.29,90.91,49.59,142.98,38
RC,0250,fentaNYL 100 mcg/hr/patch PATCH 72 HR 5 Each Box,63.12,34.72,18.94,54.6,38
RC,0250,fentaNYL 12 mcg/hr/patch PATCH 72 HR 1 Each Package,40.48,22.27,12.14,35.02,38
RC,0250,fentaNYL 12 mcg/hr/patch PATCH 72 HR 5 Each Box,40.48,22.27,12.14,35.02,76
RC,0250,fentaNYL 200 MCG LOLLIPOP 30 Each Box,349.97,192.49,104.99,302.72,38
RC,0250,fentaNYL 25 mcg/hr PATCH 72 HR 1 Each Package,23.97,13.19,7.19,20.73,38
RC,0250,fentaNYL 25 mcg/hr PATCH 72 HR 5 Each Box,23.97,13.19,7.19,20.73,38
RC,0250,fentaNYL 50 mcg/hr/patch PATCH 72 HR 1 Each Package,33.33,18.34,10.0,28.83,38
RC,0250,fentaNYL 50 mcg/hr/patch PATCH 72 HR 5 Each Box,33.33,18.34,10.0,28.83,76
RC,0250,fentaNYL 50 mcg/mL Solution 30 mL Syringe,259.2,142.56,70.5,245.14,76
RC,0250,fentaNYL 75 mcg/hr PATCH 72 HR 1 Each Package,48.04,26.43,14.41,41.55,38
RC,0250,fentaNYL/vecuronium/atropine 25-250-25 mcg/mL Injection 2 mL Syringe,202.4,111.32,60.72,175.08,38
RC,0250,ferric subsulfate 259 MG/GM Solution 8 g Bottle,56.1,30.86,16.83,48.53,38
RC,0250,ferric subsulfate Solution 8 mL Bottle,20.0,11.0,6.0,17.3,38
RC,0250,ferrous gluconate 324 (38 Fe) MG Tab 100 Each Bottle,4.22,2.33,1.27,3.65,38
RC,0250,ferrous sulfate 220 (44 Fe) MG/5ML Solution 473 mL Bottle,31.41,17.28,9.42,27.17,38
RC,0250,ferrous sulfate 220 (44 Fe) MG/5ML Solution 7.4 mL Oral Syringe,8.37,4.61,2.51,7.24,38
RC,0250,ferrous sulfate 325 (65 Fe) MG Tablet Delayed Response 100 Each Box,4.05,2.23,1.22,3.5,38
RC,0250,ferrous sulfate 75 (15 Fe) MG/ML Solution 50 mL Bottle,16.75,9.22,5.03,14.49,38
RC,0250,fidaxomicin 200 MG Tab 20 Each Bottle,629.6,346.28,188.88,544.6,38
RC,0250,finasteride 5 MG Tab 1 Each Blister,9.7,5.34,2.91,8.39,38
RC,0250,fish oil 1000 MG Cap 90 Each Bottle,4.33,2.39,1.3,3.75,38
RC,0250,flanders buttocks Ointment 113 g Tube,41.75,22.97,12.53,36.11,38
RC,0250,flavoxATE 100 MG Tab 100 Each Bottle,10.32,5.68,3.1,8.93,38
RC,0250,flecainide 100 MG Tab 100 Each Bottle,9.81,5.4,2.94,8.49,38
RC,0250,flecainide 25 mg half tablet Tab 0.5 tablet Package,7.86,4.33,2.36,6.8,38
RC,0250,flecainide 50 MG Tab 60 Each Bottle,8.72,4.8,2.62,7.54,38
RC,0250,fluPHENAZine 5 MG Tab 100 Each Bottle,11.35,6.25,3.41,9.82,38
RC,0250,fluPHENAZine 5 MG/ML Conc 120 mL Bottle,948.4,521.62,284.52,820.37,38
RC,0250,fluconazole 100 MG Tab 1 Each Blister,12.61,6.94,3.78,10.91,38
RC,0250,fluconazole 200 MG Tab 1 Each Blister,15.08,8.3,4.52,13.04,38
RC,0250,fluconazole 200 MG Tab 100 Each Box,15.08,8.3,4.52,13.04,38
RC,0250,fluconazole 40 MG/ML Recon Susp 35 mL Bottle,127.02,69.87,38.11,109.87,38
RC,0250,fluconazole 50 MG Tab 30 Each Bottle,10.36,5.7,3.11,8.96,38
RC,0250,flucytosine 50 mg/mL Suspension 100 mL Bottle,9265.0,5095.75,2779.5,8014.23,38
RC,0250,flucytosine 500 MG Cap 100 Each Bottle,60.0,33.0,18.0,51.9,38
RC,0250,fludrocortisone 100 mcg Tab 1 Each Blister,9.52,5.24,2.86,8.23,38
RC,0250,fludrocortisone 50 mcg half tablet Tab 0.5 tablet Package,8.65,4.76,2.6,7.48,38
RC,0250,flumazenil 0.5 MG/5ML Solution 5 mL Vial,70.5,38.78,21.15,60.98,38
RC,0250,fluorescein 0.6 MG Strip 300 Each Box,20.42,11.24,6.13,17.66,38
RC,0250,fluorescein 1 MG Strip 100 Each Box,20.74,11.41,6.22,17.94,38
RC,0250,fluorescein 10 % Solution 0.2 mL Syringe,46.6,25.63,13.98,40.31,38
RC,0250,fluorescein 10 % Solution 5 mL Vial,447.0,245.85,134.1,386.66,38
RC,0250,fluorescein 2 % Solution 0.2 mL Syringe,52.84,29.07,15.85,45.71,38
RC,0250,fluorescein 2 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
RC,0250,fluorescein 2 % Solution 2 mL Bottle,38.92,21.41,11.68,33.67,38
RC,0250,fluorescein-benoxinate 0.25-0.4 % Solution 5 mL Bottle,132.0,72.6,39.6,114.18,38
RC,0250,fluorescein-benoxinate Solution 5 mL Bottle,87.465,48.11,12.88,114.18,114
RC,0250,fluorometholone 0.1 % Suspension 5 mL Bottle,266.68,146.68,80.0,230.68,38
RC,0250,fluorouracil 10 mg/2 mL Solution 1 Each Syringe,30.35,16.7,9.11,26.25,38
RC,0250,fluorouracil 5 % Cream 40 g Tube,349.62,192.3,104.89,302.42,38
RC,0250,flurbiprofen 0.03 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
RC,0250,flurbiprofen 0.03 % Solution 2.5 mL Bottle,146.0,80.3,43.8,126.29,38
RC,0250,"fluticasone furoate 100 mcg/act AEROSOL POWDER, BREATH ACTIVATED 14 Each Disp Pack",44.32,24.38,13.3,38.34,38
RC,0250,"fluticasone furoate 200 mcg/act AEROSOL POWDER, BREATH ACTIVATED 14 Each Disp Pack",52.56,28.91,15.77,45.46,38
RC,0250,"fluticasone furoate-vilanterol 100-25 mcg/act AEROSOL POWDER, BREATH ACTIVATED 28 Each Disp Pack",39.61,21.79,11.88,34.26,38
RC,0250,"fluticasone furoate-vilanterol 200-25 mcg/act AEROSOL POWDER, BREATH ACTIVATED 28 Each Disp Pack",39.61,21.79,11.88,34.26,38
RC,0250,fluticasone propionate 50 mcg/act Suspension 16 g Bottle,83.0,45.65,24.9,71.8,38
RC,0250,fluvoxaMINE 50 MG Tab 100 Each Bottle,8.8,4.84,2.64,7.61,38
RC,0250,folic acid 0.5 mg half tablet Tab 0.5 tablet Package,8.26,4.55,2.48,7.14,38
RC,0250,folic acid 1 MG Tab 1 Each Blister,8.57,4.72,2.57,7.41,38
RC,0250,formoterol 20 mcg/2 mL Nebu Soln 2 mL Packet,49.31,27.13,14.79,42.65,38
RC,0250,fosamprenavir calcium 700 MG Tab 60 Each Bottle,51.0,28.05,15.3,44.12,38
RC,0250,fosfomycin tromethamine 3 g Pack 1 Each Sachet,197.77,108.78,59.33,171.07,38
RC,0250,fosphenytoin 1000 mg PE/120 mL Kit 120 mL,131.37,72.26,39.41,113.64,38
RC,0250,furosemide 10 MG/ML Solution 120 mL Bottle,51.16,28.14,15.35,44.25,38
RC,0250,furosemide 10 mg half tablet Tab 0.5 tablet Package,8.06,4.44,2.42,6.97,38
RC,0250,furosemide 20 MG Tab 100 Each Box,8.24,4.54,2.47,7.13,38
RC,0250,furosemide 40 MG Tab 100 Each Bottle,8.14,4.48,2.44,7.04,38
RC,0250,furosemide 80 MG Tab 100 Each Bottle,8.25,4.54,2.48,7.14,38
RC,0250,furosemide 80 MG Tab 100 Each Box,8.4,4.62,2.52,7.27,38
RC,0250,furosemide Solution 10 mL Vial,62.5,34.38,18.75,54.06,38
RC,0250,gabapentin 100 MG Cap 100 Each Bottle,8.18,4.5,2.45,7.08,38
RC,0250,gabapentin 250 MG/5ML Solution 2 mL Oral Syringe,9.31,5.13,2.79,8.05,38
RC,0250,gabapentin 250 MG/5ML Solution 470 mL Bottle,315.1,173.31,94.53,272.56,38
RC,0250,gabapentin 250 MG/5ML Solution 6 mL Oral Syringe,22.93,12.62,6.88,19.83,38
RC,0250,gabapentin 250 MG/5ML Solution 8 mL Oral Syringe,13.23,7.28,3.97,11.44,38
RC,0250,gabapentin 300 MG Cap 1 Each Blister,8.46,4.66,2.54,7.32,38
RC,0250,gabapentin 300 MG Cap 100 Each Box,8.46,4.66,2.54,7.32,38
RC,0250,gabapentin 400 MG Cap 100 Each Box,8.64,4.76,2.59,7.47,38
RC,0250,galantamine 4 MG Tab 60 Each Bottle,8.97,4.94,2.69,7.76,38
RC,0250,galantamine 8 MG Tab 60 Each Bottle,10.47,5.76,3.14,9.06,38
RC,0250,ganciclovir 2 mg/0.05 ml Injection 1 Each Syringe,368.4,202.62,110.52,318.67,38
RC,0250,ganciclovir 2 mg/0.1 mL Solution 1 Each Syringe,368.4,202.62,110.52,318.67,38
RC,0250,ganciclovir 3 mg/0.1 ml Injection 1 Each Syringe,368.4,202.62,110.52,318.67,38
RC,0250,gelatin adsorbable FILM 6 Each Box,753.85,414.62,226.16,652.08,38
RC,0250,gemfibrozil 300 mg half tablet Tab 0.5 tablet Package,8.83,4.86,2.65,7.64,38
RC,0250,gemfibrozil 600 MG Tab 60 Each Bottle,8.57,4.72,2.57,7.41,38
RC,0250,gentamicin (preservative free) 10 MG/ML Solution 2 mL Vial,68.19,37.51,20.46,58.98,38
RC,0250,gentamicin (preservative free) 10 mg/mL Solution 2 mL Vial,68.19,37.51,20.46,58.98,38
RC,0250,gentamicin (preservative free) neonatal 2 mg/mL Solution 30 mL Vial,570.3,313.67,171.09,493.31,38
RC,0250,gentamicin 0.1 % Ointment 15 g Tube,158.23,87.03,47.47,136.87,38
RC,0250,gentamicin 0.3 % Ointment 3.5 g Tube,88.85,48.87,26.66,76.86,38
RC,0250,gentamicin 0.3 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
RC,0250,gentamicin 0.3 % Solution 5 mL Bottle,37.5,20.63,11.25,32.44,38
RC,0250,gentamicin 1.4 % Solution 7 mL Bottle,125.98,69.29,37.79,108.97,38
RC,0250,gentamicin 1.5 % Solution 10 mL Bottle,97.51,53.64,29.25,84.35,38
RC,0250,gentamicin 100 mcg/0.1 mL Solution 0.1 mL Syringe,32.47,17.86,9.74,28.09,38
RC,0250,gentamicin 40 MG/ML Solution 2 mL Vial,52.09,28.65,15.63,45.06,38
RC,0250,gentamicin 80 mg in NS 30 ml ophthalmic soak syringe 30 mL Syringe,314.88,173.19,94.46,272.37,38
RC,0250,gentamicin 80 mg/100 mL Solution 100 mL Flex Cont,58.0,31.9,17.4,50.17,38
RC,0250,gentian violet 1 % Solution 59 mL Bottle,44.37,24.41,13.31,38.38,38
RC,0250,gilteritinib 40 MG Tab 90 Each Bottle,777.78,427.78,233.33,672.78,38
RC,0250,glimepiride 0.5 mg half tablet Tab 0.5 tablet Package,10.99,6.05,3.3,9.51,38
RC,0250,glimepiride 1 MG Tab 1 Each Blister,9.52,5.24,2.86,8.23,38
RC,0250,glimepiride 2 MG Tab 100 Each Bottle,8.62,4.75,2.59,7.46,38
RC,0250,glimepiride 4 MG Tab 100 Each Box,9.3,5.12,2.79,8.04,38
RC,0250,glipiZIDE 10 MG Tab 100 Each Bottle,8.26,4.55,2.48,7.14,38
RC,0250,glipiZIDE 2.5 mg half tablet Tab 0.5 tablet Package,9.16,5.04,2.75,7.92,38
RC,0250,glipiZIDE 5 MG Tab 1 Each Blister,9.04,4.98,2.71,7.82,38
RC,0250,glucose (tolerance test) 100 g Solution 1 Bottle Bottle,10.11,5.57,3.03,8.75,38
RC,0250,glucose (tolerance test) 50 g Solution 1 Bottle Bottle,10.11,5.57,3.03,8.75,38
RC,0250,glucose (tolerance test) 75 g Solution 1 Bottle Bottle,10.11,5.57,3.03,8.75,76
RC,0250,glucose 4 g Chew Tab 10 Each Tube,5.06,2.79,1.52,4.38,38
RC,0250,glucose 40 % Gel 1 mL Oral Syringe,8.11,4.47,2.43,7.02,38
RC,0250,glucose 40 % Gel 15 g Tube,9.67,5.32,2.9,8.36,38
RC,0250,glucose 77.4 % Gel 31 g Tube,33.02,18.17,9.91,28.56,38
RC,0250,glutamine (sickle cell) 5 g Pack 1 Each Packet,69.91,38.46,20.97,60.47,38
RC,0250,glycerin (adult) 2 g Suppos 12 Each Box,4.31,2.38,1.29,3.73,38
RC,0250,glycerin (pediatric) 1 g Suppos 12 Each Box,4.74,2.61,1.42,4.1,38
RC,0250,glycerin (rectal) Liquid 1 mL Syringe,4.22,2.33,1.27,3.65,38
RC,0250,glycerin 99% (sterile) Solution 10 mL Vial,470.4,258.72,141.12,406.9,38
RC,0250,glycerin 99.5% (sterile) Solution 10 mL Vial,405.0,222.75,121.5,350.33,38
RC,0250,glycerin 99.7% (sterile) Solution 15 mL Vial,7.24,3.99,2.17,6.26,38
RC,0250,glycerin Liquid 177 mL Bottle,38.02,20.92,11.41,32.89,38
RC,0250,glycerin Liquid 473 mL Bottle,106.17,58.4,31.85,91.84,38
RC,0250,glycine diluent Solution 50 mL Vial,114.25,62.84,34.28,98.83,38
RC,0250,glycopyrrolate 1 MG Tab 90 Each Bottle,8.44,4.65,2.53,7.3,38
RC,0250,guaiFENesin 100 MG/5ML Liquid 10 mL Cup,11.25,6.19,3.38,9.73,38
RC,0250,guaiFENesin 100 MG/5ML Liquid 15 mL Cup,12.17,6.7,3.65,10.53,38
RC,0250,guaiFENesin 100 MG/5ML Liquid 5 mL Cup,8.57,4.72,2.57,7.41,38
RC,0250,guaiFENesin 100 MG/5ML Liquid 5 mL Oral Syringe,8.57,4.72,2.57,7.41,38
RC,0250,guaiFENesin 600 MG TABLET SR 12 HR 1 Each Blister,9.51,5.24,2.85,8.23,38
RC,0250,guaiFENesin 600 MG TABLET SR 12 HR 100 Each Box,9.51,5.24,2.85,8.23,38
RC,0250,guaiFENesin/codeine 100-10 MG/5ML Solution 10 mL Oral Syringe,11.63,6.4,3.49,10.06,38
RC,0250,guaiFENesin/codeine 100-10 MG/5ML Solution 118 mL Bottle,36.85,20.27,11.06,31.88,38
RC,0250,guaiFENesin/codeine 100-10 MG/5ML Solution 5 mL Cup,17.59,9.68,5.28,15.22,38
RC,0250,guaiFENesin/dextromethorphan 100-10 MG/5ML Syrup 10 mL Cup,14.4,7.92,4.32,12.46,38
RC,0250,guaiFENesin/dextromethorphan 100-10 MG/5ML Syrup 237 mL Bottle,30.66,16.87,9.2,26.52,38
RC,0250,guaiFENesin/dextromethorphan 100-10 MG/5ML Syrup 5 mL Oral Syringe,5.37,2.96,1.61,4.65,38
RC,0250,guanFACINE 1 MG Tab 100 Each Bottle,9.65,5.31,2.9,8.35,38
RC,0250,haloperidol 0.5 MG Tab 100 Each Bottle,8.86,4.88,2.66,7.66,38
RC,0250,haloperidol 1 MG Tab 100 Each Bottle,9.22,5.08,2.77,7.98,38
RC,0250,haloperidol 2 MG Tab 1 Each Blister,8.68,4.78,2.6,7.51,38
RC,0250,haloperidol 5 MG Tab 100 Each Bottle,9.46,5.21,2.84,8.18,38
RC,0250,haloperidol lactate 2 MG/ML Conc 120 mL Bottle,99.08,54.5,29.72,85.7,38
RC,0250,heparin (porcine) lock flush 10 units/mL 3 mL Solution 3 mL Syringe,34.8,19.14,10.44,30.1,38
RC,0250,heparin (porcine) lock flush 100 UNIT/ML Solution 5 mL Syringe,38.0,20.9,11.4,32.87,38
RC,0250,"heparin 10,000 units (20 units/mL) in NaCl 0.9% 500 mL 20 units/mL Solution 500 mL Flex Cont",95.88,52.74,28.76,82.94,38
RC,0250,heparin 1000 unit/mL Solution 30 mL Vial,74.98,41.24,22.49,64.86,38
RC,0250,heparin 1000 units/mL Solution 1 mL Syringe,31.9,17.55,9.57,27.59,38
RC,0250,"heparin 25,000 units in dextrose 5 % 500 mL 50 Solution 500 mL Flex Cont",156.0,85.8,46.8,134.94,38
RC,0250,"heparin 5,000 units (10 units/mL) in NaCl 0.9% 500 mL 10 units/mL Solution 500 mL Flex Cont",95.88,52.74,28.76,82.94,76
RC,0250,"heparin 5,000 units in NS 1000 mL 5 units/mL Solution 1,000 mL Bag",160.04,88.03,48.01,138.43,38
RC,0250,heparin DIALYSIS 1000 unit/ml Solution 10 mL Vial,75.89,41.74,22.77,65.64,38
RC,0250,heparin DIALYSIS 1000 unit/ml Solution 8 mL Syringe,65.71,36.15,19.71,56.84,38
RC,0250,hepatitis B immune globulin 110 UNIT/0.5ML Solution Prefilled Syringe 0.5 mL Syringe,545.7,300.14,163.71,472.03,38
RC,0250,hetastarch 6% in 0.9% NaCl 6-0.9 % Solution 500 mL Plas Cont,236.88,130.29,71.06,204.9,38
RC,0250,homatropine 5 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
RC,0250,homatropine 5 % Solution 5 mL Bottle,149.33,82.14,44.8,129.17,38
RC,0250,hydrALAZINE 10 MG Tab 1 Each Blister,8.76,4.82,2.63,7.58,38
RC,0250,hydrALAZINE 100 MG Tab 100 Each Bottle,8.47,4.66,2.54,7.33,38
RC,0250,hydrALAZINE 12.5 mg half tablet Tab 0.5 tablet Package,8.25,4.54,2.48,7.14,38
RC,0250,hydrALAZINE 25 MG Tab 1 Each Blister,8.79,4.84,2.64,7.6,38
RC,0250,hydrALAZINE 5 mg half tablet Tab 0.5 tablet Package,8.53,4.7,2.56,7.38,38
RC,0250,hydrALAZINE 50 MG Tab 1 Each Blister,9.02,4.97,2.71,7.8,38
RC,0250,hydrALAZINE Solution 1 mcg Oral Syringe,8.0,4.4,2.4,6.92,38
RC,0250,hydrOXYzine HCl 10 MG Tab 100 Each Bottle,8.2,4.51,2.46,7.09,38
RC,0250,hydrOXYzine HCl 10 MG Tab 500 Each Bottle,8.2,4.51,2.46,7.09,38
RC,0250,hydrOXYzine HCl 25 MG Tab 100 Each Box,9.04,4.98,2.71,7.82,38
RC,0250,hydrOXYzine HCl 50 MG Tab 100 Each Bottle,9.24,5.09,2.77,7.99,38
RC,0250,hydrOXYzine HCl 50 MG Tab 100 Each Box,9.25,5.09,2.78,8.0,38
RC,0250,hydroCHLOROthiazide 12.5 MG Tab 100 Each Bottle,8.92,4.91,2.68,7.72,38
RC,0250,hydroCHLOROthiazide 25 MG Tab 1 Each Blister,8.69,4.78,2.61,7.52,38
RC,0250,hydroCHLOROthiazide 50 MG Tab 100 Each Bottle,8.22,4.53,2.47,7.11,38
RC,0250,hydrochloric acid 37 % Liquid 500 mL Bottle,172.25,94.74,51.68,149.0,38
RC,0250,hydrocodone/acetaminophen 2.5-162.5 (half-tablet) Tab 0.5 tablet Package,10.4,5.72,3.12,9.0,38
RC,0250,hydrocodone/chlorpheniramine 10-8 MG/5ML Suspension Extended Release 10 mL Plas Cont,25.82,14.21,7.75,22.33,38
RC,0250,hydrocodone/chlorpheniramine 10-8 MG/5ML Suspension Extended Release 2.5 mL Plas Cont,12.82,7.06,3.85,11.09,38
RC,0250,hydrocodone/chlorpheniramine 10-8 MG/5ML Suspension Extended Release 5 mL Plas Cont,17.91,9.86,5.37,15.49,38
RC,0250,hydrocodone/homatropine 5-1.5 mg/5 mL Solution 10 mL Plas Cont,15.52,8.54,4.66,13.42,38
RC,0250,hydrocodone/homatropine 5-1.5 mg/5 mL Solution 473 mL Bottle,239.01,131.46,71.7,206.74,38
RC,0250,hydrocodone/homatropine 5-1.5 mg/5 mL Solution 5 mL Plas Cont,11.76,6.47,3.53,10.17,38
RC,0250,hydrocortisone 1 % Cream 30 g Tube,27.35,15.05,8.21,23.66,38
RC,0250,hydrocortisone 1 % Lotion 120 mL Bottle,38.06,20.94,11.42,32.92,38
RC,0250,hydrocortisone 1 % Ointment 28 g Tube,27.35,15.05,8.21,23.66,38
RC,0250,hydrocortisone 10 MG Tab 100 Each Bottle,8.94,4.92,2.68,7.73,38
RC,0250,hydrocortisone 100 MG/60ML Enema 60 mL Bottle,78.69,43.28,23.61,68.07,38
RC,0250,hydrocortisone 2.5 % Cream 28.35 g Tube,30.12,16.57,9.04,26.05,38
RC,0250,hydrocortisone 2.5 % Ointment 28.35 g Tube,31.51,17.34,9.45,27.26,38
RC,0250,hydrocortisone 2.5 % Ointment 454 g Jar,142.35,78.3,42.71,123.13,38
RC,0250,hydrocortisone 2.5 mg half tablet Tab 0.5 tablet Package,8.57,4.72,2.57,7.41,38
RC,0250,hydrocortisone 20 MG Tab 100 Each Bottle,8.54,4.7,2.56,7.39,38
RC,0250,hydrocortisone 25 MG Suppos 24 Each Box,35.49,19.52,10.65,30.7,38
RC,0250,hydrocortisone 5 MG Tab 50 Each Bottle,8.57,4.72,2.57,7.41,38
RC,0250,hydrocortisone acetate rectal 2.5 % Cream 30 g Tube,240.23,132.13,72.07,207.8,38
RC,0250,hydrocortisone acetate/pramoxine 1-1 % Cream 30 g Tube,409.29,225.11,122.79,354.04,38
RC,0250,hydrocortisone sodium succinate PF 500 mg Recon Soln 1 Each Vial,539.64,296.81,161.89,466.79,38
RC,0250,hydroxychloroquine 100 mg half tablet Tab 0.5 tablet Package,18.76,10.32,5.63,16.23,38
RC,0250,hydroxychloroquine 200 MG Tab 100 Each Bottle,9.06,4.99,2.72,7.84,38
RC,0250,hydroxychloroquine 25 mg/mL Liquid 480 mL Bottle,351.73,193.46,105.52,304.25,38
RC,0250,hydroxychloroquine 25 mg/mL Liquid 8 mL Oral Syringe,13.73,7.56,4.12,11.88,38
RC,0250,hydroxyurea 100 mg/mL Suspension 500 mL Bottle,364.66,200.57,109.4,315.43,38
RC,0250,hydroxyurea 500 MG Cap 1 Each Blister,9.76,5.37,2.93,8.44,38
RC,0250,hyoscyamine 0.125 MG SL Tab 100 Each Bottle,9.49,5.22,2.85,8.21,38
RC,0250,hyoscyamine sulfate 0.375 MG TABLET SR 12 HR 100 Each Bottle,8.99,4.95,2.7,7.78,38
RC,0250,hypochlorous acid 0.024 % Solution 500 mL Bottle,119.96,65.98,35.99,103.77,38
RC,0250,hypromellose 0.3 % Gel 10 g Tube,45.03,24.77,13.51,38.95,38
RC,0250,hypromellose 2.5 % Solution 15 mL Bottle,87.78,48.28,26.33,75.93,38
RC,0250,i-vite Tab 120 Each Bottle,4.32,2.38,1.3,3.74,38
RC,0250,ibuprofen 100 MG/5ML Suspension 20 mL Oral Syringe,12.42,6.84,3.73,10.74,38
RC,0250,ibuprofen 100 MG/5ML Suspension 30 mL Cup,14.63,8.05,4.39,12.65,38
RC,0250,ibuprofen 100 MG/5ML Suspension 40 mL Cup,16.84,9.27,5.05,14.57,38
RC,0250,ibuprofen 100 MG/5ML Suspension 473 mL Bottle,90.73,49.91,27.22,78.48,38
RC,0250,ibuprofen 200 MG Tab 100 Each Bottle,4.08,2.25,1.22,3.53,38
RC,0250,ibuprofen 200 MG Tab 100 Each Box,4.3,2.37,1.29,3.72,38
RC,0250,ibuprofen 400 MG Tab 1 Each Blister,8.41,4.63,2.52,7.27,38
RC,0250,ibuprofen 400 MG Tab 100 Each Bottle,8.26,4.55,2.48,7.14,38
RC,0250,ibuprofen 600 MG Tab 1 Each Blister,8.63,4.75,2.59,7.46,38
RC,0250,ibuprofen 600 MG Tab 100 Each Bottle,8.36,4.6,2.51,7.23,38
RC,0250,ibuprofen 800 MG Tab 100 Each Bottle,8.51,4.69,2.55,7.36,38
RC,0250,ibuprofen 800 MG Tab 100 Each Box,8.25,4.54,2.48,7.14,38
RC,0250,imatinib 100 MG Tab 90 Each Bottle,11.92,6.56,3.58,10.31,38
RC,0250,imatinib 400 MG Tab 30 Each Bottle,20.12,11.07,6.04,17.4,38
RC,0250,imipramine 25 MG Tab 100 Each Bottle,8.79,4.84,2.64,7.6,38
RC,0250,imipramine 50 MG Tab 100 Each Bottle,9.02,4.97,2.71,7.8,38
RC,0250,indapamide 1.25 mg half tablet Tab 0.5 tablet Package,11.98,6.59,3.59,10.36,38
RC,0250,indapamide 2.5 MG Tab 100 Each Bottle,8.66,4.77,2.6,7.49,38
RC,0250,indocyanine green 25 MG Recon Soln 1 Each Vial,1115.25,613.39,334.58,964.69,38
RC,0250,indomethacin 25 MG Cap 1 Each Blister,9.19,5.06,2.76,7.95,38
RC,0250,indomethacin 50 MG Cap 50 Each Box,9.08,5.0,2.72,7.85,38
RC,0250,indomethacin 50 MG Suppos 30 Each Box,830.14,456.58,249.04,718.07,38
RC,0250,indomethacin 75 MG Cap CR 1 Each Blister,14.2,7.81,4.26,12.28,38
RC,0250,insulin NPH 100 UNIT/ML Suspension Pen-injector 3 mL Pen,105.32,57.93,31.6,91.1,38
RC,0250,insulin REGULAR 100 units/100 mL Solution 100 mL Bag,106.45,58.55,31.94,92.08,38
RC,0250,insulin glargine 100 UNIT/ML Solution Pen-injector 3 mL Pen,75.63,41.6,22.69,65.42,38
RC,0250,insulin isophane & regular 70/30 - sliding scale 100 (70-30) UNIT/ML Suspension Pen-injector 3 mL Pen,105.33,57.94,31.6,91.11,38
RC,0250,insulin isophane & regular 70/30 Suspension Pen-injector 3 mL Pen,105.33,57.94,31.6,91.11,38
RC,0250,insulin lispro human 100 UNIT/ML Solution Pen-injector 3 mL Pen,117.01,64.36,35.1,101.21,38
RC,0250,insulin regular - sliding scale 100 U/ML Solution 3 mL Vial,56.15,30.89,16.85,48.57,38
RC,0250,insulin regular 1 unit/mL Solution 5 mL Syringe,76.0,41.8,22.8,65.74,38
RC,0250,insulin regular 100 UNITS/ML Solution 3 mL Vial,56.15,30.89,16.85,48.57,38
RC,0250,insulin regular 100 units/mL Solution 3 mL Vial,56.15,30.89,16.85,48.57,38
RC,0250,insulin regular 100 units/mL Solution Pen-injector 3 mL Pen,72.12,39.67,21.64,62.38,38
RC,0250,insulin regular human U-500 HIGH CONC 500 units/mL Solution Pen-injector 3 mL Pen,959.43,527.69,287.83,829.91,38
RC,0250,iodine strong 5 % Solution 14 mL Bottle,132.9,73.1,39.87,114.96,76
RC,0250,iodine strong 5 % Solution 473 mL Bottle,233.29,128.31,69.99,201.8,38
RC,0250,iodine/sodium iodide 2 % Tincture 30 mL Bottle,32.18,17.7,9.65,27.84,38
RC,0250,iodine/sodium iodide 2 % Tincture 473 mL Bottle,122.64,67.46,36.79,106.08,38
RC,0250,iohexol 9 mg/mL Solution 500 mL Bottle,40.0,22.0,12.0,34.6,38
RC,0250,ipratropium 0.02 % Solution 2.5 mL Plas Cont,9.19,5.06,2.76,7.95,38
RC,0250,ipratropium 0.02 % Solution 2.5 mL Vial,8.92,4.91,2.68,7.72,38
RC,0250,ipratropium 0.03 % Solution 30 mL Bottle,146.0,80.3,43.8,126.29,38
RC,0250,ipratropium 0.06 % Solution 15 mL Bottle,146.0,80.3,43.8,126.29,38
RC,0250,ipratropium/albuterol 0.5-2.5 (3) MG/3ML Solution 3 mL Plas Cont,10.15,5.59,3.05,8.78,38
RC,0250,iron polysaccharides 150 MG Cap 100 Each Box,8.42,4.64,2.53,7.28,38
RC,0250,iron sucrose Solution 100 mg,425.64,234.11,127.69,368.18,38
RC,0250,isoniazid 100 MG Tab 100 Each Bottle,8.39,4.62,2.52,7.26,38
RC,0250,isoniazid 100 MG/ML Solution 10 mL Vial,1726.04,949.33,517.81,1493.02,38
RC,0250,isoniazid 300 MG Tab 100 Each Bottle,8.82,4.86,2.65,7.63,38
RC,0250,isoproterenol 0.2 MG/ML Solution 5 mL Vial,771.0,424.05,231.3,666.92,38
RC,0250,isosorbide dinitrate 10 MG Tab 100 Each Box,9.79,5.39,2.94,8.47,38
RC,0250,isosorbide dinitrate 20 MG Tab 100 Each Box,9.73,5.36,2.92,8.42,38
RC,0250,isosorbide dinitrate 40 MG Tab 100 Each Bottle,42.06,23.14,12.62,36.38,38
RC,0250,isosorbide dinitrate 5 MG Tab 100 Each Bottle,9.36,5.15,2.81,8.1,38
RC,0250,isosorbide mononitrate 30 MG Tablet Extended Release 24 Hour 1 Each Blister,8.58,4.72,2.57,7.42,38
RC,0250,isosorbide mononitrate 30 MG Tablet Extended Release 24 Hour 100 Each Box,9.25,5.09,2.78,8.0,38
RC,0250,isosorbide mononitrate 60 MG Tablet Extended Release 24 Hour 1 Each Blister,9.37,5.16,2.81,8.11,38
RC,0250,isosorbide mononitrate CR 15 mg half tablet Tablet Extended Release 24 Hour 0.5 tablet Package,8.94,4.92,2.68,7.73,38
RC,0250,itraconazole 10 MG/ML Solution 150 mL Bottle,757.15,416.44,227.15,654.93,38
RC,0250,itraconazole 10 MG/ML Solution 20 mL Oral Syringe,146.86,80.78,44.06,127.03,38
RC,0250,itraconazole 100 MG Cap 30 Each Bottle,12.0,6.6,3.6,10.38,38
RC,0250,ivabradine 2.5 mg half tablet Tab 0.5 tablet Package,20.08,11.05,6.02,17.37,38
RC,0250,ivabradine 5 MG Tab 60 Each Bottle,14.25,7.84,4.28,12.33,38
RC,0250,ketamine 10 MG/ML Solution 20 mL Vial,213.0,117.15,63.9,184.25,38
RC,0250,ketamine 10 mg/1 mL Solution 1 mL Oral Syringe,13.13,7.23,3.94,11.36,38
RC,0250,ketamine 10 mg/mL *STOCK SUPPLY* Solution 25 mL Bottle,96.31,52.98,28.89,83.31,38
RC,0250,ketamine 100 mg in NaCl 0.9 % 50 mL 100 MG/50 ML Solution 50 mL,122.4,67.32,34.5,112.28,76
RC,0250,ketamine 1000 mg in NaCl 100 mL 1000 MG/100 ML Solution 100 mL Flex Cont,398.5,219.175,113.7,361.57,76
RC,0250,ketamine 20 mg/2 mL Solution 2 mL Oral Syringe,18.8,10.34,5.64,16.26,38
RC,0250,ketamine 30 mg/3 mL Solution 3 mL Oral Syringe,21.39,11.77,6.42,18.5,38
RC,0250,ketamine 50 MG/ML Solution 10 mL Vial,84.0,46.2,25.2,72.66,38
RC,0250,ketamine 50 mg/10 ml 50 mg/10 mL Injection 1 mL Syringe,51.62,28.4,15.49,44.65,38
RC,0250,ketamine 50 mg/5 mL Solution Prefilled Syringe 5 mL Syringe,99.3,54.62,29.79,85.89,38
RC,0250,ketoconazole 2 % Cream 60 g Tube,151.25,83.19,45.38,130.83,38
RC,0250,ketoconazole 200 MG Tab 100 Each Bottle,13.65,7.51,4.1,11.81,38
RC,0250,ketorolac 0.5 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
RC,0250,ketorolac 0.5 % Solution 5 mL Bottle,125.105,68.81,35.4,114.36,76
RC,0250,ketorolac 10 MG Tab 100 Each Bottle,12.44,6.85,3.73,10.76,38
RC,0250,ketotifen fumarate 0.035 % Solution 5 mL Bottle,53.95,29.675,15.24,49.39,76
RC,0250,labetalol 100 MG Tab 100 Each Bottle,8.66,4.77,2.6,7.49,38
RC,0250,labetalol 150 mg half tablet Tab 0.5 tablet Package,8.12,4.47,2.44,7.02,38
RC,0250,labetalol 200 MG Tab 1 Each Blister,8.75,4.82,2.63,7.57,38
RC,0250,labetalol 300 MG Tab 100 Each Bottle,9.24,5.09,2.77,7.99,38
RC,0250,labetalol 50 mg half tablet Tab 0.5 tablet Package,8.66,4.77,2.6,7.49,38
RC,0250,lacosamide 10 MG/ML Solution 200 mL Bottle,233.0,128.15,69.9,201.55,38
RC,0250,lacosamide 100 MG Tab 60 Each Bottle,28.125,15.475000000000001,3.15,39.57,76
RC,0250,lacosamide 150 MG Tab 60 Each Bottle,29.345,16.145,3.21,41.5,76
RC,0250,lacosamide 200 MG Tab 60 Each Bottle,29.46,16.21,3.28,41.51,76
RC,0250,lacosamide 50 MG Tab 60 Each Bottle,21.205,11.665,3.08,27.8,76
RC,0250,lactase 3000 units Tab 1 Each Blister,4.93,2.72,1.48,4.26,38
RC,0250,"lactated ringers (bottle) Solution 1,000 mL Plas Cont",111.0,61.05,33.3,96.02,38
RC,0250,lactose hydrous Powder 454 g Bottle,187.63,103.2,56.29,162.3,38
RC,0250,lactulose 10 GM/15ML Solution 15 mL Cup,12.8,7.04,3.84,11.07,38
RC,0250,lactulose 10 GM/15ML Solution 30 mL Cup,14.53,8.0,4.36,12.57,38
RC,0250,lactulose 10 GM/15ML Solution 45 mL Cup,19.43,10.69,5.83,16.81,38
RC,0250,lactulose 10 GM/15ML Solution 473 mL Bottle,73.56,40.46,22.07,63.63,38
RC,0250,lactulose 10 g/15 mL Solution 15 mL Cup,12.8,7.04,3.84,11.07,38
RC,0250,lactulose 20 g/30 mL Solution 30 mL Cup,14.53,8.0,4.36,12.57,38
RC,0250,"lactulose 200 g/1000 mL Enema 1,000 mL Bottle",75.65,41.61,22.7,65.44,38
RC,0250,lamiVUDine 10 MG/ML Solution 240 mL Bottle,282.03,155.12,84.61,243.96,38
RC,0250,lamiVUDine 100 MG Tab 60 Each Bottle,37.64,20.71,11.29,32.56,38
RC,0250,lamiVUDine 150 MG Tab 60 Each Bottle,9.5,5.23,2.85,8.22,38
RC,0250,lamiVUDine 50 mg half tablet Tab 0.5 tablet Package,27.95,15.38,8.39,24.18,38
RC,0250,lamiVUDine/zidovudine 150-300 mg Tab 60 Each Bottle,13.68,7.53,4.1,11.83,38
RC,0250,lamoTRIgine 100 MG Tab 100 Each Bottle,8.24,4.54,2.47,7.13,38
RC,0250,lamoTRIgine 100 mg/6 mL Suspension 6 mL Bottle,41.27,22.7,12.38,35.7,38
RC,0250,lamoTRIgine 12.5 mg half tablet Tab 0.5 tablet Package,35.0,19.25,10.5,30.28,38
RC,0250,lamoTRIgine 150 MG Tab 60 Each Bottle,8.315,4.574999999999999,2.49,7.21,76
RC,0250,lamoTRIgine 200 MG Tab 60 Each Bottle,8.91,4.91,2.67,7.71,38
RC,0250,lamoTRIgine 25 MG Tab 100 Each Bottle,8.2,4.51,2.46,7.09,38
RC,0250,lanolin Cream 0.3 oz Box,20.23,11.13,6.07,17.5,38
RC,0250,lanthanum carbonate 1000 MG Chew Tab 10 Each Bottle,21.0,11.55,6.3,18.17,76
RC,0250,lanthanum carbonate 500 MG Chew Tab 45 Each Bottle,21.0,11.55,6.3,18.17,38
RC,0250,lanthanum carbonate 750 MG Chew Tab 15 Each Bottle,21.0,11.55,6.3,18.17,38
RC,0250,latanoprost 0.005 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
RC,0250,latanoprost 0.005 % Solution 2.5 mL Bottle,28.75,15.82,8.63,24.87,38
RC,0250,leflunomide 10 MG Tab 30 Each Bottle,10.28,5.66,3.08,8.89,38
RC,0250,leflunomide 20 MG Tab 30 Each Bottle,10.28,5.66,3.08,8.89,38
RC,0250,letermovir 480 MG Tab 1 Each Blister,663.54,364.95,199.06,573.96,38
RC,0250,letermovir 480 MG/24ML Solution 24 mL Vial,2063.98,1135.19,619.19,1785.34,38
RC,0250,letrozole 2.5 MG Tab 1 Each Blister,8.68,4.78,2.6,7.51,38
RC,0250,leucovorin 10 MG Tab 12 Each Bottle,22.82,12.56,6.85,19.74,38
RC,0250,leucovorin 15 MG Tab 24 Each Bottle,20.3,11.17,6.09,17.56,38
RC,0250,leucovorin 5 MG Tab 30 Each Bottle,10.35,5.7,3.11,8.95,38
RC,0250,levETIRAcetam 100 MG/ML Solution 2.5 mL Oral Syringe,21.64,11.91,6.49,18.72,38
RC,0250,levETIRAcetam 100 MG/ML Solution 473 mL Bottle,106.34,58.49,31.9,91.98,38
RC,0250,levETIRAcetam 100 MG/ML Solution 5 mL Oral Syringe,36.28,19.96,10.88,31.38,38
RC,0250,levETIRAcetam 100 MG/ML Solution 7.5 mL Oral Syringe,50.92,28.01,15.28,44.05,38
RC,0250,levETIRAcetam 1000 MG Tab 60 Each Bottle,8.97,4.94,2.69,7.76,38
RC,0250,levETIRAcetam 250 MG Tab 120 Each Bottle,8.89,4.89,2.67,7.69,38
RC,0250,levETIRAcetam 500 MG Tab 1 Each Blister,8.89,4.89,2.67,7.69,38
RC,0250,levETIRAcetam 750 MG Tab 1 Each Blister,9.29,5.11,2.79,8.04,38
RC,0250,levETIRAcetam 750 MG Tab 100 Each Box,9.29,5.11,2.79,8.04,38
RC,0250,levOCARNitine 1 GM/10ML Solution 118 mL Bottle,143.51,78.94,43.05,124.14,38
RC,0250,levOCARNitine 1 GM/10ML Solution 3.3 mL Oral Syringe,11.42,6.29,3.43,9.88,38
RC,0250,levOCARNitine 330 MG Tab 90 Each Box,9.63,5.3,2.89,8.33,38
RC,0250,levalbuterol hydrochloride 0.63 MG/3ML Nebu Soln 3 mL Plas Cont,11.8,6.49,3.54,10.21,38
RC,0250,levalbuterol hydrochloride 1.25 MG/3ML Nebu Soln 3 mL Box,11.8,6.49,3.54,10.21,38
RC,0250,levoFLOXacin 500 MG Tab 100 Each Bottle,9.27,5.1,2.78,8.02,38
RC,0250,levoFLOXacin 500 MG Tab 50 Each Bottle,9.25,5.09,2.78,8.0,38
RC,0250,levoFLOXacin 750 MG Tab 20 Each Bottle,9.18,5.05,2.75,7.94,38
RC,0250,levoFLOXacin Suspension 1 mg Package,25.32,13.93,7.6,21.9,38
RC,0250,levonorgestrel 1.5 MG Tab 1 Each Box,42.45,23.35,12.74,36.72,38
RC,0250,levonorgestrel 20 MCG/DAY IUD 1 Each Box,6574.0,3615.7,1972.2,5686.51,38
RC,0250,levothyroxine 100 MCG Tab 100 Each Box,8.81,4.85,2.64,7.62,38
RC,0250,levothyroxine 112 MCG Tab 1 Each Blister,9.04,4.98,2.71,7.82,38
RC,0250,levothyroxine 12.5 mcg half tablet Tab 0.5 tablet Package,7.81,4.3,2.34,6.76,38
RC,0250,levothyroxine 125 MCG Tab 100 Each Bottle,9.11,5.02,2.73,7.88,38
RC,0250,levothyroxine 150 MCG Tab 1 Each Blister,9.04,4.98,2.71,7.82,38
RC,0250,levothyroxine 200 MCG Tab 90 Each Bottle,11.97,6.59,3.59,10.35,38
RC,0250,levothyroxine 25 MCG Tab 100 Each Bottle,8.74,4.81,2.62,7.56,38
RC,0250,levothyroxine 50 MCG Tab 90 Each Bottle,8.48,4.67,2.54,7.34,38
RC,0250,levothyroxine 62.5 mcg Tab 0.5 tablet Package,11.97,6.59,3.59,10.35,38
RC,0250,levothyroxine 75 MCG Tab 1 Each Blister,8.76,4.82,2.63,7.58,38
RC,0250,levothyroxine 88 MCG Tab 100 Each Bottle,8.94,4.92,2.68,7.73,38
RC,0250,lidocaine (PF) 1 % Solution 10 mL Syringe,95.14,52.33,26.51,88.14,76
RC,0250,lidocaine (PF) 1 % Solution 2 mL Vial,42.7,23.49,12.81,36.94,38
RC,0250,lidocaine (PF) 1 % Solution 30 mL Vial,73.08500000000001,40.205,14.86,83.59,76
RC,0250,lidocaine (PF) 1 % Solution 5 mL Ampule,42.760000000000005,23.525,12.55,37.78,76
RC,0250,lidocaine (PF) 1 % Solution 5 mL Syringe,81.0,44.55,24.3,70.07,38
RC,0250,lidocaine (PF) 1 % Solution 5 mL Vial,48.965,26.935,13.04,47.13,76
RC,0250,lidocaine (PF) 2 % Solution 10 mL Ampule,73.51,40.44,22.05,63.59,38
RC,0250,lidocaine (PF) 2 % Solution 2 mL Vial,50.01,27.51,15.0,43.26,38
RC,0250,lidocaine (PF) 2 % Solution 5 mL Vial,51.93,28.57,15.58,44.92,38
RC,0250,lidocaine 1 % Solution 10 mL Vial,44.95,24.73,13.49,38.88,38
RC,0250,lidocaine 1 % Solution 20 mL Vial,49.675,27.325000000000003,14.66,43.68,76
RC,0250,lidocaine 1 % Solution 30 mL Vial,49.53,27.25,14.86,42.84,38
RC,0250,lidocaine 1 % Solution 5 mL Syringe,36.36,20.0,10.91,31.45,38
RC,0250,lidocaine 1 % Solution 50 mL Vial,64.9,35.7,19.47,56.14,38
RC,0250,lidocaine 1% (preservative free) 1 % (PF) Solution 30 mL Vial,49.53,27.25,14.86,42.84,38
RC,0250,"lidocaine 1% - EPINEPHrine 1:100,000 buffered in sod bicarbonate injection 1 %-1:100000 Solution Prefilled Syringe 10 mL Syringe",49.75,27.37,14.93,43.03,38
RC,0250,"lidocaine 1% - EPINEPHrine 1:100,000 buffered in sod bicarbonate injection 1 %-1:100000 Solution Prefilled Syringe 3 mL Syringe",100.48,55.27,30.14,86.92,38
RC,0250,lidocaine 1% buffered with 8.4% sod bicarbonate 1-8.4 % Solution Prefilled Syringe 10 mL Syringe,42.25,23.24,12.68,36.55,38
RC,0250,lidocaine 1.5 % Solution 20 mL Ampule,86.04,47.33,25.81,74.42,38
RC,0250,"lidocaine 1.5 % w/EPINEPHrine 1:200,000 (PF) 1.5%/1:200,000 Solution 30 mL Vial",140.32,77.18,42.1,121.38,38
RC,0250,lidocaine 10 MG/ML Solution Prefilled Syringe 5 mL Syringe,67.0,36.85,20.1,57.96,38
RC,0250,lidocaine 100 MG/5ML Solution Prefilled Syringe 5 mL Syringe,75.89,41.74,22.77,65.64,38
RC,0250,lidocaine 2 % Gel 10 mL Syringe,28.12,15.47,8.44,24.32,38
RC,0250,lidocaine 2 % Gel 30 mL Tube,362.59,199.43,108.78,313.64,38
RC,0250,lidocaine 2 % Gel 5 mL Tube,44.5,24.48,13.35,38.49,38
RC,0250,lidocaine 2 % Prefilled Syringe 20 mL Syringe,40.3,22.17,12.09,34.86,38
RC,0250,lidocaine 2 % Solution 20 mL Vial,53.8,29.59,16.14,46.54,38
RC,0250,lidocaine 2 % Solution 50 mL Vial,75.05,41.28,22.52,64.92,38
RC,0250,lidocaine 2 g in D5W 500 mL 4-5 mg/ml-% Solution 500 mL Flex Cont,100.5,55.28,30.15,86.93,38
RC,0250,lidocaine 2% (PF) 2 % Solution 10 mL Ampule,75.61,41.59,22.68,65.4,38
RC,0250,lidocaine 2% jelly plus double antibiotic ointment Ointment 120 mL Jar,212.34,116.79,63.7,183.67,38
RC,0250,lidocaine 2% jelly plus double antibiotic ointment Ointment 60 mL Jar,126.26,69.45,37.88,109.21,38
RC,0250,"lidocaine 2% w/EPINEPHrine 1:400,000 (PF) Solution 10 mL Vial",75.61,41.59,22.68,65.4,38
RC,0250,lidocaine 2% zinc oxide 12% in A&D ointment Ointment 270 g Jar,161.08,88.6,48.32,139.33,38
RC,0250,lidocaine 2% zinc oxide 12% in A&D ointment Ointment 30 g Jar,40.12,22.07,12.04,34.7,38
RC,0250,lidocaine 20 MG/ML Solution 5 mL Syringe,82.925,45.614999999999995,23.44,75.88,76
RC,0250,lidocaine 3.5 % Gel 1 mL Tube,101.77,55.98,30.53,88.03,38
RC,0250,lidocaine 4 % Cream 30 g Tube,61.69,33.93,18.51,53.36,76
RC,0250,lidocaine 4 % Patch 5 Each Box,10.76,5.92,3.23,9.31,38
RC,0250,lidocaine 4 % Solution 4 mL Bottle,196.2,107.91,58.86,169.71,38
RC,0250,lidocaine 5 % Ointment 50 g Jar,197.0,108.35,59.1,170.41,38
RC,0250,lidocaine HCl 4 % Solution 50 mL Bottle,190.01,104.51,57.0,164.36,38
RC,0250,"lidocaine MPF 2% & sodium bicarb 1 mEq/mL & EPINEPHrine 1:200,000 Solution 10 mL Syringe",73.51,40.44,22.05,63.59,38
RC,0250,lidocaine PF 0.5 % Solution 50 mL Vial,114.25,62.84,34.28,98.83,38
RC,0250,lidocaine PF 4 % Solution 5 mL Ampule,61.245,33.69,18.37,52.99,76
RC,0250,lidocaine hcl 4 % Solution 50 mL Bottle,160.0,88.0,48.0,138.4,38
RC,0250,lidocaine viscous 2 % Solution 100 mL Bottle,58.5,32.18,17.55,50.6,38
RC,0250,lidocaine viscous 2 % Solution 15 mL Cup,10.97,6.04,3.29,9.49,38
RC,0250,lidocaine viscous 2 % Solution 15 mL Oral Syringe,10.57,5.82,3.17,9.14,38
RC,0250,lidocaine-racepinephrine-tetracaine 3 Gel 3 mL Syringe,73.16,40.24,21.95,63.28,38
RC,0250,"lidocaine/EPINEPHrine (preservative free) 1.5%/1:200,000 Solution 10 mL Vial",90.98,50.04,27.29,78.7,38
RC,0250,"lidocaine/EPINEPHrine (preservative free) 1.5%/1:200,000 Solution 30 mL Vial",94.49,51.97,28.35,81.73,38
RC,0250,"lidocaine/EPINEPHrine (preservative free) 1.5%/1:200,000 Solution 5 mL Ampule",62.959999999999994,34.629999999999995,18.88,54.48,76
RC,0250,"lidocaine/EPINEPHrine 0.5%-1:200,000 Solution 50 mL Vial",89.05,48.98,26.72,77.03,38
RC,0250,"lidocaine/EPINEPHrine 1%-1:100,000 Solution 20 mL Vial",64.2,35.31,19.26,55.53,38
RC,0250,"lidocaine/EPINEPHrine 1%-1:100,000 Solution 30 mL Vial",93.71,51.55,28.11,81.06,38
RC,0250,"lidocaine/EPINEPHrine 1%-1:100,000 Solution 50 mL Vial",104.5,57.48,31.35,90.39,38
RC,0250,"lidocaine/EPINEPHrine 1%-1:200,000 Solution 10 mL Vial",91.76,50.47,27.53,79.37,38
RC,0250,"lidocaine/EPINEPHrine 2%-1:100,000 Solution 1.7 mL Cartridge",37.04,20.38,11.11,32.04,38
RC,0250,"lidocaine/EPINEPHrine 2%-1:100,000 Solution 20 mL Vial",64.76,35.62,19.43,56.02,38
RC,0250,"lidocaine/EPINEPHrine 2%/1:200,000 Solution 20 mL Vial",172.75,95.02,51.83,149.43,38
RC,0250,lidocaine/dexAMETHasone/tetracycline/nystatin Suspension 15 mL Oral Syringe,14.58,8.02,4.37,12.61,38
RC,0250,lidocaine/diphenhydrAMINE/alum & mag-simethicone 30 mL Solution 30 mL Cup,23.44,12.9,7.03,20.28,38
RC,0250,lidocaine/nystatin/al & mag hydroxide Suspension 240 mL Plas Cont,189.46,104.21,56.84,163.88,38
RC,0250,lidocaine/prilocaine 2.5-2.5 % Cream 5 g Tube,48.93,26.92,14.68,42.32,38
RC,0250,linaCLOtide 145 MCG Cap 30 Each Bottle,57.12,31.42,17.14,49.41,38
RC,0250,linaCLOtide 290 MCG Cap 30 Each Bottle,57.12,31.42,17.14,49.41,38
RC,0250,linaCLOtide 72 MCG Cap 30 Each Bottle,57.12,31.42,17.14,49.41,38
RC,0250,linezolid 300 mg half tablet Tab 0.5 tablet Package,413.16,227.24,123.95,357.38,38
RC,0250,linezolid 600 MG Tab 1 Each Blister,17.5,9.63,5.25,15.14,38
RC,0250,linezolid Solution 300 mL Syringe,116.9,64.3,35.07,101.12,38
RC,0250,liothyronine 25 MCG Tab 90 Each Bottle,9.64,5.31,2.89,8.34,38
RC,0250,liothyronine 5 MCG Tab 90 Each Bottle,9.04,4.98,2.71,7.82,38
RC,0250,liothyronine sodium 10 MCG/ML Solution 1 mL Vial,2181.75,1199.97,654.53,1887.21,38
RC,0250,lisinopril 1.25 mg half tablet Tab 0.5 tablet Package,8.12,4.47,2.44,7.02,38
RC,0250,lisinopril 10 MG Tab 1 Each Blister,8.41,4.63,2.52,7.27,38
RC,0250,lisinopril 2.5 MG Tab 500 Each Bottle,8.08,4.45,2.42,6.99,38
RC,0250,lisinopril 20 MG Tab 1 Each Blister,8.41,4.63,2.52,7.27,38
RC,0250,lisinopril 40 MG Tab 1 Each Blister,8.63,4.75,2.59,7.46,38
RC,0250,lisinopril 5 MG Tab 1 Each Blister,8.56,4.71,2.57,7.4,38
RC,0250,lithium 150 MG Cap 100 Each Box,8.5,4.68,2.55,7.35,38
RC,0250,lithium 300 MG Cap 1 Each Blister,8.97,4.94,2.69,7.76,38
RC,0250,lithium carbonate 300 MG Tab CR 100 Each Bottle,9.1,5.01,2.73,7.87,38
RC,0250,lithium carbonate 450 MG Tab CR 1 Each Blister,8.68,4.78,2.6,7.51,38
RC,0250,loperamide 1 MG/7.5ML Solution 120 mL Bottle,20.2,11.11,6.06,17.47,38
RC,0250,loperamide 1 MG/7.5ML Solution 15 mL Oral Syringe,5.89,3.24,1.77,5.09,38
RC,0250,loperamide 1 MG/7.5ML Solution 7.5 mL Oral Syringe,4.95,2.73,1.49,4.28,38
RC,0250,loperamide 2 MG Cap 100 Each Bottle,9.21,5.07,2.76,7.97,38
RC,0250,loperamide 2 MG Cap 100 Each Box,9.55,5.26,2.87,8.26,38
RC,0250,lopinavir/ritonavir 200-50 mg Tab 120 Each Bottle,25.91,14.26,7.77,22.41,38
RC,0250,lopinavir/ritonavir 400-100 mg/5 mL Solution 160 mL Bottle,1543.0,848.65,462.9,1334.7,38
RC,0250,loratadine 10 MG Tab 1 Each Blister,8.96,4.93,2.69,7.75,38
RC,0250,loratadine 5 mg half tablet Tab 0.5 tablet Package,8.19,4.51,2.46,7.08,38
RC,0250,losartan 100 MG Tab 90 Each Bottle,8.47,4.66,2.54,7.33,38
RC,0250,losartan 12.5 mg half tablet Tab 0.5 tablet Packet,10.23,5.63,3.07,8.85,38
RC,0250,losartan 25 MG Tab 1 Each Blister,8.54,4.7,2.56,7.39,38
RC,0250,losartan 50 MG Tab 90 Each Bottle,8.31,4.58,2.49,7.19,38
RC,0250,loteprednol etabonate 0.5 % Suspension 5 mL Bottle,814.9,448.2,195.34,846.55,76
RC,0250,loxapine 10 MG Cap 100 Each Bottle,9.16,5.04,2.75,7.92,38
RC,0250,loxapine 5 MG Cap 100 Each Bottle,8.64,4.76,2.59,7.47,38
RC,0250,lubiprostone 24 MCG Cap 60 Each Bottle,10.0,5.5,3.0,8.65,38
RC,0250,lubiprostone 8 MCG Cap 60 Each Bottle,10.0,5.5,3.0,8.65,38
RC,0250,lurasidone 120 MG Tab 30 Each Bottle,9.5,5.23,2.85,8.22,76
RC,0250,lurasidone 20 MG Tab 30 Each Bottle,9.0,4.95,2.7,7.79,38
RC,0250,lurasidone 40 MG Tab 30 Each Bottle,9.0,4.95,2.7,7.79,38
RC,0250,macitentan 10 MG Tab 15 Each Box,1041.4,572.77,312.42,900.81,38
RC,0250,mafenide 85 MG/GM Cream 56.7 g Tube,250.32,137.68,75.1,216.53,38
RC,0250,magnesium citrate Solution 296 mL Bottle,10.66,5.87,3.2,9.22,38
RC,0250,magnesium hydroxide 400 MG/5ML Suspension 30 mL Cup,5.62,3.1,1.69,4.86,38
RC,0250,magnesium hydroxide 400 MG/5ML Suspension 473 mL Bottle,18.9,10.4,5.67,16.35,38
RC,0250,magnesium oxide 200 mg half tablet Tab 0.5 tablet Package,4.16,2.29,1.25,3.6,38
RC,0250,magnesium oxide 400 mg Tab 1 Each Blister,4.47,2.46,1.34,3.87,38
RC,0250,magnesium plus protein (amino acid chelate) 133 MG Tab 100 Each Bottle,8.2,4.51,2.46,7.09,38
RC,0250,maraviroc 150 MG Tab 60 Each Bottle,37.5,20.63,11.25,32.44,38
RC,0250,maribavir 200 MG Tab 28 Each Bottle,554.58,305.02,166.37,479.71,38
RC,0250,meclizine 12.5 MG Tab 50 Each Box,4.68,2.58,1.4,4.05,38
RC,0250,meclizine 25 MG Tab 1 Each Blister,5.38,2.96,1.61,4.65,38
RC,0250,medroxyPROGESTERone 10 MG Tab 100 Each Bottle,8.87,4.88,2.66,7.67,76
RC,0250,medroxyPROGESTERone 2.5 MG Tab 100 Each Bottle,8.47,4.66,2.54,7.33,38
RC,0250,medroxyPROGESTERone 5 MG Tab 100 Each Bottle,8.71,4.8,2.61,7.53,38
RC,0250,megestrol 20 MG Tab 100 Each Bottle,9.19,5.06,2.76,7.95,38
RC,0250,megestrol 40 MG Tab 100 Each Bottle,9.09,5.0,2.73,7.86,38
RC,0250,megestrol 40 MG/ML Suspension 10 mL Cup,9.54,5.25,2.86,8.25,38
RC,0250,megestrol 40 MG/ML Suspension 20 mL Cup,38.43,21.14,11.53,33.24,38
RC,0250,megestrol 40 MG/ML Suspension 480 mL Bottle,245.6,135.08,73.68,212.44,38
RC,0250,melatonin 3 MG Tab 100 Each Bottle,8.09,4.45,2.43,7.0,38
RC,0250,melatonin 3 MG Tab 100 Each Box,8.47,4.66,2.54,7.33,38
RC,0250,meloxicam 7.5 MG Tab 1 Each Blister,8.56,4.71,2.57,7.4,38
RC,0250,melphalan flufenamide 0.5 mg/mL Recon Soln 1 Each Vial,38965.0,21430.75,11689.5,33704.73,38
RC,0250,memantine 10 MG Tab 1 Each Blister,9.0,4.95,2.7,7.79,38
RC,0250,memantine 5 MG Tab 1 Each Blister,9.58,5.27,2.87,8.29,38
RC,0250,memantine HCl 14 MG CAPSULE SR 24 HR 30 Each Bottle,11.0,6.05,3.3,9.52,38
RC,0250,memantine HCl 28 MG CAPSULE SR 24 HR 30 Each Bottle,11.0,6.05,3.3,9.52,38
RC,0250,memantine HCl 7 MG CAPSULE SR 24 HR 30 Each Bottle,11.0,6.05,3.3,9.52,38
RC,0250,menthol-methyl salicylate Cream 35.4 g Tube,29.29,16.11,8.79,25.34,38
RC,0250,menthol-methyl salicylate Cream 85 g Tube,30.715,16.9,9.04,27.08,76
RC,0250,menthol-zinc oxide 0.44-20.6 % Ointment 113 g Tube,31.47,17.31,9.44,27.22,38
RC,0250,"mepivacine 1.5% w/EPINEPHrine 1:400,000 Solution 30 mL Syringe",64.48,35.47,19.34,55.78,38
RC,0250,mercaptopurine 50 MG Tab 25 Each Bottle,16.51,9.09,4.95,14.28,38
RC,0250,mesalamine 1.2 g Tablet Delayed Response 120 Each Bottle,20.34,11.19,6.1,17.59,38
RC,0250,mesalamine 1000 MG Suppos 30 Each Box,21.23,11.68,6.37,18.36,38
RC,0250,mesalamine 250 MG Cap CR 240 Each Bottle,16.11,8.87,4.83,13.94,38
RC,0250,mesalamine 4 g Enema 60 mL Bottle,52.95,29.13,15.89,45.8,38
RC,0250,mesalamine 400 MG CAPSULE DELAYED RELEASE 180 Each Bottle,17.06,9.39,5.12,14.76,38
RC,0250,metOLazone 10 MG Tab 100 Each Bottle,9.7,5.34,2.91,8.39,38
RC,0250,metOLazone 2.5 MG Tab 100 Each Bottle,8.76,4.82,2.63,7.58,38
RC,0250,metOLazone 5 MG Tab 100 Each Bottle,13.15,7.24,3.95,11.37,38
RC,0250,methIMAzole 10 MG Tab 100 Each Bottle,8.73,4.81,2.62,7.55,38
RC,0250,methIMAzole 2.5 mg half tablet Tab 0.5 tablet Packet,8.4,4.62,2.52,7.27,38
RC,0250,methIMAzole 5 MG Tab 100 Each Bottle,8.79,4.84,2.64,7.6,38
RC,0250,methadone 10 MG Tab 100 Each Box,10.88,5.99,3.26,9.41,38
RC,0250,methadone 10 mg/1 mL Conc 1 mL Plas Cont,10.2,5.61,3.06,8.82,38
RC,0250,"methadone 10 mg/mL Conc 1,000 mL Bottle",205.0,112.75,61.5,177.33,38
RC,0250,methadone 100 mg/10 mL Conc 10 mL Plas Cont,11.95,6.58,3.59,10.34,38
RC,0250,methadone 2 mg/mL Solution 30 mL,497.22,273.48,149.17,430.1,38
RC,0250,methadone 2.5 mg half tablet Tab 0.5 tablet Package,10.39,5.72,3.12,8.99,38
RC,0250,methadone 5 MG Tab 1 Each Blister,11.0,6.05,3.3,9.52,38
RC,0250,methadone 50 mg/5 mL Conc 5 mL Plas Cont,10.85,5.97,3.26,9.39,38
RC,0250,methenamine hippurate 1 g Tab 100 Each Bottle,9.4,5.17,2.82,8.13,38
RC,0250,methocarbamol 250 mg half tablet Tab 0.5 tablet Package,8.24,4.54,2.47,7.13,38
RC,0250,methocarbamol 500 MG Tab 1 Each Blister,8.83,4.86,2.65,7.64,38
RC,0250,methocarbamol 500 MG Tab 100 Each Box,8.83,4.86,2.65,7.64,38
RC,0250,methocarbamol 750 MG Tab 100 Each Bottle,8.21,4.52,2.46,7.1,38
RC,0250,methohexital 10 mg/mL Solution 10 mL Syringe,165.02,90.77,49.51,142.74,38
RC,0250,methohexital Recon Soln 1 Each Vial,617.26,339.5,185.18,533.93,38
RC,0250,methotrexate 200mcg/0.05 mL Solution 0.05 mL Syringe,30.47,16.76,9.14,26.36,38
RC,0250,methotrexate 400mcg/0.1 mL Solution 0.1 mL Syringe,30.94,17.02,9.28,26.76,38
RC,0250,methoxsalen 20 mcg/mL Solution 10 mL Vial,2864.5,1575.48,859.35,2477.79,38
RC,0250,methylergonovine 0.2 MG Tab 12 Each Bottle,43.87,24.13,13.16,37.95,38
RC,0250,methylphenidate 10 MG Tab 100 Each Bottle,10.55,5.81,3.17,9.13,38
RC,0250,methylphenidate 2.5 mg half tablet Tab 0.5 tablet Package,10.25,5.64,3.08,8.87,38
RC,0250,methylphenidate 5 MG Tab 100 Each Bottle,10.49,5.77,3.15,9.07,38
RC,0250,methylphenidate HCl 10 MG Tab CR 100 Each Bottle,11.25,6.19,3.38,9.73,38
RC,0250,methylphenidate HCl 20 MG Tab CR 100 Each Bottle,11.41,6.279999999999999,3.42,9.88,76
RC,0250,"metoclopramide 10 MG Tab 1,000 Each Bottle",8.22,4.53,2.47,7.11,38
RC,0250,metoclopramide 10 MG Tab 100 Each Box,8.8,4.84,2.64,7.61,38
RC,0250,metoclopramide 10 MG/10ML Solution 10 mL Oral Syringe,21.37,11.76,6.41,18.49,38
RC,0250,metoclopramide 5 MG Tab 100 Each Bottle,8.24,4.54,2.47,7.13,38
RC,0250,metoclopramide 5 MG/5ML Solution 473 mL Bottle,239.01,131.46,71.7,206.74,38
RC,0250,metoclopramide 5 mg/5 mL Solution 5 mL Oral Syringe,9.02,4.97,2.71,7.8,38
RC,0250,metoprolol succinate 100 MG Tablet Extended Release 24 Hour 100 Each Bottle,9.21,5.07,2.76,7.97,38
RC,0250,metoprolol succinate 25 MG Tablet Extended Release 24 Hour 100 Each Bottle,8.83,4.86,2.65,7.64,38
RC,0250,metoprolol succinate 50 MG Tablet Extended Release 24 Hour 1 Each Blister,9.92,5.46,2.98,8.58,38
RC,0250,metoprolol succinate XL 12.5 mg half tablet Tablet Extended Release 24 Hour 0.5 tablet Packet,8.79,4.84,2.64,7.6,38
RC,0250,metoprolol succinate XL 6.25 mg quarter tablet Tablet Extended Release 24 Hour 0.25 tablet Package,8.21,4.52,2.46,7.1,38
RC,0250,metoprolol tartrate 100 MG Tab 1 Each Blister,8.92,4.91,2.68,7.72,38
RC,0250,metoprolol tartrate 12.5 mg half tablet Tab 0.5 tablet Package,8.04,4.43,2.41,6.95,38
RC,0250,"metoprolol tartrate 25 MG Tab 1,000 Each Bottle",8.11,4.47,2.43,7.02,38
RC,0250,"metoprolol tartrate 50 MG Tab 1,000 Each Bottle",8.09,4.45,2.43,7.0,38
RC,0250,metoprolol tartrate 6.25 mg Tab 0.25 tablet Package,8.22,4.53,2.47,7.11,38
RC,0250,metoprolol tartrate Solution 1 Each Syringe,8.03,4.42,2.41,6.95,38
RC,0250,metroNIDAZOLE 0.75 % Gel 45 g Tube,333.53,183.45,100.06,288.5,38
RC,0250,metroNIDAZOLE 0.75% Gel 70 g Tube,90.07,49.54,27.02,77.91,38
RC,0250,metroNIDAZOLE 250 MG Tab 250 Each Bottle,8.97,4.94,2.69,7.76,38
RC,0250,metroNIDAZOLE 500 MG Tab 500 Each Bottle,9.6,5.28,2.88,8.3,38
RC,0250,metroNIDAZOLE 500 mg Tab 14 Each Bottle,9.6,5.28,2.88,8.3,38
RC,0250,metroNIDAZOLE Solution 10 mg Syringe,30.24,16.64,9.07,26.16,38
RC,0250,mexiletine 150 MG Cap 100 Each Bottle,10.88,5.99,3.26,9.41,38
RC,0250,mexiletine 200 MG Cap 100 Each Bottle,10.685,5.88,2.9,10.14,76
RC,0250,mexiletine 250 MG Cap 100 Each Bottle,9.1,5.01,2.73,7.87,38
RC,0250,miFEPRIStone 200 MG Tab 1 Each Box,108.2,59.51,32.46,93.59,38
RC,0250,miSOPROStol 100 MCG Tab 60 Each Bottle,8.99,4.95,2.7,7.78,38
RC,0250,miSOPROStol 200 MCG Tab 60 Each Bottle,9.9,5.45,2.97,8.56,38
RC,0250,miSOPROStol 25 mcg quarter tablet in gelcap Tab 0.25 tablet,10.14,5.58,3.04,8.77,38
RC,0250,miconazole 2 % Cream 28.4 g Tube,28.35,15.6,8.51,24.52,38
RC,0250,miconazole 2 % Cream 45 g Tube,40.79,22.44,12.24,35.28,38
RC,0250,miconazole 2 % Ointment 57 g Tube,45.74,25.16,13.72,39.57,38
RC,0250,miconazole 2 % Powder 85 g Bottle,39.34,21.64,11.8,34.03,38
RC,0250,miconazole nitrate 200 MG Suppos 3 Each Box,48.98,26.94,14.69,42.37,38
RC,0250,microfibrillar collagen Powder 0.5 g Jar,249.98,137.49,74.99,216.23,38
RC,0250,midazolam 10 mg/5 mL Syrup 5 mL Oral Syringe,20.57,11.32,6.17,17.79,38
RC,0250,midazolam 2 MG/ML Syrup 118 mL Bottle,282.08,155.15,84.62,244.0,38
RC,0250,midazolam 5 MG/1ML Solution 1 mL Vial,58.58,32.22,17.57,50.67,38
RC,0250,midazolam 5 mg/2.5 mL Syrup 2.5 mL Oral Syringe,14.79,8.14,4.44,12.79,38
RC,0250,midodrine 10 MG Tab 100 Each Bottle,8.8,4.84,2.64,7.61,38
RC,0250,midodrine 2.5 MG Tab 100 Each Bottle,8.79,4.84,2.64,7.6,38
RC,0250,midodrine 5 MG Tab 100 Each Bottle,9.2,5.06,2.76,7.96,38
RC,0250,midostaurin 25 MG Cap 56 Each Box,528.0,290.4,158.4,456.72,38
RC,0250,milnacipran 50 MG Tab 60 Each Bottle,29.03,15.97,8.71,25.11,38
RC,0250,mineral oil Oil 472 mL Bottle,27.36,15.05,8.21,23.67,38
RC,0250,mineral oil light 100 % Oil 10 mL Vial,99.73,54.86,29.92,86.27,38
RC,0250,mineral oil light 100 % Oil 25 mL Bottle,34.88,19.19,10.46,30.17,38
RC,0250,mineral oil/petrolatum Ointment 85 g Tube,44.99,24.75,13.5,38.92,38
RC,0250,minocycline 100 MG Cap 50 Each Bottle,8.67,4.77,2.6,7.5,38
RC,0250,minoxidil 10 MG Tab 1 Each Blister,8.92,4.91,2.68,7.72,38
RC,0250,minoxidil 2.5 MG Tab 100 Each Bottle,8.69,4.78,2.61,7.52,38
RC,0250,mirabegron 25 MG Tablet Extended Release 24 Hour 30 Each Bottle,47.43,26.09,14.23,41.03,38
RC,0250,mirtazapine 15 MG TABLET DISPERSIBLE 30 Each Box,8.82,4.86,2.65,7.63,38
RC,0250,mirtazapine 15 MG Tab 1 Each Blister,8.79,4.84,2.64,7.6,38
RC,0250,mirtazapine 30 MG TABLET DISPERSIBLE 30 Each Box,9.16,5.04,2.75,7.92,38
RC,0250,mirtazapine 30 MG Tab 100 Each Box,9.11,5.02,2.73,7.88,38
RC,0250,mirtazapine 45 MG TABLET DISPERSIBLE 30 Each Box,9.39,5.17,2.82,8.12,38
RC,0250,mirtazapine 45 MG Tab 1 Each Blister,9.32,5.13,2.8,8.06,38
RC,0250,mirtazapine 7.5 mg half tablet Tab 0.5 tablet Package,8.49,4.67,2.55,7.34,38
RC,0250,mitoMYcin 0.02% Solution 5 mL Bottle,486.06,267.34,145.82,420.44,38
RC,0250,mitoMYcin 0.4 mg/mL Solution 12.5 mL Vial,151.87,83.53,45.56,131.37,38
RC,0250,modafinil 100 MG Tab 30 Each Bottle,11.465,6.3100000000000005,3.23,10.54,76
RC,0250,modafinil 200 MG Tab 30 Each Bottle,11.25,6.19,3.38,9.73,38
RC,0250,modafinil 50 mg half tablet Tab 0.5 tablet Package,39.01,21.46,11.7,33.74,38
RC,0250,"mometasone furoate 220 mcg/act AEROSOL POWDER, BREATH ACTIVATED 1 Each Inhaler",255.37,140.46,76.61,220.9,38
RC,0250,monsels ferric subsulfate Solution 8 mL Bottle,71.04,39.08,21.31,61.45,38
RC,0250,montelukast 10 MG Tab 1 Each Blister,9.65,5.31,2.9,8.35,38
RC,0250,morphine (preservative free) 25 mg/mL Solution 10 mL Vial,97.1,53.41,29.13,83.99,38
RC,0250,morphine 0.04 mg/0.1 mL Solution 0.1 mL Oral Syringe,9.41,5.18,2.82,8.14,38
RC,0250,morphine 0.06 mg/0.15 mL Solution 0.15 mL Oral Syringe,9.61,5.29,2.88,8.31,38
RC,0250,morphine 0.08 mg/0.2 mL Solution 0.2 mL Oral Syringe,9.82,5.41,2.95,8.49,38
RC,0250,morphine 0.1 mg/0.25 mL Solution 0.25 mL Oral Syringe,10.02,5.52,3.01,8.67,38
RC,0250,morphine 0.12 mg/0.3 mL Solution 0.3 mL Oral Syringe,10.23,5.63,3.07,8.85,38
RC,0250,morphine 0.15 mg/0.375 mL Solution 0.375 mL Oral Syringe,10.53,5.8,3.16,9.11,38
RC,0250,morphine 0.2 mg/0.5 mL Solution 0.5 mL Oral Syringe,11.04,6.08,3.31,9.55,38
RC,0250,morphine 0.25 mg/0.625 mL Solution 0.625 mL Oral Syringe,11.55,6.36,3.47,9.99,38
RC,0250,morphine 0.3 mg/0.75 mL Solution 0.75 mL Oral Syringe,12.06,6.64,3.62,10.43,38
RC,0250,morphine 0.4 mg/mL Solution 1 Each Oral Syringe,23.28,12.81,6.98,20.14,38
RC,0250,morphine 1 mg/mL Solution 30 mL Syringe,149.6,82.28,29.94,172.48,76
RC,0250,morphine 10 mg/0.5 mL Solution 0.5 mL Plas Cont,10.49,5.77,3.15,9.07,38
RC,0250,morphine 10 mg/5 mL Solution 5 mL Cup,13.4,7.37,4.02,11.59,38
RC,0250,morphine 10 mg/mL Solution 1 mL Cartridge,60.02,33.02,18.01,51.92,38
RC,0250,morphine 10 mg/mL Solution 30 mL Syringe,229.15,126.035,44.55,267.98,114
RC,0250,morphine 100 mg in 0.9% NaCl 100 mL 1 mg/mL Solution 100 mL Bag,364.0,200.2,109.2,314.86,38
RC,0250,morphine 100 mg in 0.9% NaCl 100 mL 1 mg/mL Solution 100 mL Flex Cont,211.0,116.05,63.3,182.52,38
RC,0250,morphine 15 MG Tab 100 Each Bottle,11.08,6.1,3.32,9.58,38
RC,0250,morphine 15 mg/7.5 mL Solution 7.5 mL Plas Cont,12.38,6.81,3.71,10.71,38
RC,0250,morphine 2 mg/mL Solution 1 mL Cartridge,57.69,31.73,17.31,49.9,38
RC,0250,morphine 2.5 mg/1.25 mL Solution 1.25 mL Plas Cont,10.4,5.72,3.12,9.0,38
RC,0250,morphine 20 MG/ML Solution 1 Each Oral Syringe,187.52,103.14,56.26,162.2,38
RC,0250,morphine 20 MG/ML Solution 120 mL Bottle,161.2,88.66,48.36,139.44,38
RC,0250,morphine 20 mg/1 mL Solution 1 mL Plas Cont,10.98,6.04,3.29,9.5,38
RC,0250,morphine 30 MG Suppos 12 Each Box,24.75,13.62,7.43,21.41,38
RC,0250,morphine 30 mg/1.5 mL Solution 1.5 mL Plas Cont,11.47,6.31,3.44,9.92,38
RC,0250,morphine 4 mg/mL Solution 1 mL Cartridge,55.3,30.42,16.59,47.83,38
RC,0250,morphine 5 MG/0.25ML Solution 0.25 mL Plas Cont,10.25,5.64,3.08,8.87,38
RC,0250,morphine 5 mg/2.5 mL Solution 2.5 mL Plas Cont,10.79,5.94,3.24,9.33,38
RC,0250,morphine 5 mg/mL Solution 30 mL Syringe,231.05,127.08,35.79,296.52,76
RC,0250,morphine 50 MG/ML Solution 20 mL Vial,175.8,96.69,52.74,152.07,38
RC,0250,morphine 7.5 mg half tablet Tab 0.5 tablet Package,10.23,5.63,3.07,8.85,38
RC,0250,morphine Solution 1 mL Syringe,51.19,28.16,15.36,44.28,38
RC,0250,morphine sulfate 100 MG CAPSULE SR 24 HR 100 Each Bottle,25.71,14.15,7.71,22.24,38
RC,0250,morphine sulfate 100 MG Tab CR 1 Each Blister,20.49,11.27,6.15,17.72,38
RC,0250,morphine sulfate 15 MG Tab CR 100 Each Box,11.4,6.27,3.42,9.86,38
RC,0250,morphine sulfate 2 mg/mL Solution 1 Each Oral Syringe,213.0,117.15,63.9,184.25,38
RC,0250,morphine sulfate 2 mg/ml Solution 500 mL Bottle,67.5,37.13,20.25,58.39,38
RC,0250,morphine sulfate 20 MG CAPSULE SR 24 HR 100 Each Bottle,17.78,9.78,5.33,15.38,38
RC,0250,morphine sulfate 30 MG CAPSULE SR 24 HR 100 Each Bottle,18.56,10.21,5.57,16.05,38
RC,0250,morphine sulfate 30 MG Tab CR 1 Each Blister,11.96,6.58,3.59,10.35,38
RC,0250,morphine sulfate 60 MG Tab CR 1 Each Blister,16.12,8.87,4.84,13.94,38
RC,0250,moxifloxacin 0.5 % Solution 1 mL Package,25.0,13.75,7.5,21.63,38
RC,0250,moxifloxacin 0.5 % Solution 3 mL Bottle,72.5,39.88,21.75,62.71,38
RC,0250,moxifloxacin 400 MG Tab 30 Each Bottle,15.82,8.71,4.75,13.68,38
RC,0250,moxifloxacin Suspension 1 mg Package,25.52,14.04,7.66,22.07,38
RC,0250,multivitamin 50 MG/ML Solution 50 mL Bottle,48.7,26.79,14.61,42.13,38
RC,0250,multivitamin Solution 10 mL Vial,119.97,65.99,35.99,103.77,38
RC,0250,multivitamin Tab 100 Each Box,4.14,2.28,1.24,3.58,38
RC,0250,multivitamin and mineral 15 mL Liquid 236 mL Bottle,24.18,13.3,7.25,20.92,38
RC,0250,multivitamin special formulation Chew Tab 60 Each Bottle,4.91,2.71,1.47,4.25,38
RC,0250,multivitamin with iron 11 MG/ML Solution 50 mL Bottle,40.9,22.5,12.27,35.38,38
RC,0250,multivitamin with iron 18 MG Chew Tab 60 Each Bottle,4.27,2.35,1.28,3.69,38
RC,0250,mupirocin 2 % Ointment 22 g Tube,51.49,28.32,15.45,44.54,38
RC,0250,muscle rub 10-15 % Cream 85 g Tube,31.31,17.23,9.39,27.08,38
RC,0250,nafcillin 1 g/50 mL Solution 50 mL Plas Cont,105.0,57.75,31.5,90.83,38
RC,0250,nafcillin 2 g Recon Soln 1 Each Vial,101.25,55.69,30.38,87.58,38
RC,0250,nafcillin 2 g/20mL Solution 1 Each Syringe,167.28,92.01,50.18,144.7,38
RC,0250,nafcillin Recon Soln 1 Each Vial,95.92,52.76,28.78,82.97,38
RC,0250,naloxone 0.4 MG/ML Solution 1 mL Vial,33.0,18.15,9.9,28.55,38
RC,0250,naloxone 1 MG/ML Liquid 2 mL Syringe,213.0,117.15,63.9,184.25,38
RC,0250,naltrexone 1 mg/mL Suspension 50 mL Bottle,12.95,7.13,3.89,11.2,38
RC,0250,naltrexone 50 MG Tab 100 Each Bottle,12.81,7.05,3.84,11.08,38
RC,0250,naphazoline/pheniramine 0.025-0.3 % Solution 15 mL Bottle,47.46,26.11,14.24,41.05,38
RC,0250,naproxen 250 MG Tab 1 Each Blister,8.86,4.88,2.66,7.66,38
RC,0250,naproxen 375 MG Tab 1 Each Blister,8.89,4.89,2.67,7.69,38
RC,0250,naproxen 500 MG Tab 1 Each Blister,8.72,4.8,2.62,7.54,38
RC,0250,nateglinide 60 MG Tab 100 Each Bottle,10.55,5.81,3.17,9.13,38
RC,0250,nateglinide 60 MG Tab 90 Each Bottle,9.65,5.31,2.9,8.35,38
RC,0250,neomycin 500 MG Tab 1 Each Blister,11.07,6.09,3.32,9.58,38
RC,0250,neomycin-polymyxin-dexameth 3.5-10000-0.1 Suspension 5 mL Bottle,75.62,41.6,22.69,65.41,38
RC,0250,neomycin/bacitracin zinc/polymyxin 5-400-10000 Ointment 3.5 g Tube,179.5,98.73,53.85,155.27,38
RC,0250,neomycin/bacitracin/polymyxin 3.5-400-5000 Ointment 14.2 g Tube,31.93,17.57,9.58,27.62,38
RC,0250,neomycin/polymyxin/bacitracin 5-400-5000 Ointment 0.9 g Packet,4.6,2.53,1.38,3.98,38
RC,0250,neomycin/polymyxin/dexamethasone 0.1 % Ointment 3.5 g Tube,75.62,41.6,22.69,65.41,38
RC,0250,neomycin/polymyxin/dexamethasone 0.1 % Suspension 5 mL Bottle,75.62,41.6,22.69,65.41,38
RC,0250,neomycin/polymyxin/hydrocortisone 3.5-10000-1 Solution 10 mL Bottle,287.68,158.23,86.3,248.84,38
RC,0250,neomycin/polymyxin/hydrocortisone 3.5-10000-1 Suspension 10 mL Bottle,287.68,158.23,86.3,248.84,38
RC,0250,neostigmine 1 MG/ML Solution 5 mL Syringe,301.2,165.66,90.36,260.54,38
RC,0250,neostigmine 10 MG/10ML Solution 10 mL Vial,88.0,48.4,26.4,76.12,38
RC,0250,nevirapine 200 MG Tab 60 Each Bottle,8.56,4.71,2.57,7.4,38
RC,0250,niCARdipine 25 mg in 0.9% NaCl 250 mL infusion 100 mcg/mL Kit 250 mL Bag,236.79,130.24,71.04,204.82,38
RC,0250,niMODipine 30 MG Cap 1 Each Blister,10.6,5.83,3.18,9.17,38
RC,0250,niMODipine 30 MG Cap 1 Each Package,15.62,8.6,4.69,13.51,38
RC,0250,niMODipine 30 MG Cap 100 Each Box,15.62,8.6,4.69,13.51,38
RC,0250,niMODipine 30 mg/mL Solution 1 mL Plas Cont,26.93,14.82,8.08,23.29,38
RC,0250,niMODipine 6 MG/ML Solution 237 mL Bottle,7022.5,3862.38,2106.75,6074.46,38
RC,0250,niMODipine 6 MG/ML Solution 5 mL Syringe,150.21,82.62,45.06,129.93,38
RC,0250,niacin 250 MG Cap CR 100 Each Bottle,8.29,4.56,2.49,7.17,38
RC,0250,niacin 250 MG Tab CR 100 Each Bottle,8.26,4.55,2.48,7.14,38
RC,0250,niacin 500 MG Tab 100 Each Bottle,4.12,2.27,1.24,3.56,38
RC,0250,niacin 500 MG Tab CR 100 Each Bottle,8.19,4.505,2.43,7.17,76
RC,0250,nicotine 14 mg/24 hour PATCH 24 HR 14 Each Box,13.1,7.21,3.93,11.33,38
RC,0250,nicotine 21 mg/24 hour PATCH 24 HR 14 Each Box,13.1,7.21,3.93,11.33,38
RC,0250,nicotine 7 mg/24 hour PATCH 24 HR 14 Each Box,13.1,7.21,3.93,11.33,38
RC,0250,nicotine polacrilex 2 MG Gum 10 Each Box,20.82,11.46,6.25,18.01,38
RC,0250,nicotine polacrilex 4 MG Gum 10 Each Box,20.82,11.46,6.25,18.01,38
RC,0250,nilotinib 200 MG Cap 28 Each Disp Pack,468.82,257.86,140.65,405.53,38
RC,0250,nitrofurantoin 25 MG/5ML Suspension 10 mL Oral Syringe,46.78,25.73,14.03,40.46,38
RC,0250,nitrofurantoin 25 MG/5ML Suspension 240 mL Bottle,3861.6,2123.88,1158.48,3340.28,38
RC,0250,nitrofurantoin monohydrate/macrocrystals 100 MG Cap 100 Each Bottle,11.69,6.43,3.51,10.11,38
RC,0250,nitroglycerin 0.01 mg/mL Solution 10 mL Syringe,30.22,16.63,9.07,26.14,38
RC,0250,nitroglycerin 0.1 mg/hour PATCH 24 HR 30 Each Box,9.24,5.085,2.65,8.35,76
RC,0250,nitroglycerin 0.1 mg/mL Solution 1 mL Syringe,30.02,16.52,9.01,25.97,38
RC,0250,nitroglycerin 0.1 mg/mL Solution 10 mL Syringe,36.56,20.11,10.97,31.62,38
RC,0250,nitroglycerin 0.2 mg/hour PATCH 24 HR 30 Each Box,9.12,5.02,2.74,7.89,38
RC,0250,nitroglycerin 0.2 mg/mL Solution 0.5 mL Syringe,30.36,16.7,9.11,26.26,38
RC,0250,nitroglycerin 0.2 mg/mL Solution 5 mL Syringe,33.6,18.48,10.08,29.06,38
RC,0250,nitroglycerin 0.3 % Ointment 30 g Jar,38.68,21.28,11.6,33.46,38
RC,0250,nitroglycerin 0.4 MG SL Tab 25 Each Bottle,8.34,4.59,2.5,7.21,38
RC,0250,nitroglycerin 0.4 mg/hour PATCH 24 HR 30 Each Box,9.45,5.2,2.84,8.17,38
RC,0250,nitroglycerin 0.4 mg/spray Solution 4.9 g Spray Bottle,622.95,342.63,186.89,538.85,38
RC,0250,nitroglycerin 2 % Ointment 1 g Packet,14.27,7.85,4.28,12.34,38
RC,0250,nitroglycerin 2.5 MG Cap CR 100 Each Bottle,9.63,5.3,2.89,8.33,38
RC,0250,nitroprusside 25 MG/ML Solution 2 mL Vial,150.0,82.5,45.0,129.75,38
RC,0250,nitroprusside 50 MG/100ML Solution 100 mL Vial,235.0,129.25,70.5,203.28,38
RC,0250,norepinephrine 1 mg/mL Solution 4 mL Vial,113.7,62.54,34.11,98.35,38
RC,0250,norepinephrine 16mg in NaCl 0.9 % 250 mL 64 mcg/mL Solution 250 mL Bag,247.0,135.85,74.1,213.66,38
RC,0250,norepinephrine 16mg in NaCl 0.9 % 250 mL 64 mcg/mL Solution 250 mL Flex Cont,157.5,86.63,47.25,136.24,38
RC,0250,norepinephrine 4mg in NaCl 0.9 % 250 mL 16 mcg/mL Solution 250 mL Bag,83.74,46.06,25.12,72.44,38
RC,0250,norethindrone acetate 5 MG Tab 50 Each Bottle,8.8,4.84,2.64,7.61,38
RC,0250,norethindrone/ethinyl estradiol 0.5-35 mg-mcg Tab 28 Each Disp Pack,9.33,5.14,2.8,8.07,38
RC,0250,norethindrone/ethinyl estradiol 1-35 mg-mcg Tab 21 Each Disp Pack,9.84,5.42,2.95,8.51,38
RC,0250,norethindrone/ethinyl estradiol/iron 1-20 mg-mcg Tab 28 Each Disp Pack,8.82,4.86,2.65,7.63,38
RC,0250,norgestimate/ethinyl estradiol 0.25-35 mg-mcg Tab 28 Each Disp Pack,9.09,5.005,2.66,8.07,76
RC,0250,nortriptyline 10 MG Cap 500 Each Bottle,8.63,4.75,2.59,7.46,38
RC,0250,nortriptyline 25 MG Cap 100 Each Bottle,8.88,4.89,2.66,7.68,38
RC,0250,nortriptyline 50 MG Cap 100 Each Bottle,9.08,5.0,2.72,7.85,38
RC,0250,nystatin 100000 UNIT/GM Cream 15 g Tube,65.47,36.01,19.64,56.63,38
RC,0250,nystatin 100000 UNIT/GM Powder 15 g Bottle,87.88,48.34,26.36,76.02,38
RC,0250,nystatin 100000 UNIT/ML Suspension 473 mL Bottle,301.45,165.8,90.44,260.75,38
RC,0250,nystatin 100000 UNIT/ML Suspension 5 mL Cup,14.27,7.85,4.28,12.34,38
RC,0250,nystatin/triamcinolone 100000-0.1 UNIT/GM-% Cream 30 g Tube,123.01,67.66,36.9,106.4,38
RC,0250,nystatin/triamcinolone 100000-0.1 UNIT/GM-% Ointment 15 g Tube,74.6,41.03,22.38,64.53,38
RC,0250,octreotide 100 MCG/ML Solution 1 mL Vial,94.58,52.02,28.37,81.81,38
RC,0250,octreotide 1000 MCG/ML Solution 5 mL Vial,2698.15,1483.99,809.45,2333.9,38
RC,0250,octreotide 50 MCG/ML Solution 1 mL Vial,58.75,32.32,17.63,50.82,38
RC,0250,octreotide 500 MCG/ML Solution 1 mL Vial,313.14,172.23,93.94,270.87,38
RC,0250,olive oil Oil 118 mL Bottle,49.14,27.03,14.74,42.51,38
RC,0250,omeprazole 20 MG CAPSULE DELAYED RELEASE 100 Each Bottle,8.37,4.61,2.51,7.24,38
RC,0250,ondansetron 4 MG/5ML Solution 5 mL Oral Syringe,16.25,8.94,4.88,14.06,38
RC,0250,ondansetron 4 MG/5ML Solution 50 mL Bottle,90.5,49.78,27.15,78.28,38
RC,0250,opium tincture 12 mg/1.2 mL Tincture 1.2 mL Oral Syringe,22.19,12.21,6.66,19.19,38
RC,0250,opium tincture 3 mg/0.3 mL Tincture 0.3 mL Oral Syringe,12.3,6.77,3.69,10.64,38
RC,0250,opium tincture 6 mg/0.6 mL Tincture 0.6 mL Oral Syringe,15.59,8.58,4.68,13.49,38
RC,0250,oseltamivir 30 MG Cap 10 Each Box,14.8,8.14,4.44,12.8,38
RC,0250,oseltamivir 6 MG/ML Recon Susp 60 mL Bottle,217.6,119.68,65.28,188.22,38
RC,0250,oseltamivir 75 MG Cap 10 Each Box,14.8,8.14,4.44,12.8,38
RC,0250,oxyBUTYnin 2.5 mg half tablet Tab 0.5 tablet Packet,8.8,4.84,2.64,7.61,38
RC,0250,"oxyBUTYnin 5 MG Tab 1,000 Each Bottle",8.33,4.59,2.5,7.21,38
RC,0250,oxyCODONE 1 mg/ml Solution 5 mL Cup,23.49,12.92,7.05,20.32,38
RC,0250,oxyCODONE 10 MG Tablet Extended Release 12 hour Abuse-Deterrent 20 Each Box,21.22,11.68,6.37,18.36,38
RC,0250,oxyCODONE 100 MG/5ML Conc 30 mL Bottle,358.46,197.16,107.54,310.07,38
RC,0250,oxyCODONE 15 MG Tab 100 Each Bottle,10.8,5.94,3.24,9.34,38
RC,0250,oxyCODONE 2.5 mg half tablet Tab 0.5 tablet Package,10.57,5.82,3.17,9.14,38
RC,0250,oxyCODONE 2.5 mg/2.5 mL Solution 2.5 mL Plas Cont,10.46,5.76,3.14,9.05,38
RC,0250,oxyCODONE 20 MG Tablet Extended Release 12 hour Abuse-Deterrent 20 Each Box,29.67,16.32,8.9,25.66,38
RC,0250,oxyCODONE 20 MG/ML Conc 0.5 mL Plas Cont,10.53,5.8,3.16,9.11,38
RC,0250,oxyCODONE 20 mg/1 mL Conc 1 mL Plas Cont,12.06,6.64,3.62,10.43,38
RC,0250,oxyCODONE 30 MG Tab 100 Each Bottle,11.6,6.38,3.48,10.03,38
RC,0250,oxyCODONE 30 MG Tablet Extended Release 12 hour Abuse-Deterrent 20 Each Box,38.15,20.99,11.45,33.0,38
RC,0250,oxyCODONE 30 mg/1.5 mL Conc 1.5 mL Plas Cont,13.59,7.48,4.08,11.76,38
RC,0250,oxyCODONE 40 MG Tablet Extended Release 12 hour Abuse-Deterrent 20 Each Box,45.1,24.81,13.53,39.01,38
RC,0250,oxyCODONE 5 MG Tab 1 Each Blister,11.25,6.19,3.38,9.73,38
RC,0250,oxyCODONE 5 mg/0.25 mL Conc 0.25 mL Plas Cont,8.09,4.45,2.43,7.0,38
RC,0250,oxyCODONE 5 mg/5 mL Solution 5 mL Cup,23.49,12.92,7.05,20.32,38
RC,0250,oxyCODONE 5 mg/5 mL Solution 5 mL Syringe,11.55,6.36,3.47,9.99,38
RC,0250,oxyCODONE 50 mg/2.5 mL Conc 2.5 mL Plas Cont,38.12,20.97,11.44,32.97,38
RC,0250,oxyCODONE 80 MG Tablet Extended Release 12 hour Abuse-Deterrent 20 Each Box,72.77,40.03,21.83,62.95,38
RC,0250,oxychlorosene Powder 2 g Box,81.66,44.92,24.5,70.64,38
RC,0250,oxymetazoline 0.05 % Solution 30 mL Bottle,31.13,17.13,9.34,26.93,38
RC,0250,oxymetazoline with lidocaine 0.05%-4% Solution 1 mL Syringe,29.37,16.16,8.81,25.41,38
RC,0250,oxymetazoline with lidocaine 0.05%-4% Solution 2 mL Syringe,33.75,18.57,10.13,29.19,38
RC,0250,oxytocin 30 units in 0.9% NaCl 500 mL Solution 500 mL Flex Cont,134.0,73.7,40.2,115.91,38
RC,0250,paliperidone 3 MG Tablet Extended Release 24 Hour 30 Each Bottle,13.5,7.43,4.05,11.68,38
RC,0250,pancrelipase (lip/prot/amyl) 12000 units/capsule Cap DR Particles 100 Each Bottle,19.87,10.93,5.96,17.19,38
RC,0250,"pancrelipase (lip/prot/amyl) 24,000 units Cap DR Particles 100 Each Bottle",28.96,15.93,8.69,25.05,38
RC,0250,"pancrelipase (lip/prot/amyl) 6,000 units/capsule Cap DR Particles 100 Each Bottle",13.44,7.4,4.03,11.63,38
RC,0250,pantoprazole 2 mg/mL Suspension 10 mL Oral Syringe,14.77,8.13,4.43,12.78,38
RC,0250,pantoprazole 2 mg/mL Suspension 20 mL Oral Syringe,21.53,11.85,6.46,18.62,38
RC,0250,pantoprazole 20 MG Tablet Delayed Response 90 Each Bottle,8.37,4.61,2.51,7.24,38
RC,0250,pantoprazole 40 MG Pack 30 Each Box,44.9,24.7,13.47,38.84,38
RC,0250,pantoprazole 40 MG Tablet Delayed Response 1 Each Blister,8.59,4.73,2.58,7.43,38
RC,0250,papaverine 30 MG/ML Solution 2 mL Vial,263.46,144.91,79.04,227.89,38
RC,0250,"penicillin G potassium 100,000 units/mL Solution 1 Each Vial",102.69,56.48,30.81,88.83,38
RC,0250,penicillin G potassium 3 million units 3 Solution 3 Million Units Bag,120.45,66.25,36.14,104.19,38
RC,0250,penicillin G potassium 5 million units 5 Solution 100 mL Bag,235.6,129.58,70.68,203.79,38
RC,0250,penicillin G potassium Recon Soln 1 Each Vial,102.69,56.48,30.81,88.83,38
RC,0250,penicillin G sodium 5000000 Units Recon Soln 1 Each Vial,291.47,160.31,87.44,252.12,38
RC,0250,penicillin V potassium 250 MG Tab 100 Each Bottle,8.27,4.55,2.48,7.15,38
RC,0250,penicillin V potassium 250 MG/5ML Recon Soln 100 mL Bottle,37.37,20.56,11.21,32.33,38
RC,0250,pentafluoropropane/tetrafluoroethane Aerosol 116 mL Can,141.8,77.99,42.54,122.66,38
RC,0250,pentafluoropropane/tetrafluoroethane Aerosol 30 mL Can,20.0,11.0,6.0,17.3,38
RC,0250,pentamidine Recon Soln 1 Each Vial,916.21,503.92,274.86,792.52,38
RC,0250,pentosan polysulfate sodium 100 MG Cap 100 Each Bottle,38.33,21.09,11.5,33.16,38
RC,0250,pentoxifylline 20 mg/mL Suspension 200 mL Bottle,76.64,42.16,22.99,66.29,38
RC,0250,pentoxifylline 400 MG Tab CR 100 Each Bottle,9.19,5.06,2.76,7.95,38
RC,0250,pentoxifylline 400 MG Tab CR 100 Each Box,9.02,4.97,2.71,7.8,38
RC,0250,pentoxifylline 400 MG Tab CR 500 Each Bottle,9.16,5.04,2.75,7.92,38
RC,0250,peppermint oil SPIRIT 30 mL Bottle,49.4,27.17,14.82,42.73,38
RC,0250,perampanel 12 MG Tab 30 Each Bottle,89.8,49.39,26.94,77.68,38
RC,0250,perampanel 2 MG Tab 30 Each Bottle,49.4,27.17,14.82,42.73,38
RC,0250,perampanel 8 MG Tab 30 Each Bottle,89.8,49.39,26.94,77.68,38
RC,0250,permethrin 1 % Liquid 59 mL Bottle,20.0,11.0,6.0,17.3,38
RC,0250,permethrin 5 % Cream 60 g Tube,125.0,68.75,37.5,108.13,38
RC,0250,perphenazine 2 MG Tab 100 Each Bottle,8.9,4.9,2.67,7.7,38
RC,0250,petrolatum Gel 28.4 g Tube,20.0,11.0,6.0,17.3,38
RC,0250,phenazopyridine 100 MG Tab 100 Each Bottle,9.06,4.99,2.72,7.84,38
RC,0250,phenazopyridine 200 MG Tab 100 Each Bottle,10.6,5.83,3.18,9.17,38
RC,0250,phenol 6 % Solution 10 mL Vial,550.74,302.91,165.22,476.39,38
RC,0250,phenol 6 % Solution 30 mL Vial,435.0,239.25,130.5,376.28,38
RC,0250,phenol 88 % Liquid 2 mL Vial,37.5,20.63,11.25,32.44,38
RC,0250,phenol 89 % Liquid 100 mL Bottle,263.8,145.09,79.14,228.19,38
RC,0250,phenol 89 % Liquid 500 mL Bottle,1291.0,710.05,387.3,1116.72,38
RC,0250,phenol 89 % SWAB 30 Each Package,12.23,6.73,3.67,10.58,38
RC,0250,phenol throat 1.4 % Liquid 177 mL Bottle,28.67,15.77,8.6,24.8,38
RC,0250,phenylephrine 0.1 mg/mL Solution 5 mL Syringe,57.55,31.66,17.27,49.78,38
RC,0250,phenylephrine 0.5 % Solution 15 mL Bottle,33.28,18.31,9.98,28.79,38
RC,0250,phenylephrine 10 % Solution 5 mL Bottle,160.0,88.0,48.0,138.4,38
RC,0250,phenylephrine 2.5 % Solution 1 mL Package,25.0,13.75,7.5,21.63,38
RC,0250,phenylephrine 2.5 % Solution 15 mL Bottle,307.5,169.13,92.25,265.99,38
RC,0250,phenylephrine 2.5 % Solution 2 mL Bottle,133.75,73.57,40.13,115.69,38
RC,0250,phenylephrine 20 mg in NS 250 mL infusion 80 mcg/mL Kit 20 mg Bag,97.7,53.74,29.31,84.51,38
RC,0250,phenylephrine 50 mg in NS 250 mL infusion 200 mcg/mL Kit 250 mL Bag,140.0,77.0,42.0,121.1,38
RC,0250,phenylephrine/mineral oil/petrolatum 0.25-14-74.9 % Ointment 57 g Tube,28.58,15.72,8.57,24.72,38
RC,0250,phenytoin 125 MG/5ML Suspension 237 mL Bottle,86.99,47.85,26.1,75.25,38
RC,0250,phenytoin 125 MG/5ML Suspension 4 mL Oral Syringe,9.33,5.14,2.8,8.07,38
RC,0250,phenytoin 125 MG/5ML Suspension 5 mL Oral Syringe,9.9,5.45,2.97,8.56,38
RC,0250,phenytoin 125 MG/5ML Suspension 6 mL Oral Syringe,10.28,5.66,3.08,8.89,38
RC,0250,phenytoin 50 MG Chew Tab 100 Each Bottle,9.39,5.17,2.82,8.12,38
RC,0250,phenytoin ER 100 MG Cap 100 Each Bottle,8.82,4.86,2.65,7.63,38
RC,0250,phenytoin ER 30 MG Cap 100 Each Bottle,11.48,6.32,3.44,9.93,38
RC,0250,phosphorus 250 MG Tab 100 Each Bottle,8.0,4.4,2.4,6.92,38
RC,0250,phytonadione 1 MG/0.5ML Solution 0.5 mL Ampule,60.63,33.35,18.19,52.44,38
RC,0250,phytonadione 1 MG/0.5ML Solution 0.5 mL Syringe,180.75,99.42,54.23,156.35,38
RC,0250,phytonadione 1 MG/ML Solution 50 mL Bottle,1535.69,844.63,460.71,1328.37,38
RC,0250,phytonadione 2.5 mg/0.25 mL Solution 0.25 mL Oral Syringe,34.38,18.91,10.31,29.74,38
RC,0250,pill box Misc 1 Each Pack,92.59,50.93,27.78,80.09,38
RC,0250,pill crusher Misc 1 Each Package,38.59,21.23,11.58,33.38,38
RC,0250,pilocarpine 1 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
RC,0250,pilocarpine 1 % Solution 15 mL Bottle,256.12,140.87,76.84,221.54,38
RC,0250,pilocarpine 2 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
RC,0250,pilocarpine 2 % Solution 15 mL Bottle,277.13,152.43,83.14,239.72,38
RC,0250,pilocarpine 4 % Solution 1 mL Package,25.0,13.75,7.5,21.63,38
RC,0250,pilocarpine 4 % Solution 15 mL Bottle,314.445,172.945,86.94,293.31,76
RC,0250,pilocarpine 5 MG Tab 1 Each Blister,13.81,7.6,4.14,11.95,38
RC,0250,piperacillin/tazobactam Recon Soln 1 Each Vial,73.09,40.2,21.93,63.22,38
RC,0250,piroxicam 10 MG Cap 100 Each Bottle,9.1,5.01,2.73,7.87,38
RC,0250,piroxicam 20 MG Cap 100 Each Bottle,10.6,5.83,3.18,9.17,38
RC,0250,podophyllum resin 25 % Solution 15 mL Bottle,333.48,183.42,100.04,288.46,38
RC,0250,polycarbophil 625 MG Tab 500 Each Bottle,4.24,2.34,1.27,3.67,38
RC,0250,polyethyl glycol 400/propyl glycol 0.4-0.3 % Gel 10 mL Bottle,56.26,30.95,16.88,48.66,38
RC,0250,polyethylene glycol 3350 17 GM/SCOOP Powder 238 g Bottle,43.32,23.83,13.0,37.47,38
RC,0250,polyethylene glycol 3350 17 g Pack 14 Each Box,12.06,6.64,3.62,10.43,38
RC,0250,polyethylene glycol/electrolytes 100 g Recon Soln 1 Each Box,424.11,233.27,127.23,366.86,38
RC,0250,"polyethylene glycol/electrolytes Recon Soln 4,000 mL Bottle",104.0,57.2,31.2,89.96,38
RC,0250,polymyxin B Recon Soln 1 Each Vial,95.0,52.25,28.5,82.18,38
RC,0250,polyvinyl alcohol 1.4 % Solution 15 mL Bottle,35.17,19.35,10.55,30.42,38
RC,0250,poractant alfa 120 MG/1.5ML Suspension 1.5 mL Vial,3249.39,1787.17,974.82,2810.72,38
RC,0250,poractant alfa 240 MG/3ML Suspension 3 mL Vial,6392.83,3516.06,1917.85,5529.8,38
RC,0250,poractant alfa 80 MG/ML Suspension 1.5 mL Vial,3249.39,1787.17,974.82,2810.72,38
RC,0250,poractant alfa 80 MG/ML Suspension 3 mL Vial,6392.83,3516.06,1917.85,5529.8,38
RC,0250,posaconazole 100 MG Tablet Delayed Response 60 Each Bottle,19.5,10.73,5.85,16.87,38
RC,0250,potassium & sodium phosphate 280-160-250 MG Pack 100 Each Box,8.63,4.75,2.59,7.46,38
RC,0250,potassium PHOSphate 15 mmol in D5W 250 mL Solution 250 mL Flex Cont,113.75,62.57,34.13,98.39,38
RC,0250,potassium PHOSphate 3 MMOLE/ML Solution 50 mL Vial,655.98,360.79,196.79,567.42,76
RC,0250,potassium PHOSphate 3 mMol/mL Solution 15 mL Vial,116.14,63.88,34.84,100.46,38
RC,0250,potassium acetate 2 MEQ/ML Solution 20 mL Vial,62.8,34.54,18.84,54.32,38
RC,0250,potassium acetate 2 MEQ/ML Solution 50 mL Vial,92.8,51.04,27.84,80.27,76
RC,0250,potassium chloride 10 MEQ Cap CR 100 Each Box,9.55,5.26,2.87,8.26,38
RC,0250,potassium chloride 20 MEQ/15ML (10%) Solution 15 mL Cup,33.945,18.675,5.86,41.83,114
RC,0250,potassium chloride 20 MEQ/15ML (10%) Solution 30 mL Cup,86.92,47.81,26.08,75.19,38
RC,0250,potassium chloride 20 MEQ/15ML (10%) Solution 473 mL Bottle,198.43,109.14,59.53,171.64,38
RC,0250,potassium chloride 40 MEQ/20 ML Solution 20 mL Syringe,37.68,20.73,11.3,32.59,38
RC,0250,potassium chloride crys 10 MEQ Tab CR 100 Each Bottle,9.57,5.27,2.87,8.28,38
RC,0250,potassium chloride crys 20 MEQ Tab CR 1 Each Blister,8.53,4.7,2.56,7.38,38
RC,0250,potassium chloride crys 20 MEQ Tab CR 100 Each Bottle,8.51,4.69,2.55,7.36,38
RC,0250,potassium citrate/citric acid 1100-334 MG/5ML Solution 473 mL Bottle,214.04,117.73,64.21,185.14,38
RC,0250,potassium iodide 1 GM/ML Solution 30 mL Bottle,903.32,496.83,271.0,781.37,38
RC,0250,povidone iodine 0.5% Solution 450 mL Bottle,639.03,351.47,191.71,552.76,38
RC,0250,povidone-iodine 10 % Solution 118 mL Bottle,26.2,14.41,7.86,22.66,38
RC,0250,pramipexole 0.125 MG Tab 90 Each Bottle,8.49,4.67,2.55,7.34,38
RC,0250,pramipexole 0.25 MG Tab 90 Each Bottle,8.49,4.67,2.55,7.34,38
RC,0250,pramipexole 0.5 MG Tab 90 Each Bottle,8.49,4.67,2.55,7.34,38
RC,0250,pramipexole 1 MG Tab 90 Each Bottle,8.49,4.67,2.55,7.34,38
RC,0250,pramoxine/hydrocortisone 1-1 % Foam 10 g Can,340.39,187.22,102.12,294.44,38
RC,0250,prasugrel 10 MG Tab 30 Each Bottle,9.48,5.22,2.84,8.2,38
RC,0250,prasugrel 5 MG Tab 30 Each Bottle,9.48,5.22,2.84,8.2,38
RC,0250,pravastatin 10 MG Tab 90 Each Bottle,8.87,4.88,2.66,7.67,38
RC,0250,pravastatin 20 MG Tab 90 Each Bottle,8.86,4.88,2.66,7.66,38
RC,0250,pravastatin 40 MG Tab 90 Each Bottle,9.27,5.1,2.78,8.02,38
RC,0250,pravastatin 80 MG Tab 90 Each Bottle,9.27,5.1,2.78,8.02,38
RC,0250,prazosin 1 MG Cap 90 Each Bottle,9.0,4.95,2.7,7.79,76
RC,0250,prazosin 2 MG Cap 100 Each Bottle,9.38,5.16,2.81,8.11,38
RC,0250,prazosin 5 MG Cap 100 Each Bottle,10.93,6.02,3.28,9.45,38
RC,0250,predniSONE 0.5 mg half tablet Tab 0.5 tablet Package,8.74,4.81,2.62,7.56,38
RC,0250,prednisoLONE 15 MG/5ML Solution 480 mL Bottle,294.7,162.09,88.41,254.92,38
RC,0250,prednisoLONE acetate 0.12 % Suspension 5 mL Bottle,536.3,294.97,160.89,463.9,38
RC,0250,prednisoLONE acetate 1 % Suspension 1 mL Package,10.0,5.5,3.0,8.65,38
RC,0250,prednisoLONE acetate 1 % Suspension 5 mL Bottle,174.44,95.945,52.2,151.27,76
RC,0250,pregabalin 100 mg Cap 90 Each Bottle,10.2,5.61,3.06,8.82,38
RC,0250,pregabalin 150 mg Cap 90 Each Bottle,10.375,5.71,3.06,9.12,76
RC,0250,pregabalin 200 mg Cap 90 Each Bottle,10.22,5.63,3.07,8.84,38
RC,0250,pregabalin 225 mg Cap 90 Each Bottle,10.21,5.62,3.06,8.83,38
RC,0250,pregabalin 25 mg Cap 90 Each Bottle,10.17,5.6,3.05,8.8,38
RC,0250,pregabalin 300 mg Cap 90 Each Bottle,10.25,5.64,3.08,8.87,38
RC,0250,pregabalin 50 mg Cap 90 Each Bottle,10.17,5.6,3.05,8.8,38
RC,0250,pregabalin 75 mg Cap 90 Each Bottle,10.17,5.6,3.05,8.8,38
RC,0250,prenatal multivitamin 27-0.8 MG Tab 100 Each Bottle,8.11,4.47,2.43,7.02,38
RC,0250,primaquine phosphate 26.3 mg (=15 mg Base) Tab 100 Each Bottle,11.01,6.06,3.3,9.52,38
RC,0250,primidone 25 mg half tablet Tab 0.5 tablet Package,8.26,4.55,2.48,7.14,38
RC,0250,primidone 250 MG Tab 1 Each Blister,9.61,5.29,2.88,8.31,38
RC,0250,primidone 50 MG Tab 100 Each Bottle,8.53,4.7,2.56,7.38,38
RC,0250,probenecid 500 MG Tab 100 Each Bottle,8.78,4.83,2.63,7.59,38
RC,0250,procarbazine 50 MG Cap 100 Each Bottle,240.01,132.01,72.0,207.61,38
RC,0250,prochlorperazine 25 MG Suppos 12 Each Box,29.53,16.25,8.86,25.54,38
RC,0250,progesterone micronized 100 MG Cap 100 Each Bottle,9.32,5.13,2.8,8.06,38
RC,0250,progesterone micronized Cap 1 Each,31.0,17.05,9.3,26.82,38
RC,0250,promethazine 12.5 MG Suppos 1 Each Box,32.32,17.78,9.7,27.96,38
RC,0250,promethazine 25 MG Suppos 12 Each Box,32.32,17.78,9.7,27.96,38
RC,0250,propafenone 150 MG Tab 1 Each Blister,9.34,5.14,2.8,8.08,38
RC,0250,propafenone 225 MG Tab 100 Each Bottle,8.52,4.69,2.56,7.37,38
RC,0250,propafenone 75 mg half tablet Tab 0.5 tablet Package,9.51,5.24,2.85,8.23,38
RC,0250,proparacaine 0.5 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
RC,0250,proparacaine 0.5 % Solution 15 mL Bottle,142.8,78.54,42.84,123.52,38
RC,0250,propranolol 10 MG Tab 1 Each Blister,8.83,4.86,2.65,7.64,38
RC,0250,propranolol 20 MG Tab 1 Each Blister,9.52,5.24,2.86,8.23,38
RC,0250,propranolol 20 MG Tab 100 Each Bottle,8.66,4.77,2.6,7.49,38
RC,0250,propranolol 20 MG Tab 100 Each Box,9.52,5.24,2.86,8.23,38
RC,0250,propranolol 20 MG/5ML Solution 500 mL Bottle,168.05,92.43,50.42,145.36,38
RC,0250,propranolol 40 MG Tab 100 Each Bottle,8.84,4.87,2.65,7.65,38
RC,0250,propranolol 5 mg half tablet Tab 0.5 tablet Package,8.45,4.65,2.54,7.31,38
RC,0250,propylthiouracil 50 MG Tab 100 Each Bottle,9.25,5.09,2.78,8.0,38
RC,0250,pseudoephedrine 120 MG TABLET SR 12 HR 10 Each Box,4.05,2.23,1.22,3.5,38
RC,0250,pseudoephedrine 30 MG Tab 100 Each Bottle,8.09,4.45,2.43,7.0,38
RC,0250,pseudoephedrine 60 MG Tab 100 Each Bottle,4.21,2.32,1.26,3.64,38
RC,0250,psyllium 51.7 % Pack 1 Each Package,4.3,2.37,1.29,3.72,38
RC,0250,psyllium 51.7 % Pack 30 Each Box,4.6,2.53,1.38,3.98,38
RC,0250,pyRIDostigmine 30 mg half tablet Tab 0.5 tablet Package,8.8,4.84,2.64,7.61,38
RC,0250,pyRIDostigmine 60 MG Tab 100 Each Bottle,9.45,5.2,2.84,8.17,38
RC,0250,pyRIDostigmine 60 MG/5ML Solution 473 mL Bottle,1807.71,994.25,542.31,1563.67,38
RC,0250,pyRIDostigmine bromide 180 MG Tab CR 30 Each Bottle,49.54,27.25,14.86,42.85,38
RC,0250,pyrazinamide 500 MG Tab 100 Each Bottle,20.3,11.17,6.09,17.56,38
RC,0250,pyridoXINE 25 mg half tablet Tab 0.5 tablet Package,8.04,4.43,2.41,6.95,38
RC,0250,pyridoXINE 50 MG Tab 100 Each Bottle,8.06,4.44,2.42,6.97,38
RC,0250,pyridoxine 50 MG Tab 100 Each Box,4.0,2.2,1.2,3.46,38
RC,0250,pyrimethamine 25 MG Tab 30 Each Bottle,620.6,341.33,186.18,536.82,38
RC,0250,pyrithione zinc 1 % Shampoo 118 mL Bottle,28.64,15.76,8.59,24.77,38
RC,0250,quizartinib dihydrochloride 17.7 MG Tab 14 Each Bottle,1407.25,773.99,422.18,1217.27,38
RC,0250,quizartinib dihydrochloride 26.5 MG Tab 14 Each Bottle,1407.25,773.99,422.18,1217.27,38
RC,0250,rOPINIRole 0.25 MG Tab 100 Each Bottle,8.4,4.62,2.52,7.27,38
RC,0250,rOPINIRole 0.5 MG Tab 100 Each Bottle,8.4,4.62,2.52,7.27,38
RC,0250,rOPINIRole 1 MG Tab 100 Each Bottle,8.4,4.62,2.52,7.27,38
RC,0250,rOPINIRole 2 MG Tab 100 Each Bottle,8.4,4.62,2.52,7.27,38
RC,0250,rOPINIRole 5 MG Tab 100 Each Bottle,8.46,4.66,2.54,7.32,38
RC,0250,racepinephrine 2.25 % Nebu Soln 1 Each Plas Cont,13.0,7.15,3.9,11.25,38
RC,0250,raloxifene 60 MG Tab 100 Each Bottle,10.47,5.76,3.14,9.06,38
RC,0250,raltegravir potassium 400 MG Tab 60 Each Bottle,88.33,48.59,26.5,76.41,38
RC,0250,ramelteon 8 MG Tab 30 Each Bottle,11.25,6.19,3.38,9.73,38
RC,0250,ranolazine 500 MG TABLET SR 12 HR 60 Each Bottle,9.65,5.31,2.9,8.35,38
RC,0250,remifentanil 100 mcg/mL Solution 30 mL Syringe,1427.0,784.85,428.1,1234.36,38
RC,0250,remifentanil Recon Soln 0.25 Each Syringe,499.25,274.59,149.78,431.85,38
RC,0250,remifentanil Recon Soln 1 Each Syringe,188.4,103.62,56.52,162.97,38
RC,0250,remifentanil Recon Soln 1 Each Vial,717.265,394.505,144.45,824.36,76
RC,0250,ribavirin Recon Soln 1 Each Vial,110890.0,60989.5,33267.0,95919.85,76
RC,0250,rifAMPin 10mg/ml Suspension 15 mL Oral Syringe,8.5,4.68,2.55,7.35,38
RC,0250,rifAMPin 10mg/ml Suspension 30 mL Cup,8.99,4.95,2.7,7.78,38
RC,0250,rifAMPin 150 MG Cap 1 Each Blister,16.57,9.12,4.97,14.33,38
RC,0250,rifAMPin 25 MG/ML Suspension 120 mL Bottle,107.0,58.85,32.1,92.56,38
RC,0250,rifAMPin 300 MG Cap 1 Each Blister,12.58,6.92,3.77,10.88,38
RC,0250,rifAMPin Solution 0.001 mg Syringe,8.03,4.42,2.41,6.95,38
RC,0250,rifAXIMin 550 MG Tab 60 Each Box,143.53,78.95,43.06,124.15,38
RC,0250,rifabutin 150 MG Cap 100 Each Bottle,40.01,22.01,12.0,34.61,38
RC,0250,rifabutin 20 mg/mL Suspension 15 mL Oral Syringe,258.46,142.16,77.54,223.57,38
RC,0250,rilpivirine 25 MG Tab 30 Each Bottle,123.67,68.02,37.1,106.97,38
RC,0250,riluzole 50 MG Tab 60 Each Bottle,9.0,4.95,2.7,7.79,38
RC,0250,riociguat 0.5 MG Tab 9 Each Bottle,381.27,209.7,114.38,329.8,38
RC,0250,riociguat 1 MG Tab 9 Each Bottle,381.27,209.7,114.38,329.8,38
RC,0250,riociguat 2 MG Tab 9 Each Bottle,381.27,209.7,114.38,329.8,38
RC,0250,riociguat 2.5 MG Tab 9 Each Bottle,381.27,209.7,114.38,329.8,38
RC,0250,risperiDONE 0.25 MG Tab 1 Each Blister,8.76,4.82,2.63,7.58,38
RC,0250,risperiDONE 0.5 MG TABLET DISPERSIBLE 1 Each Blister,17.49,9.62,5.25,15.13,38
RC,0250,risperiDONE 0.5 MG Tab 1 Each Blister,8.89,4.89,2.67,7.69,38
RC,0250,risperiDONE 1 MG TABLET DISPERSIBLE 1 Each Blister,19.26,10.6,5.78,16.66,38
RC,0250,risperiDONE 1 MG Tab 1 Each Blister,9.39,5.17,2.82,8.12,38
RC,0250,risperiDONE 2 MG TABLET DISPERSIBLE 28 Each Box,23.93,13.17,7.18,20.7,38
RC,0250,risperiDONE 2 MG Tab 60 Each Bottle,8.72,4.8,2.62,7.54,38
RC,0250,risperiDONE 3 MG TABLET DISPERSIBLE 28 Each Box,28.62,15.75,8.59,24.76,38
RC,0250,risperiDONE 3 MG Tab 1 Each Blister,8.53,4.7,2.56,7.38,38
RC,0250,risperiDONE 4 MG Tab 1 Each Blister,8.53,4.7,2.56,7.38,38
RC,0250,ritonavir 100 MG Tab 30 Each Bottle,15.0,8.25,4.5,12.98,38
RC,0250,rivaroxaban 10 MG Tab 1 Each Blister,59.84,32.92,17.95,51.76,38
RC,0250,rivaroxaban 15 MG Tab 1 Each Blister,36.9,20.3,11.07,31.92,38
RC,0250,rivaroxaban 2.5 MG Tab 100 Each Box,32.91,18.11,9.87,28.47,38
RC,0250,rivaroxaban 20 MG Tab 1 Each Blister,59.84,32.92,17.95,51.76,38
RC,0250,rivastigmine 1.5 MG Cap 1 Each Blister,16.95,9.33,5.09,14.66,38
RC,0250,rivastigmine 3 MG Cap 60 Each Bottle,8.75,4.82,2.63,7.57,38
RC,0250,rivastigmine 4.6 mg/24hr/patch PATCH 24 HR 30 Each Box,55.12,30.32,12.75,58.6,76
RC,0250,rivastigmine 9.5 mg/24hr/patch PATCH 24 HR 30 Each Box,42.5,23.38,12.75,36.76,38
RC,0250,rocuronium 50 MG/5ML Solution 5 mL Vial,52.86,29.08,15.86,45.72,38
RC,0250,roflumilast 500 MCG Tab 30 Each Bottle,9.6,5.28,2.88,8.3,38
RC,0250,rosuvastatin 10 MG Tab 90 Each Bottle,8.22,4.53,2.47,7.11,38
RC,0250,rosuvastatin 20 MG Tab 90 Each Bottle,8.329999999999998,4.585,2.49,7.24,76
RC,0250,rosuvastatin 40 MG Tab 30 Each Bottle,8.25,4.54,2.48,7.14,38
RC,0250,rosuvastatin 5 MG Tab 90 Each Bottle,8.37,4.61,2.51,7.24,38
RC,0250,rufinamide 200 MG Tab 120 Each Bottle,16.21,8.92,4.86,14.02,38
RC,0250,ruxolitinib 10 MG Tab 60 Each Bottle,709.0,389.95,212.7,613.29,38
RC,0250,ruxolitinib 10 mg half tablet Tab 0.5 tablet Packet,709.0,389.95,212.7,613.29,38
RC,0250,ruxolitinib 5 mg half tablet Tab 0.5 tablet Package,1413.0,777.15,423.9,1222.25,38
RC,0250,sacubitril/valsartan 24-26 MG Tab 60 Each Bottle,37.74,20.76,11.32,32.65,38
RC,0250,sacubitril/valsartan 49-51 MG Tab 60 Each Bottle,37.74,20.76,11.32,32.65,38
RC,0250,sacubitril/valsartan 97-103 MG Tab 60 Each Bottle,37.74,20.76,11.32,32.65,38
RC,0250,saline Gel 14.1 g Tube,29.72,16.35,8.92,25.71,38
RC,0250,saliva substitute Solution 59 mL Spray Bottle,38.38,21.11,11.51,33.2,38
RC,0250,salsalate 500 MG Tab 1 mg Package,25.01,13.76,7.5,21.63,38
RC,0250,salsalate 500 MG Tab 100 Each Bottle,8.99,4.95,2.7,7.78,38
RC,0250,scopolamine 1 mg/3 days/patch PATCH 72 HR 1 Each Package,27.26,15.0,8.18,23.58,38
RC,0250,selenium sulfide 2.5 % Lotion 120 mL Bottle,54.86,30.18,16.46,47.45,38
RC,0250,selexipag 200 MCG Tab 60 Each Bottle,618.93,340.42,185.68,535.37,38
RC,0250,senna 8.6 MG Tab 100 Each Bottle,4.075,2.245,1.22,3.53,76
RC,0250,senna/docusate 8.6-50 mg Tab 100 Each Bottle,4.1,2.26,1.23,3.55,38
RC,0250,senna/docusate 8.6-50 mg Tab 100 Each Box,4.72,2.6,1.42,4.08,38
RC,0250,sennosides 8.8 MG/5ML Syrup 237 mL Bottle,42.06,23.14,12.62,36.38,38
RC,0250,sennosides 8.8 MG/5ML Syrup 5 mL Cup,16.18,8.9,4.85,14.0,38
RC,0250,sennosides 8.8 MG/5ML Syrup 5 mL Oral Syringe,9.25,5.09,2.78,8.0,38
RC,0250,sertraline 100 MG Tab 500 Each Bottle,8.3,4.57,2.48,7.2,76
RC,0250,sertraline 12.5 mg half tablet Tab 0.5 tablet Package,14.24,7.84,4.27,12.32,38
RC,0250,sertraline 25 MG Tab 30 Each Bottle,8.31,4.58,2.49,7.19,38
RC,0250,sertraline 50 MG Tab 1 Each Blister,9.29,5.11,2.79,8.04,38
RC,0250,sevelamer carbonate 0.8 g Pack 1 Each Packet,12.67,6.97,3.8,10.96,38
RC,0250,sevelamer carbonate 2.4 g Pack 90 Each Box,12.67,6.97,3.8,10.96,38
RC,0250,sevelamer carbonate 800 MG Tab 270 Each Bottle,9.28,5.11,2.78,8.03,38
RC,0250,sildenafil 10 mg half tablet Tab 0.5 tablet Package,69.86,38.43,20.96,60.43,38
RC,0250,sildenafil 20 MG Tab 90 Each Bottle,10.94,6.02,3.28,9.46,38
RC,0250,silicone oil 1000 Misc 8.5 mL Vial,2284.84,1256.67,685.45,1976.39,38
RC,0250,silicone oil 5000 Misc 10 mL Syringe,2249.3,1237.12,674.79,1945.64,38
RC,0250,silodosin 4 mg Cap 30 Each Bottle,10.0,5.5,3.0,8.65,38
RC,0250,silver nitrate/potassium nitrate 75-25 % Misc 1 Each Package,9.27,5.1,2.78,8.02,38
RC,0250,silver sulfADIAZINE 1% Cream 400 g Jar,233.4,128.37,70.02,201.89,38
RC,0250,silver sulfADIAZINE 1% Cream 50 g Tube,62.88,34.59,18.86,54.39,38
RC,0250,simethicone 40 MG/0.6ML Suspension 30 mL Bottle,27.67,15.22,8.3,23.93,38
RC,0250,simethicone 40 mg Tab 1 Each Package,8.27,4.55,2.48,7.15,38
RC,0250,simethicone 80 MG Chew Tab 1 Each Blister,8.78,4.83,2.63,7.59,38
RC,0250,simvastatin 20 MG Tab 1 Each Blister,8.79,4.84,2.64,7.6,38
RC,0250,simvastatin 40 MG Tab 100 Each Box,8.64,4.76,2.59,7.47,38
RC,0250,small pill box - 7 day strip Misc 1 Each Box,43.45,23.9,13.04,37.58,38
RC,0250,soap & cleaners Bar 1 Each Box,25.6,14.08,7.68,22.14,38
RC,0250,sod bicarbonate/citric acid/simethicone 2.21-1.53-0.04 g Pack 50 Each Box,12.77,7.03,3.83,11.05,38
RC,0250,sodium PHOSphate 15 mmol 15 mmol/250 mL Solution 250 mL Flex Cont,108.01,59.41,32.4,93.43,38
RC,0250,sodium PHOSphate 20 mmol 20 mmol/250 mL Solution 250 mL Flex Cont,123.97,68.19,37.19,107.23,38
RC,0250,sodium PHOSphate 25 mmol 25 mmol/250 mL Solution 250 mL Bag,139.87,76.93,41.96,120.99,38
RC,0250,sodium PHOSphate 25 mmol 25 mmol/250 mL Solution 250 mL Flex Cont,139.87,76.93,41.96,120.99,38
RC,0250,sodium acetate 2 MEQ/ML Solution 100 mL Vial,86.6,47.63,25.98,74.91,38
RC,0250,sodium acetate 2 MEQ/ML Solution 20 mL Vial,92.8,51.04,27.84,80.27,38
RC,0250,sodium acetate Solution 100 mL Vial,239.0,131.45,71.7,206.74,38
RC,0250,sodium benzoate/sodium phenylacetate 10-10 % Solution 50 mL Vial,191784.94,105481.72,57535.48,165893.97,76
RC,0250,sodium bicarbonate 0.5 mEq/mL Solution 10 mL Syringe,90.27,49.65,27.08,78.08,38
RC,0250,sodium bicarbonate 1 mEq/mL Solution 1 mL Syringe,31.56,17.36,9.47,27.3,76
RC,0250,sodium bicarbonate 1 mEq/mL Solution 10 mL Vial,59.7,32.835,9.0,77.33,76
RC,0250,sodium bicarbonate 1 mEq/mL Solution 50 mL Bottle,40.18,22.1,12.05,34.76,38
RC,0250,sodium bicarbonate 1 mEq/mL Solution 50 mL Syringe,123.84,68.12,27.16,135.93,76
RC,0250,sodium bicarbonate 1 mEq/mL Solution 50 mL Vial,90.1,49.56,25.88,81.27,76
RC,0250,"sodium bicarbonate 100 mEq/L in dextrose 5 % Solution 1,000 mL Bag",273.3,150.32,81.99,236.4,38
RC,0250,sodium bicarbonate 325 MG Tab 100 Each Bottle,8.17,4.5,2.45,7.07,38
RC,0250,sodium bicarbonate 650 MG Tab 1 Each Blister,8.67,4.77,2.6,7.5,38
RC,0250,sodium chloride (PF) 0.9 % Solution 10 mL Vial,7.675000000000001,4.225,2.19,6.97,76
RC,0250,sodium chloride (hypertonic) 5 % Ointment 3.5 g Tube,56.269999999999996,30.955,16.77,48.99,76
RC,0250,sodium chloride (hypertonic) 5 % Solution 15 mL Bottle,35.33,19.44,10.6,30.56,38
RC,0250,sodium chloride 0.65 % Solution 44 mL Bottle,23.23,12.78,6.97,20.09,38
RC,0250,sodium chloride 1 g Tab 100 Each Bottle,8.26,4.55,2.48,7.14,38
RC,0250,sodium chloride 2.5 MEQ/ML Solution 20 mL Vial,39.92,21.96,11.98,34.53,38
RC,0250,sodium chloride 2.5 MEQ/ML Solution 40 mL Vial,71.76,39.47,21.53,62.07,38
RC,0250,sodium chloride 23.4% Solution 30 mL Vial,78.55,43.21,23.57,67.95,38
RC,0250,sodium chloride 3 % Nebu Soln 4 mL Plas Cont,32.66,17.97,9.8,28.25,38
RC,0250,sodium chloride 4 MEQ/ML Solution 100 mL Vial,120.1,66.06,36.03,103.89,38
RC,0250,sodium chloride 4 MEQ/ML Solution 30 mL Vial,78.55,43.21,23.57,67.95,38
RC,0250,sodium chloride 4 mEq/mL Solution 30 mL Bag,60.88,33.49,18.26,52.66,38
RC,0250,sodium chloride 4 mEq/mL Solution 30 mL Vial,78.55,43.21,23.57,67.95,38
RC,0250,sodium chloride 7 % Nebu Soln 4 mL Plas Cont,8.91,4.91,2.67,7.71,38
RC,0250,sodium chloride bacteriostatic 0.9 % Solution 30 mL Vial,42.33,23.29,12.7,36.62,38
RC,0250,sodium chondroitin/sodium hyaluronate 20-15 MG/0.5ML Solution Prefilled Syringe 0.5 mL Syringe,1085.66,597.12,325.7,939.1,38
RC,0250,sodium citrate 4 % Solution 3 mL Syringe,30.26,16.65,9.08,26.17,38
RC,0250,sodium citrate/citric acid 500-334 MG/5ML Solution 30 mL Cup,23.71,13.05,7.11,20.51,38
RC,0250,sodium hyaluron/sodium chondroitin 0.55-0.5 ML Kit 1 Each Syringe,1432.42,787.84,429.73,1239.04,38
RC,0250,sodium hyaluronate 10 mg/mL Solution 0.55 mL Syringe,1024.31,563.38,307.29,886.03,38
RC,0250,sodium hyaluronate 10 mg/mL Solution 0.85 mL Syringe,785.9,432.25,235.77,679.8,38
RC,0250,sodium hyaluronate 14 mg/mL Solution Prefilled Syringe 0.85 mL Syringe,805.02,442.77,241.51,696.34,38
RC,0250,sodium hyaluronate 18 mg/mL Solution Prefilled Syringe 0.85 mL Syringe,828.72,455.8,248.62,716.84,38
RC,0250,sodium hyaluronate 23 mg/mL Solution Prefilled Syringe 0.6 mL Syringe,638.7,351.29,191.61,552.48,38
RC,0250,sodium hypochlorite 0.125 % Solution 473 mL Bottle,20.0,11.0,6.0,17.3,76
RC,0250,sodium hypochlorite 0.25 % Solution 473 mL Bottle,20.0,11.0,6.0,17.3,38
RC,0250,sodium hypochlorite 0.5 % Solution 473 mL Bottle,20.0,11.0,6.0,17.3,38
RC,0250,sodium phosphate 45 MMOLE/15ML Solution 15 mL Vial,234.69,129.08,63.93,221.69,76
RC,0250,sodium polystyrene 15 GM/60ML Suspension 60 mL Bottle,89.77,49.38,26.93,77.65,38
RC,0250,sodium polystyrene 15 g Powder 15 g Bottle,22.85,12.57,6.86,19.77,38
RC,0250,sodium polystyrene 15 g Powder 454 g Jar,457.46,251.61,137.24,395.7,38
RC,0250,sodium tetradecyl sulfate 1 % Solution 2 mL Vial,483.76,266.07,145.13,418.45,38
RC,0250,sodium tetradecyl sulfate 3 % Solution 2 mL Vial,477.0,262.35,143.1,412.61,38
RC,0250,sodium zirconium cyclosilicate 10 g Pack 1 Each Packet,73.93,40.67,22.18,63.95,38
RC,0250,sodium zirconium cyclosilicate 5 g Pack 1 Each Packet,73.93,40.67,22.18,63.95,38
RC,0250,sodium zirconium cyclosilicate 5 g Pack 30 Each Box,73.92,40.66,22.18,63.94,38
RC,0250,sotalol 120 MG Tab 100 Each Bottle,8.41,4.63,2.52,7.27,38
RC,0250,sotalol 40 mg half tablet Tab 0.5 tablet Package,8.46,4.66,2.54,7.32,38
RC,0250,sotalol 60 mg half tablet Tab 0.5 tablet Package,8.62,4.75,2.59,7.46,38
RC,0250,sotalol 80 MG Tab 1 Each Blister,8.99,4.95,2.7,7.78,38
RC,0250,spironolactone 100 MG Tab 100 Each Box,9.19,5.06,2.76,7.95,38
RC,0250,spironolactone 12.5 mg half tablet Tab 0.5 tablet Package,8.26,4.55,2.48,7.14,38
RC,0250,spironolactone 25 MG Tab 1 Each Blister,8.63,4.75,2.59,7.46,38
RC,0250,sterile talc 3 g Powder 1 Each Vial,585.38,321.96,175.61,506.35,38
RC,0250,"sterile water Solution 1,000 mL Bottle",66.0,36.3,19.8,57.09,38
RC,0250,"sterile water Solution 1,000 mL Flex Cont",137.5,75.63,41.25,118.94,38
RC,0250,"sterile water Solution 2,000 mL Flex Cont",100.5,55.28,30.15,86.93,38
RC,0250,succimer 100 MG Cap 100 Each Bottle,65.49,36.02,19.65,56.65,38
RC,0250,sucralfate 1 GM/10ML Suspension 10 mL Cup,37.75,20.77,11.33,32.65,38
RC,0250,sucralfate 1 GM/10ML Suspension 420 mL Bottle,588.73,323.81,176.62,509.25,38
RC,0250,sucralfate 1 g Tab 1 Each Blister,9.27,5.1,2.78,8.02,38
RC,0250,sucralfate/diphenhydrAMINE/alum & mag-simethicone Suspension 30 mL Bottle,108.46,59.66,32.54,93.82,38
RC,0250,sulfADIAZINE 500 MG Tab 100 Each Bottle,19.11,10.52,5.73,16.53,38
RC,0250,sulfADIAZINE 500 MG Tab 60 Each Bottle,49.28,27.11,14.78,42.63,38
RC,0250,sulfaSALAzine 500 MG Tab 100 Each Bottle,8.64,4.76,2.59,7.47,38
RC,0250,sulfacetamide 10 % Solution 15 mL Bottle,190.63,104.85,57.19,164.89,38
RC,0250,sulfacetamide/prednisoLONE 10-0.2 % Ointment 3.5 g Tube,511.47,281.31,153.44,442.42,76
RC,0250,sulfacetamide/prednisoLONE 10-0.2 % Suspension 5 mL Bottle,536.3,294.97,160.89,463.9,38
RC,0250,sulfamethoxazole-trimethoprim Solution 160 mg Vial,63.08,34.7,18.92,54.56,38
RC,0250,sulfamethoxazole/trimethoprim 200-40 mg/5 mL Suspension 10 mL Oral Syringe,14.24,7.84,4.27,12.32,38
RC,0250,sulfamethoxazole/trimethoprim 200-40 mg/5 mL Suspension 20 mL Cup,21.07,11.59,6.32,18.23,38
RC,0250,sulfamethoxazole/trimethoprim 200-40 mg/5 mL Suspension 473 mL Bottle,318.62,175.25,95.59,275.61,38
RC,0250,sulfamethoxazole/trimethoprim 400-80 mg Tab 500 Each Bottle,8.19,4.51,2.46,7.08,38
RC,0250,sulfamethoxazole/trimethoprim 800-160 mg Tab 500 Each Bottle,8.2,4.51,2.46,7.09,38
RC,0250,sulfamethoxazole/trimethoprim oral desensitization Suspension 473 mL Bottle,303.01,166.66,90.9,262.1,38
RC,0250,sulphan blue 1 % Solution 5 mL Vial,180.0,99.0,54.0,155.7,38
RC,0250,syringe (disposable) 10 ML Misc 850 Each Box,0.18,0.1,0.05,0.16,38
RC,0250,tacrolimus 0.02 % Solution 15 mL Bottle,1825.0,1003.75,547.5,1578.63,38
RC,0250,tacrolimus 0.02 % Solution 5 mL Bottle,4525.0,2488.75,1357.5,3914.13,38
RC,0250,tacrolimus 1 mg/mL Suspension 0.5 mL Oral Syringe,13.81,7.6,4.14,11.95,38
RC,0250,tacrolimus 1 mg/mL Suspension 1 mL Oral Syringe,13.81,7.6,4.14,11.95,38
RC,0250,tacrolimus 1 mg/mL Suspension 480 mL Bottle,3275.8,1801.69,982.74,2833.57,38
RC,0250,tadalafil (PAH) 20 MG Tab 60 Each Bottle,9.65,5.31,2.9,8.35,38
RC,0250,tamoxifen 10 MG Tab 100 Each Box,9.58,5.27,2.87,8.29,38
RC,0250,tamoxifen 10 MG Tab 60 Each Bottle,8.63,4.75,2.59,7.46,38
RC,0250,tamsulosin 0.4 MG Cap 1 Each Blister,8.77,4.83,2.63,7.59,38
RC,0250,tedizolid 200 MG Tab 30 Each Bottle,1121.19,616.66,336.36,969.83,38
RC,0250,tedizolid 200 MG Tab 6 Each Box,1121.19,616.66,336.36,969.83,38
RC,0250,temazepam 15 mg Cap 100 Each Bottle,10.23,5.63,3.07,8.85,38
RC,0250,temazepam 30 MG Cap 100 Each Bottle,10.325,5.6850000000000005,3.09,8.95,76
RC,0250,temazepam 7.5 mg Cap 30 Each Box,16.36,9.0,4.91,14.15,38
RC,0250,tenofovir disoproxil fumarate 300 MG Tab 30 Each Bottle,11.440000000000001,6.295,2.96,11.25,76
RC,0250,terazosin 1 MG Cap 100 Each Bottle,8.59,4.73,2.58,7.43,38
RC,0250,terazosin 10 MG Cap 100 Each Bottle,8.59,4.73,2.58,7.43,38
RC,0250,terazosin 2 MG Cap 1 Each Blister,9.51,5.24,2.85,8.23,38
RC,0250,terazosin 5 MG Cap 1 Each Blister,9.52,5.24,2.86,8.23,38
RC,0250,terazosin 5 MG Cap 50 Each Box,9.52,5.24,2.86,8.23,38
RC,0250,terbutaline 5 MG Tab 100 Each Bottle,20.36,11.2,6.11,17.61,38
RC,0250,testosterone 2 MG/24HR PATCH 24 HR 1 Each Box,33.73,18.56,10.12,29.18,38
RC,0250,testosterone 25 MG/2.5GM (1%) Gel 2.5 g Box,21.6,11.88,6.48,18.68,38
RC,0250,testosterone 25 MG/2.5GM (1%) Gel 2.5 g Package,34.52,18.99,10.36,29.86,38
RC,0250,testosterone 4 MG/24HR PATCH 24 HR 1 Each Package,61.43,33.79,18.43,53.14,38
RC,0250,testosterone 50 MG/5GM (1%) Gel 5 g Package,35.23,19.38,10.57,30.47,38
RC,0250,tetracaine 0.5 % Solution 4 mL Plas Cont,68.58,37.72,20.57,59.32,38
RC,0250,tetracaine 1 % Solution 2 mL Vial,525.0,288.75,157.5,454.13,38
RC,0250,theophylline 100 MG CAPSULE SR 24 HR 100 Each Bottle,18.61,10.24,5.58,16.1,38
RC,0250,theophylline 200 MG CAPSULE SR 24 HR 100 Each Bottle,21.53,11.85,6.46,18.62,38
RC,0250,theophylline 400 MG Tablet Extended Release 24 Hour 100 Each Bottle,9.504999999999999,5.23,2.4,9.52,76
RC,0250,theophylline 80 MG/15ML Elixir 473 mL Bottle,546.2950000000001,300.465,41.74,824.75,76
RC,0250,theophylline CR (24-hour) 200 mg Tablet Extended Release 24 Hour 0.5 tablet Package,11.55,6.36,3.47,9.99,38
RC,0250,therapeutic hand/body Lotion 473 mL Bottle,33.24,18.29,9.97,28.75,38
RC,0250,thiamine 100 mg Tab 100 Each Bottle,4.13,2.28,1.24,3.57,38
RC,0250,thiamine 50 MG Tab 100 Each Bottle,8.09,4.45,2.43,7.0,38
RC,0250,"thrombin (recombinant) 20,000 units Recon Soln 1 Each Box",1899.6,1044.78,569.88,1643.15,38
RC,0250,"thrombin (recombinant) 5,000 units Recon Soln 1 Each Vial",531.0,292.05,159.3,459.32,38
RC,0250,thrombin 20000 units Kit 1 Each Box,1862.07,1024.14,558.62,1610.69,38
RC,0250,thrombin 5000 unit Recon Soln 1 Each Vial,469.68,258.33,140.9,406.27,38
RC,0250,thrombin 5000 units Kit 1 Each Box,533.22,293.28,156.19,472.13,76
RC,0250,thyroid 15 MG Tab 100 Each Bottle,8.76,4.82,2.63,7.58,38
RC,0250,thyroid 30 MG Tab 100 Each Bottle,10.03,5.52,3.01,8.68,38
RC,0250,tiZANidine 1 mg Tab 0.5 tablet Package,8.95,4.93,2.69,7.74,38
RC,0250,tiZANidine 2 MG Tab 150 Each Bottle,8.55,4.71,2.57,7.4,38
RC,0250,tiZANidine 4 MG Tab 150 Each Bottle,8.34,4.59,2.5,7.21,38
RC,0250,tiaGABine 2 MG Tab 30 Each Bottle,23.14,12.73,6.94,20.02,38
RC,0250,tiaGABine 4 MG Tab 30 Each Bottle,23.14,12.73,6.94,20.02,38
RC,0250,ticagrelor 90 MG Tab 60 Each Bottle,9.32,5.13,2.8,8.06,38
RC,0250,timolol 0.25 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
RC,0250,timolol 0.25 % Solution 5 mL Bottle,38.1,20.96,11.43,32.96,38
RC,0250,timolol 0.5 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
RC,0250,timolol 0.5 % Solution 5 mL Bottle,53.78,29.58,16.13,46.52,38
RC,0250,tobramycin (preservative free) 80 mg/mL Nebu Soln 1 Each Vial,516.0,283.8,154.8,446.34,38
RC,0250,tobramycin 0.3 % Solution 5 mL Bottle,74.25,40.84,22.28,64.23,38
RC,0250,tobramycin 1.5% 1.5% Solution 10 mL Bottle,95.68,52.63,28.7,82.76,38
RC,0250,tobramycin 100 mcg/0.1 mL Solution 0.1 mL Syringe,32.43,17.84,9.73,28.05,38
RC,0250,tobramycin 300 MG/5ML Nebu Soln 5 mL Plas Cont,57.9,31.85,17.37,50.08,38
RC,0250,tobramycin-impregnated polymethylmethacrylate 5.5% Beads 1 Device Package,855.0,470.25,256.5,739.58,38
RC,0250,tobramycin-impregnated polymethylmethacrylate 6.4 mm Beads 1 Device Package,1075.0,591.25,322.5,929.88,38
RC,0250,tobramycin/dexamethasone 0.3-0.1 % Ointment 3.5 g Tube,694.63,382.05,208.39,600.85,38
RC,0250,tobramycin/dexamethasone 0.3-0.1 % Suspension 2.5 mL Bottle,179.35,98.65,53.81,155.14,38
RC,0250,tolvaptan 15 MG Tab 1 Each Blister,149.0,81.95,44.7,128.89,38
RC,0250,tolvaptan 30 MG Tab 10 Each Bottle,1158.26,637.05,347.48,1001.89,38
RC,0250,topiramate 100 MG Tab 1 Each Blister,9.57,5.27,2.87,8.28,38
RC,0250,topiramate 200 MG Tab 60 Each Bottle,8.5,4.68,2.55,7.35,38
RC,0250,topiramate 25 MG Tab 1 Each Blister,8.98,4.94,2.69,7.77,38
RC,0250,topiramate 25 mg/mL Solution 473 mL Bottle,2321.39,1276.77,696.42,2008.0,38
RC,0250,topiramate sprinkle 25 MG CAPSULE SPRINKLE 60 Each Bottle,10.98,6.04,3.29,9.5,38
RC,0250,torsemide 10 MG Tab 50 Each Box,9.01,4.96,2.7,7.79,38
RC,0250,torsemide 100 MG Tab 50 Each Box,9.35,5.15,2.81,8.09,38
RC,0250,torsemide 20 MG Tab 100 Each Bottle,8.85,4.87,2.66,7.66,38
RC,0250,traMADol 12.5 mg quarter tablet Tab 0.25 tablet Packet,7.59,4.18,2.28,6.57,38
RC,0250,traMADol 25 mg half tablet Tab 0.5 tablet Package,8.18,4.5,2.45,7.08,38
RC,0250,traMADol 25 mg half tablet Tab 0.5 tablet Packet,8.18,4.5,2.45,7.08,38
RC,0250,traMADol 50 MG Tab 100 Each Bottle,10.33,5.69,3.1,8.94,38
RC,0250,traZODone 100 MG Tab 1 Each Blister,8.61,4.74,2.58,7.45,38
RC,0250,traZODone 100 MG Tab 100 Each Bottle,8.29,4.56,2.49,7.17,38
RC,0250,traZODone 100 MG Tab 100 Each Box,8.61,4.74,2.58,7.45,38
RC,0250,traZODone 25 mg half tablet Tab 0.5 tablet Packet,8.41,4.63,2.52,7.27,38
RC,0250,traZODone 50 MG Tab 1 Each Blister,8.43,4.64,2.53,7.29,38
RC,0250,trace minerals Solution 1 mL Vial,176.88,97.29,53.06,153.0,76
RC,0250,tranexamic acid 1000 MG/10ML Solution 10 mL Vial,63.5,34.93,19.05,54.93,76
RC,0250,tranexamic acid 650 MG Tab 30 Each Bottle,15.0,8.25,4.5,12.98,38
RC,0250,treprostinil 0.6 MG/ML Solution 4 Each Pack,2249.94,1237.47,674.98,1946.2,38
RC,0250,treprostinil diolamine 0.125 MG Tab CR 100 Each Bottle,26.04,14.33,7.81,22.52,38
RC,0250,treprostinil diolamine 0.25 MG Tab CR 100 Each Bottle,46.08,25.35,13.82,39.86,38
RC,0250,treprostinil diolamine 1 MG Tab CR 100 Each Bottle,147.52,81.14,44.26,127.6,38
RC,0250,tretinoin 0.01 % Gel 45 g Tube,177.5,97.63,53.25,153.54,38
RC,0250,tretinoin 10 MG Cap 1 Each Blister,71.07,39.09,21.32,61.48,38
RC,0250,tretinoin 5 MG/ML Emulsion 10 mL Oral Syringe,510.23,280.63,153.07,441.35,38
RC,0250,triamcinolone acetonide 0.025 % Cream 80 g Tube,48.56,26.71,14.57,42.0,38
RC,0250,triamcinolone acetonide 0.025 % Ointment 80 g Tube,48.56,26.71,14.57,42.0,38
RC,0250,triamcinolone acetonide 0.1 % Cream 15 g Tube,32.6,17.93,9.78,28.2,38
RC,0250,triamcinolone acetonide 0.1 % Cream 454 g Jar,88.33,48.59,26.5,76.41,38
RC,0250,triamcinolone acetonide 0.1 % Cream 80 g Tube,47.72,26.25,14.32,41.28,38
RC,0250,triamcinolone acetonide 0.1 % Ointment 15 g Tube,27.72,15.25,8.32,23.98,38
RC,0250,triamcinolone acetonide 0.1 % Ointment 454 g Jar,107.4,59.07,32.22,92.9,38
RC,0250,triamcinolone acetonide 0.1 % Ointment 80 g Tube,54.72,30.1,16.42,47.33,38
RC,0250,triamcinolone acetonide 0.1 % Paste 5 g Tube,224.53,123.5,67.36,194.22,38
RC,0250,triamterene/hydrochlorothiazide 37.5-25 mg Tab 100 Each Bottle,8.91,4.91,2.67,7.71,38
RC,0250,triamterene/hydrochlorothiazide 75-50 mg Tab 100 Each Bottle,8.93,4.92,2.68,7.72,38
RC,0250,trihexyphenidyl 1 mg half tablet Tab 0.5 tablet Package,8.5,4.68,2.55,7.35,38
RC,0250,trihexyphenidyl 2 MG Tab 100 Each Bottle,8.5,4.68,2.55,7.35,38
RC,0250,trihexyphenidyl 5 MG Tab 100 Each Bottle,9.0,4.95,2.7,7.79,38
RC,0250,trimethoprim 100 MG Tab 100 Each Bottle,12.59,6.93,3.78,10.89,38
RC,0250,trimethoprim/polymyxin B 10000-0.1 UNIT/ML-% Solution 1 mL Package,10.0,5.5,3.0,8.65,38
RC,0250,trimethoprim/polymyxin B 10000-0.1 UNIT/ML-% Solution 10 mL Bottle,56.23,30.93,16.87,48.64,38
RC,0250,tropicamide 0.5 % Solution 15 mL Bottle,47.98,26.39,14.39,41.5,38
RC,0250,tropicamide 1 % Solution 1 mL Package,10.0,5.5,3.0,8.65,38
RC,0250,tropicamide 1 % Solution 15 mL Bottle,49.77,27.38,14.93,43.05,38
RC,0250,tropicamide 1 % Solution 2 mL Bottle,48.0,26.4,14.4,41.52,38
RC,0250,trospium 20 MG Tab 60 Each Bottle,9.38,5.16,2.81,8.11,38
RC,0250,trospium chloride 60 MG CAPSULE SR 24 HR 30 Each Bottle,20.55,11.31,6.17,17.78,38
RC,0250,trypan blue 0.15 % Solution Prefilled Syringe 0.5 mL Syringe,1266.94,696.82,380.08,1095.9,38
RC,0250,ulipristal acetate 30 MG Tab 1 Each Box,98.0,53.9,29.4,84.77,38
RC,0250,"umeclidinium bromide 62.5 mcg/act AEROSOL POWDER, BREATH ACTIVATED 7 Each Disp Pack",57.52,31.64,17.26,49.75,38
RC,0250,"umeclidinium-vilanterol 62.5-25 mcg/act AEROSOL POWDER, BREATH ACTIVATED 7 Each Disp Pack",49.39,27.17,14.82,42.72,38
RC,0250,upadacitinib ER 15 MG Tablet Extended Release 24 Hour 30 Each Bottle,545.22,299.88,163.57,471.62,38
RC,0250,upadacitinib ER 30 MG Tablet Extended Release 24 Hour 30 Each Bottle,545.22,299.88,163.57,471.62,38
RC,0250,upadacitinib ER 45 MG Tablet Extended Release 24 Hour 28 Each Bottle,1085.43,596.99,325.63,938.9,38
RC,0250,urea 20 % Cream 85 g Tube,55.11,30.32,16.53,47.67,38
RC,0250,ursodiol 300 MG Cap 100 Each Bottle,9.37,5.16,2.81,8.11,38
RC,0250,ursodiol 50 MG/ML Suspension 480 mL Bottle,1245.4,684.97,373.62,1077.27,38
RC,0250,ursodiol 50 MG/ML Suspension 6 mL Oral Syringe,22.48,12.37,6.74,19.45,38
RC,0250,ursodiol 60 MG/ML Suspension 120 mL Bottle,316.6,174.13,94.98,273.86,38
RC,0250,ursodiol 60 MG/ML Suspension 5 mL Oral Syringe,19.9,10.95,5.97,17.21,38
RC,0250,valACYclovir 1 g Tab 30 Each Bottle,10.89,5.99,3.27,9.42,38
RC,0250,valACYclovir 500 MG Tab 90 Each Bottle,9.28,5.11,2.78,8.03,38
RC,0250,valGANciclovir 450 MG Tab 60 Each Bottle,19.5,10.73,5.85,16.87,38
RC,0250,valGANciclovir 50 MG/ML Recon Soln 88 mL Bottle,1684.17,926.3,505.25,1456.81,38
RC,0250,valproate 100 MG/ML Solution 5 mL Vial,132.35,72.8,39.71,114.48,38
RC,0250,valproic acid 250 MG Cap 100 Each Bottle,9.45,5.2,2.84,8.17,38
RC,0250,valproic acid 250 MG/5ML Solution 10 mL Oral Syringe,8.86,4.88,2.66,7.66,38
RC,0250,valproic acid 250 MG/5ML Solution 473 mL Bottle,70.44,38.75,21.13,60.93,38
RC,0250,valproic acid 250 MG/5ML Solution 5 mL Cup,12.52,6.89,3.76,10.83,38
RC,0250,valproic acid 250 MG/5ML Solution 5 mL Oral Syringe,8.43,4.64,2.53,7.29,38
RC,0250,vancomycin (oral) 50 MG/ML Recon Soln 2.5 mL Oral Syringe,11.16,6.14,3.35,9.65,38
RC,0250,vancomycin (preservative free) 50 mg/mL Solution 1 Each Vial,82.13,45.18,24.64,71.04,38
RC,0250,vancomycin 1 mg/0.05 mL Solution 0.5 mL Syringe,97.36,53.55,29.21,84.22,38
RC,0250,vancomycin 1 mg/0.1 mL Solution 1 Each Vial,92.54,50.9,27.76,80.05,38
RC,0250,vancomycin 125 MG Cap 20 Each Box,9.6,5.28,2.88,8.3,38
RC,0250,vancomycin 1250 mg Solution 250 mL Flex Cont,120.0,66.0,36.0,103.8,76
RC,0250,vancomycin 1500 mg Solution 250 mL Flex Cont,135.04,74.28,40.51,116.81,38
RC,0250,vancomycin 1500 mg Solution 500 mL Flex Cont,135.04,74.28,40.51,116.81,38
RC,0250,vancomycin 1750 mg Solution 250 mL Flex Cont,136.88,75.29,41.06,118.4,38
RC,0250,vancomycin 1750 mg Solution 500 mL Flex Cont,136.88,75.29,41.06,118.4,38
RC,0250,vancomycin 2.5% Solution 10 mL Bottle,99.7,54.84,29.91,86.24,38
RC,0250,vancomycin 2000 MG/250ML Solution 250 mL Flex Cont,136.88,75.29,41.06,118.4,38
RC,0250,vancomycin 2000 mg Solution 500 mL Flex Cont,136.88,75.29,41.06,118.4,38
RC,0250,vancomycin 5% Solution 10 mL Bottle,99.7,54.84,29.91,86.24,38
RC,0250,vancomycin 500mg Recon Soln 1 Each Vial,82.13,45.18,24.64,71.04,38
RC,0250,vancomycin 500mg/10mL Solution 1 Each Syringe,81.28,44.71,24.38,70.31,38
RC,0250,vancomycin Recon Soln 1 Each Vial,124.26,68.35,37.28,107.48,38
RC,0250,vancomycin Solution 0.5 mL Syringe,86.21,47.42,25.86,74.57,38
RC,0250,vancomycin Solution 1 Each Syringe,82.13,45.18,24.64,71.04,38
RC,0250,vancomycin-impregnated polymethylmethacrylate 11% Beads 1 Device Package,965.0,530.75,256.5,929.88,76
RC,0250,varenicline 0.5 MG Tab 56 Each Bottle,9.95,5.48,2.99,8.61,38
RC,0250,varenicline 1 MG Tab 56 Each Bottle,9.95,5.48,2.99,8.61,38
RC,0250,vasopressin 20 units in 0.9% NaCl 100 mL infusion 0.2 units/mL Kit 100 mL Pack,16127.5,8870.13,4838.25,13950.29,38
RC,0250,vecuronium Recon Soln 1 Each Vial,69.1,38.01,17.4,92.58,114
RC,0250,venetoclax 10 MG Tab 2 Each Box,41.13,22.63,12.34,35.58,38
RC,0250,venetoclax 100 MG Tab 1 Each Box,317.36,174.55,95.21,274.52,38
RC,0250,venetoclax 50 MG Tab 1 Each Box,161.22,88.68,48.37,139.46,38
RC,0250,venlafaxine 100 MG Tab 100 Each Bottle,9.25,5.09,2.78,8.0,38
RC,0250,venlafaxine 25 MG Tab 100 Each Bottle,9.06,4.99,2.72,7.84,38
RC,0250,venlafaxine 37.5 MG Tab 100 Each Bottle,9.09,5.0,2.73,7.86,38
RC,0250,venlafaxine 75 MG Tab 100 Each Bottle,9.19,5.06,2.76,7.95,38
RC,0250,venlafaxine HCl 150 MG CAPSULE SR 24 HR 90 Each Bottle,8.92,4.91,2.68,7.72,38
RC,0250,venlafaxine HCl 37.5 MG CAPSULE SR 24 HR 90 Each Bottle,8.94,4.92,2.68,7.73,38
RC,0250,venlafaxine HCl 75 MG CAPSULE SR 24 HR 90 Each Bottle,8.77,4.83,2.63,7.59,38
RC,0250,verapamil 120 MG Tab 100 Each Bottle,9.53,5.25,2.86,8.24,38
RC,0250,verapamil 2.5 MG/ML Solution 2 mL Vial,95.0,52.25,28.5,82.18,38
RC,0250,verapamil 2.5 MG/ML Solution 4 mL Vial,195.0,107.25,58.5,168.68,38
RC,0250,verapamil 40 MG Tab 100 Each Bottle,8.51,4.69,2.55,7.36,38
RC,0250,verapamil 60 mg Tab 0.5 tablet Package,8.21,4.52,2.46,7.1,38
RC,0250,verapamil 80 MG Tab 100 Each Bottle,8.17,4.5,2.45,7.07,38
RC,0250,verapamil HCl 120 MG Tab CR 100 Each Bottle,8.81,4.85,2.64,7.62,38
RC,0250,verapamil HCl 180 MG Tab CR 100 Each Bottle,8.8,4.84,2.64,7.61,38
RC,0250,verapamil HCl 240 MG Tab CR 100 Each Bottle,8.77,4.83,2.63,7.59,38
RC,0250,vilazodone 10 MG Tab 30 Each Bottle,20.18,11.1,6.05,17.46,38
RC,0250,vilazodone 20 MG Tab 30 Each Bottle,19.78,10.88,5.93,17.11,38
RC,0250,vitamin A 10000 units Cap 100 Each Bottle,8.14,4.48,2.44,7.04,38
RC,0250,vitamin D3 1000 units Tab 100 Each Bottle,4.08,2.25,1.22,3.53,38
RC,0250,vitamin D3 2000 units Tab 100 Each Bottle,4.12,2.27,1.24,3.56,38
RC,0250,vitamin D3 400 units Tab 100 Each Bottle,8.05,4.43,2.42,6.96,38
RC,0250,vitamin E 100 units Cap 100 Each Bottle,4.08,2.25,1.22,3.53,38
RC,0250,vitamin E 1000 units Cap 30 Each Bottle,4.56,2.51,1.37,3.94,38
RC,0250,vitamin E 400 units Cap 100 Each Bottle,4.140000000000001,2.2800000000000002,1.2,3.7,76
RC,0250,vitamin E 400 units Cap 300 Each Bottle,4.18,2.3,1.25,3.62,38
RC,0250,vitamins A & D Ointment 113 g Tube,33.84,18.62,10.15,29.27,38
RC,0250,voriconazole 1% Solution 15 mL Package,924.64,508.56,277.39,799.81,38
RC,0250,voriconazole 200 MG Tab 30 Each Bottle,26.25,14.44,7.88,22.71,38
RC,0250,voriconazole 25 mcg/0.1 mL Solution 1 Each Syringe,376.8,207.24,113.04,325.93,38
RC,0250,voriconazole 50 MG Tab 30 Each Bottle,13.5,7.43,4.05,11.68,38
RC,0250,voriconazole 50 mcg/0.05 mL Solution 1 Each Syringe,281.1,154.61,84.33,243.15,38
RC,0250,voriconazole 50 mcg/0.1 ml Solution 1 Each Syringe,376.8,207.24,113.04,325.93,38
RC,0250,vortioxetine 10 MG Tab 30 Each Bottle,52.27,28.75,15.68,45.21,38
RC,0250,warfarin 0.5 mg half tablet Tab 0.5 tablet Package,9.03,4.97,2.71,7.81,38
RC,0250,warfarin 1 mg Tab 100 Each Box,11.205,6.17,2.77,11.41,76
RC,0250,warfarin 1.25 mg half tablet Tab 0.5 tablet Package,13.66,7.52,4.1,11.82,38
RC,0250,warfarin 1.5 mg half tablet Tab 0.5 tablet Package,9.11,5.02,2.73,7.88,38
RC,0250,warfarin 10 mg Tab 100 Each Box,12.705,6.995000000000001,2.65,14.35,76
RC,0250,warfarin 2 mg Tab 1 Each Blister,9.05,4.98,2.72,7.83,38
RC,0250,warfarin 2.5 mg Tab 100 Each Box,9.06,4.99,2.72,7.84,38
RC,0250,warfarin 3 mg Tab 100 Each Box,11.495000000000001,6.33,2.79,11.83,76
RC,0250,warfarin 3.75 mg half tablet Tab 0.5 tablet Package,9.65,5.31,2.9,8.35,38
RC,0250,warfarin 4 mg Tab 100 Each Box,11.504999999999999,6.335,2.79,11.85,76
RC,0250,warfarin 5 mg Tab 1 Each Blister,9.1,5.01,2.73,7.87,38
RC,0250,warfarin 6 mg Tab 100 Each Box,12.309999999999999,6.775,2.6,13.79,76
RC,0250,warfarin 7.5 mg Tab 100 Each Box,12.495000000000001,6.875,2.62,14.06,76
RC,0250,white petrolatum/mineral oil Ointment 3.5 g Tube,41.665,22.92,11.66,38.46,76
RC,0250,witch hazel/glycerin Pads 100 Each Box,20.14,11.08,6.04,17.42,38
RC,0250,witch hazel/glycerin Pads 40 Each Jar,20.22,11.13,6.07,17.49,38
RC,0250,zafirlukast 20 MG Tab 60 Each Bottle,12.41,6.83,3.72,10.73,38
RC,0250,zaleplon 10 MG Cap 100 Each Bottle,11.21,6.17,3.36,9.7,38
RC,0250,zaleplon 5 MG Cap 100 Each Bottle,11.19,6.16,3.36,9.68,38
RC,0250,zidovudine (neonatal) Solution 20 mL Vial,212.04,116.63,63.61,183.41,38
RC,0250,zidovudine 10 MG/ML Syrup 240 mL Bottle,126.8,69.74,38.04,109.68,38
RC,0250,zidovudine 100 MG Cap 100 Each Bottle,11.55,6.36,3.47,9.99,38
RC,0250,zinc (as sulfate) 220 mg (50 mg elemental) Cap 100 Each Bottle,4.13,2.28,1.24,3.57,38
RC,0250,zinc chloride 1 MG/ML Solution 10 mL Vial,173.99,95.7,52.2,150.5,38
RC,0250,zinc oxide 16 % Ointment 113 g Tube,38.59,21.23,11.58,33.38,38
RC,0250,zinc oxide 40 % Paste 113 g Tube,42.15,23.19,12.65,36.46,38
RC,0250,zinc sulfate 3 MG/ML Solution 10 mL Vial,265.92,146.26,79.78,230.02,38
RC,0250,ziprasidone 20 MG Cap 60 Each Bottle,9.73,5.36,2.92,8.42,38
RC,0250,ziprasidone 40 MG Cap 60 Each Bottle,9.690000000000001,5.335,2.9,8.42,76
RC,0250,ziprasidone 60 MG Cap 60 Each Bottle,9.81,5.4,2.94,8.49,38
RC,0250,ziprasidone 80 MG Cap 60 Each Bottle,9.81,5.4,2.94,8.49,38
RC,0250,zolpidem 2.5 mg half tablet Tab 1 Each Package,10.18,5.6,3.05,8.81,38
RC,0250,zolpidem 5 MG Tab 1 Each Blister,10.38,5.71,3.11,8.98,38
RC,0250,zonisamide 100 MG Cap 1 Each Blister,10.33,5.69,3.1,8.94,38
RC,0250,zonisamide 25 MG Cap 100 Each Bottle,8.69,4.78,2.61,7.52,38
RC,0258,"0.45% NaCl 0.45 % Solution 1,000 mL Flex Cont",134.0,73.7,40.2,115.91,38
RC,0258,0.45% NaCl 0.45 % Solution 500 mL Flex Cont,127.0,69.85,38.1,109.86,38
RC,0258,"0.9% NaCl 5 L Solution 5,000 mL Bag",153.75,84.57,46.13,132.99,38
RC,0258,"0.9% NaCl with KCl 20 mEq solution 1000 mL 20-0.9 MEQ/L-% Solution 1,000 mL Flex Cont",204.0,112.2,61.2,176.46,38
RC,0258,"0.9% NaCl with KCl 40 mEq/L 40-0.9 MEQ/L-% Solution 1,000 mL Flex Cont",156.0,85.8,46.8,134.94,38
RC,0258,D5W 0.05 Solution 100 mL Flex Cont,48.9,26.9,14.67,42.3,38
RC,0258,D5W 0.05 Solution 250 mL Flex Cont,56.5,31.08,16.95,48.87,38
RC,0258,"DELFLEX 2.5% dextrose 394 mOsmo/L low magnesium/low calcium 394 MOSM/L Solution 5,000 mL Flex Cont",183.75,101.07,55.13,158.94,38
RC,0258,"NaCl 0.45 % Solution 1,000 mL Flex Cont",134.0,73.7,40.2,115.91,38
RC,0258,"NaCl 0.9 % Solution 1,000 mL Flex Cont",134.0,73.7,36.0,128.02,190
RC,0258,NaCl 0.9 % Solution 100 mL Cartridge,41.9,23.05,12.57,36.24,38
RC,0258,NaCl 0.9 % Solution 100 mL Flex Cont,50.65,27.86,15.09,44.12,152
RC,0258,NaCl 0.9 % Solution 150 mL Flex Cont,56.5,31.08,16.95,48.87,38
RC,0258,NaCl 0.9 % Solution 250 mL Flex Cont,58.125,31.974999999999998,16.95,51.68,152
RC,0258,NaCl 0.9 % Solution 50 mL Flex Cont,49.075,26.995,14.36,43.51,76
RC,0258,NaCl 0.9 % Solution 500 mL Flex Cont,88.94,48.92,24.6,82.94,114
RC,0258,"PLASMA-LYTE A Solution 1,000 mL Flex Cont",202.25,111.24,60.68,174.95,38
RC,0258,"dextrose 10 % Solution 1,000 mL Flex Cont",162.0,89.1,48.6,140.13,38
RC,0258,dextrose 20 % Solution 500 mL Flex Cont,253.0,139.15,75.9,218.85,38
RC,0258,"dextrose 5 % Solution 1,000 mL Flex Cont",134.0,73.7,40.2,115.91,76
RC,0258,dextrose 5 % Solution 10 mL Syringe,30.16,16.59,9.05,26.09,38
RC,0258,dextrose 5 % Solution 100 mL Flex Cont,48.9,26.9,14.67,42.3,38
RC,0258,dextrose 5 % Solution 150 mL Flex Cont,64.6,35.53,19.38,55.88,38
RC,0258,dextrose 5 % Solution 250 mL Flex Cont,59.75,32.87,17.93,51.68,38
RC,0258,dextrose 5 % Solution 50 mL Flex Cont,49.25,27.09,14.78,42.6,38
RC,0258,dextrose 5 % Solution 500 mL Flex Cont,86.63,47.65,25.99,74.93,38
RC,0258,"dextrose 5 % and 0.2% NaCl 5-0.2 % Solution 1,000 mL Flex Cont",134.0,73.7,40.2,115.91,38
RC,0258,"dextrose 5 % and 0.45% NaCl 5-0.45 % Solution 1,000 mL Flex Cont",134.0,73.7,40.2,115.91,38
RC,0258,"dextrose 5 % and 0.9% NaCl 5-0.9 % Solution 1,000 mL Flex Cont",134.0,73.7,40.2,115.91,38
RC,0258,"dextrose 5% and 0.45% NaCl with KCl 10 mEq/L 10-5-0.45 MEQ/L-%-% Solution 1,000 mL Flex Cont",190.0,104.5,57.0,164.35,38
RC,0258,"dextrose 5% and 0.45% NaCl with KCl 20 mEq/L 20-5-0.45 MEQ/L-%-% Solution 1,000 mL Flex Cont",134.0,73.7,40.2,115.91,38
RC,0258,"dextrose 5% and 0.9% NaCl with KCl 20 mEq/L 20-5-0.9 MEQ/L-%-% Solution 1,000 mL Flex Cont",204.0,112.2,61.2,176.46,38
RC,0258,"dextrose 5% and NaCl 0.45% Solution 1,000 mL Flex Cont",134.0,73.7,40.2,115.91,38
RC,0258,dextrose 5% and NaCl 0.45% Solution 500 mL Flex Cont,113.0,62.15,33.9,97.75,38
RC,0258,"dextrose 5% in lactated ringers Solution 1,000 mL Flex Cont",117.25,64.49000000000001,30.15,115.91,76
RC,0258,dextrose 50 % Solution 50 mL Syringe,139.28,76.61,24.72,128.06,114
RC,0258,dextrose 50 % Solution 50 mL Vial,61.4,33.77,18.42,53.11,76
RC,0258,"dextrose 55 % Solution 3,000 mL Flex Cont",512.0,281.6,153.6,442.88,38
RC,0258,"dextrose 70 % Solution 2,000 mL Plas Cont",330.0,181.5,99.0,285.45,38
RC,0258,fat emulsion (INTRALIPID) 20 % Emulsion 250 mL Flex Cont,255.0,140.25,76.5,220.58,114
RC,0258,fat emulsion (INTRALIPID) 20 % Emulsion 500 mL Flex Cont,227.5,125.13,68.25,196.79,38
RC,0258,fat emulsion 20 % Emulsion 500 mL Flex Cont,273.0,150.15,81.9,236.15,38
RC,0258,"fat emulsion fish oil based (SMOFLIPID) 20 % Emulsion 1,000 mL Flex Cont",291.0,160.05,87.3,251.72,38
RC,0258,fat emulsion fish oil based (SMOFLIPID) 20 % Emulsion 250 mL Flex Cont,162.5,89.38,48.75,140.56,38
RC,0258,"lactated ringers Solution 1,000 mL Flex Cont",120.0,66.0,36.0,103.8,114
RC,0258,lactated ringers Solution 250 mL Flex Cont,61.5,33.83,18.45,53.2,76
RC,0258,lactated ringers Solution 500 mL Flex Cont,86.63,47.65,25.99,74.93,114
RC,0258,mannitol 20% 20 % Solution 250 mL Flex Cont,139.5,76.73,41.85,120.67,76
RC,0258,mannitol 20% 20 % Solution 500 mL Flex Cont,220.75,121.42,66.23,190.95,76
RC,0258,plasma protein fraction 5 % Solution 250 mL Vial,333.0,183.15,99.9,288.05,38
RC,0258,sodium chloride 3 % Solution 500 mL Flex Cont,105.13,57.83,31.54,90.94,38
RC,0258,"sterile water (preservative free) Solution 1,000 mL Flex Cont",137.5,75.63,41.25,118.94,38
RC,0258,"sterile water for injection (PF) Solution 1,000 mL Flex Cont",95.0,52.25,28.5,82.18,38
RC,0258,sterile water for injection (PF) Solution 10 mL Vial,56.614999999999995,31.145000000000003,15.22,54.06,76
RC,0258,"sterile water for injection (PF) Solution 2,000 mL Flex Cont",67.0,36.85,20.1,57.96,38
RC,0258,sterile water for injection (PF) Solution 2.2 mL Syringe,36.14,19.88,10.84,31.26,38
RC,0258,sterile water for injection (PF) Solution 50 mL Vial,74.35,40.9,22.31,64.31,38
RC,0270,HC CHW NICU DELIVERY TEAM SERVICE,560.5,308.28,168.15,484.83,38
RC,0270,HC PERFUSION CARDIOPULM ADD HRS >,308.0,169.4,92.4,266.42,38
RC,0270,HC PERFUSION CARDIOPULM TO 6 HRS,2459.5,1352.73,737.85,2127.47,38
RC,0270,HC PERFUSION MONITOR EMCO HRLY,211.0,116.05,63.3,182.52,38
RC,0270,HC PERFUSION MONITOR VAD HRLY,211.0,116.05,63.3,182.52,38
RC,0270,HC PERFUSIONIST CADIOPULM BYP LIM,3738.0,2055.9,1121.4,3233.37,38
RC,0270,HC PERFUSIONIST CADIOPULM BYPASS,5653.0,3109.15,1695.9,4889.85,38
RC,0270,HC PERFUSIONIST CADIOPULM LTD,1352.5,743.88,405.75,1169.91,38
RC,0270,HC PERFUSIONIST CELL SAVER,1581.0,869.55,474.3,1367.57,38
RC,0270,HC PERFUSIONIST ECMO,2811.0,1546.05,843.3,2431.52,38
RC,0270,HC PERFUSIONIST HYPERTHERMIA CHEM,2718.5,1495.18,815.55,2351.5,38
RC,0270,HC PERFUSIONIST HYPRTHERM LTD,1154.5,634.98,346.35,998.64,38
RC,0270,HC PERFUSIONIST IMPLANT IVAD LIMI,2705.5,1488.03,811.65,2340.26,38
RC,0270,HC PERFUSIONIST MAINTAIN INPLANTA,223.0,122.65,66.9,192.9,38
RC,0270,HC PERFUSIONIST MONITOR IMPLANTAB,185.5,102.03,55.65,160.46,38
RC,0270,HC PERFUSIONIST MONITOR INTRA-AOR,527.0,289.85,158.1,455.86,38
RC,0270,HC PERFUSIONIST OPCAB,6219.0,3420.45,1865.7,5379.44,38
RC,0270,HC PERFUSIONIST PERFORM INTRA-AOR,880.0,484.0,264.0,761.2,38
RC,0270,HC PERFUSIONIST PLATELET,1916.0,1053.8,574.8,1657.34,38
RC,0270,HC PERFUSIONIST PTCA LTD,399.0,219.45,119.7,345.14,38
RC,0270,HC PERFUSIONIST VAD,2811.0,1546.05,843.3,2431.52,38
RC,0270,HC PERFUSIONIST VEN-VEN BYPSS LTD,1154.5,634.98,346.35,998.64,38
RC,0270,HC PERFUSIONIST VENO-VENO BYPASS,2539.5,1396.73,761.85,2196.67,38
RC,0270,HC PERFUSN CARDIOPULM BYP-HI RISK,5689.0,3128.95,1706.7,4920.99,38
RC,0271,DEVICE REMOTE INSPIRE,5810.0,3195.5,1743.0,5025.65,38
RC,0271,"HC ABDOMINAL BINDER 82-94 15"" WD 5 PANEL",237.0,130.35,71.1,205.01,38
RC,0271,HC ADHEAR LOSS PROCESSING FEE,300.0,165.0,90.0,259.5,38
RC,0271,HC BOX BATTERY HOLDER,1131.5,622.33,339.45,978.75,38
RC,0271,HC CART-CODE 4,681.0,374.55,204.3,589.07,38
RC,0271,"HC CD34 SELECTION, HDE, 2ND BOTTLE REAGENT ANTIBODY",17803.0,9791.65,5340.9,15399.6,38
RC,0271,HC CERVICAL TRACTION,271.5,149.33,81.45,234.85,38
RC,0271,HC CI AB AQUA CASE,762.5,419.38,228.75,659.56,38
RC,0271,HC CI AQUA MIC/ADVANCED BIONICS,762.5,419.38,228.75,659.56,38
RC,0271,HC CI COCHLEAR AQUA KIT,762.5,419.38,228.75,659.56,38
RC,0271,HC DILATOR UTERINE HEGAR 11-14MM,286.5,157.58,85.95,247.82,38
RC,0271,HC DILATOR UTERINE HEGAR 15-18MM,384.5,211.48,115.35,332.59,38
RC,0271,HC DILATOR UTERINE HEGAR 3-4MM,241.0,132.55,72.3,208.47,38
RC,0271,HC DILATOR UTERINE HEGAR 5-6MM,244.0,134.2,73.2,211.06,38
RC,0271,HC DILATOR UTERINE HEGAR 7-8MM,274.0,150.7,82.2,237.01,38
RC,0271,HC EXTERNAL NEUROSTIMULATOR,2372.0,1304.6,711.6,2051.78,38
RC,0271,HC EXTERNAL PACING PAD ZOLL,231.0,127.05,69.3,199.82,38
RC,0271,HC HEARING AID EXTENDED WARRANTY,250.0,137.5,75.0,216.25,38
RC,0271,HC HEARING AID WARRANTY DEDUCTABL,300.0,165.0,90.0,259.5,38
RC,0271,HC HELIOX 80/20 DAILY,2965.0,1630.75,889.5,2564.73,38
RC,0271,HC INTUBATION KIT,575.0,316.25,172.5,497.38,38
RC,0271,HC LINK EXTENDED WARRANTY 3 YEARS,575.0,316.25,172.5,497.38,38
RC,0271,"HC LIONS FOUNDAT HEARING AID SERV, BINAURAL",500.0,275.0,150.0,432.5,38
RC,0271,"HC LIONS FOUNDAT HEARING AID SERV, MONAURAL",300.0,165.0,90.0,259.5,38
RC,0271,HC MED STOCKING M-LG STD CALF,275.0,151.25,82.5,237.88,38
RC,0271,HC NITRIC DAILY,14456.5,7951.08,4336.95,12504.87,38
RC,0271,HC OB REGIONAL ANESTHESIA - L&D,278.0,152.9,83.4,240.47,38
RC,0271,HC PAD REPL ASPEN COLLAR REG,296.0,162.8,88.8,256.04,38
RC,0271,HC PELVIC BINDER,433.5,238.43,130.05,374.98,38
RC,0271,HC PLUROGEL 50G,575.0,316.25,172.5,497.38,38
RC,0271,HC ROOKE BOOT,575.0,316.25,172.5,497.38,38
RC,0271,"HC SP ONLY, CUSTOM EAR PLUG MONAURAL - TAXABLE",100.0,55.0,30.0,86.5,38
RC,0271,"HC SP ONLY, ONE MUSICIAN'S FILTER TAXABLE",50.0,27.5,15.0,43.25,38
RC,0271,HC SPLINT BOHLER BRAUN,4450.0,2447.5,1335.0,3849.25,38
RC,0271,HC SUPPLIES LARGE,50.0,27.5,15.0,43.25,38
RC,0271,HC SUPPLIES MAJOR,150.0,82.5,45.0,129.75,38
RC,0271,HC SUPPLIES MEDIUM,25.0,13.75,7.5,21.63,38
RC,0271,HC SUPPLIES SMALL,10.0,5.5,3.0,8.65,38
RC,0271,HC SUPPLIES XL,100.0,55.0,30.0,86.5,38
RC,0271,HC TINNITUS MASKER,950.0,522.5,285.0,821.75,38
RC,0271,HC TRACTION BUCKS W BUCKS BRACKET,251.0,138.05,75.3,217.12,38
RC,0271,HC TRACTION-BALANCED SKELETAL-BIL,670.0,368.5,201.0,579.55,38
RC,0271,HC TRACTION-BALANCED SKELETAL-UNI,755.0,415.25,226.5,653.08,38
RC,0271,HC VAC KIT DRESSING,289.5,159.23,86.85,250.42,38
RC,0271,LIGHT PIPE WA 23GA,575.0,316.25,172.5,497.38,38
RC,0271,PAD PREMIUM FOAM 32INX73INX4IN,238.22,131.03,71.47,206.06,38
RC,0271,PAD THERMAL PT WARMING SYS MED,1001.7,550.94,300.51,866.47,38
RC,0271,PAD THERMAL PT WARMING SYS SM,1001.7,550.94,300.51,866.47,38
RC,0272,2.5 DRILL BIT FOR 4.5 SCREWS,484.84,266.67,145.45,419.39,38
RC,0272,ADAPTER ILLUMISITE BRONCH 190,534.75,294.12,160.43,462.56,38
RC,0272,AGENT SUBMUCOSAL LIFTING 1 GRAM ABSORBABLE MODIFIED POLYMER,575.0,316.25,172.5,497.38,38
RC,0272,ANCHOR GII QUICK REL MINI 2/0,3726.0,2049.3,1117.8,3222.99,38
RC,0272,ANOSCOPE DOPPL THD,3674.16,2020.79,1102.25,3178.15,38
RC,0272,ANTENNA ABLAT EMPRINT STD 20CM,12450.0,6847.5,3735.0,10769.25,38
RC,0272,APPL ENDOCLIP 5MM,520.72,286.4,156.22,450.42,38
RC,0272,APPL LIGACLIP STR LG 20,240.81,132.45,72.24,208.3,38
RC,0272,APPL/CASSETTE ENDOANCHOR EVAR,16483.5,9065.93,4945.05,14258.23,38
RC,0272,ASSY MINI BOLT 1.6MM DISP,5946.95,3270.83,1784.09,5144.11,38
RC,0272,BALLOON BAKRI POSTPARTUM RAPID,1779.17,978.55,533.75,1538.98,38
RC,0272,BALLOON ENDDOCAVITY 2X14CM LF,281.75,154.97,84.53,243.71,38
RC,0272,BASKET 0 TIP 4 WIRE 2.4FR,866.75,476.72,260.03,749.74,38
RC,0272,BASKET LITHOTRIPSY FUSION .035,1431.0,787.05,429.3,1237.82,38
RC,0272,BASKET N COMPASS 2.4,1190.07,654.54,357.02,1029.41,38
RC,0272,BASKET RETRIEVAL 4.2MM STL,1710.13,940.58,513.04,1479.26,38
RC,0272,BASKET ZEROTIP AIRWAY RETRIEVL,1100.97,605.54,330.29,952.34,38
RC,0272,BIT DRILL 2.5MM X 135MM ADD ON FOR PANGEA SYSTEM,1129.5,621.23,338.85,977.02,38
RC,0272,BIT DRILL 2.5MM X 215MM ADD ON FOR PANGEA SYSTEM,1368.0,752.4,410.4,1183.32,38
RC,0272,BIT DRILL 3.2MM X 145MM ADD ON FOR PANGEA SYSTEM,805.5,443.03,241.65,696.76,38
RC,0272,BIT DRILL 3.2MM X 215MM ADD ON FOR PANGEA SYSTEM,1287.0,707.85,386.1,1113.26,38
RC,0272,BIT DRILL 3.5MM X 135MM ADD ON FOR PANGEA SYSTEM,1206.0,663.3,361.8,1043.19,38
RC,0272,BIT DRILL 4.3MM X 215MM ADD ON FOR PANGEA SYSTEM,1368.0,752.4,410.4,1183.32,38
RC,0272,BIT DRILL CALIBRATED 2.5X285MM,575.0,316.25,172.5,497.38,38
RC,0272,BIT DRILL DIA2.4MM LONG FOR 3.5MM SCREW SYMPHONY,765.45,421.0,229.64,662.11,38
RC,0272,BIT DRILL FLEX REUSE NS 15MM,375.07,206.29,112.52,324.44,76
RC,0272,BIT DRILL FLEX REUSE NS 25MM,375.07,206.29,112.52,324.44,38
RC,0272,BIT DRILL L125MM DIA2MM AO FITTING QUICK CONNECT REUSABLE FO,465.75,256.17,139.73,402.87,38
RC,0272,BIT DRILL L285MM DIA3.1MM CALIBRATED ADD ON FITTING,575.0,316.25,172.5,497.38,38
RC,0272,BIT DRILL LG A0 DIA 4MM,575.0,316.25,172.5,497.38,38
RC,0272,BIT DRILL MD L296MM DIA4.3MM LOCKING DISPOSABLE AXSOS,639.0,351.45,191.7,552.74,38
RC,0272,BIT DRILL PANGEA 2.0X135MM,1179.0,648.45,353.7,1019.84,38
RC,0272,BIT DRILL PANGEA 2.0X175MM,1444.5,794.48,433.35,1249.49,38
RC,0272,BIT DRILL PANGEA 2.7X125MM,1233.0,678.15,369.9,1066.55,38
RC,0272,BIT DRILL PERIPH SCREW 3.2MM,323.38,177.86,97.01,279.72,38
RC,0272,BIT DRILL SHT 3.1X216MM,648.0,356.4,194.4,560.52,38
RC,0272,BIT DRILL SHT NOLOCK 3.2X216MM,657.0,361.35,197.1,568.31,38
RC,0272,BIT DRILL W/QK CONN 4.5X241MM,940.19,517.11,282.06,813.26,38
RC,0272,BLADE ARACHNOID BACKCUT 8IN,877.5,482.63,263.25,759.04,38
RC,0272,BLADE BONE MILL+ MED DISP,2342.03,1288.12,702.61,2025.86,38
RC,0272,BLADE CRVD FEATHER 1MM STL,2034.45,1118.95,610.34,1759.8,38
RC,0272,BLADE FEATHER MCELVEEN,818.1,449.96,245.43,707.66,38
RC,0272,BLADE RESURFACING 2.5MM,575.0,316.25,172.5,497.38,38
RC,0272,BNDG CONTACT LEN KONTUR 9.8X22,316.25,173.94,94.88,273.56,38
RC,0272,BOLT MONTERIS MINI 3.3MM,5262.2,2894.21,1578.66,4551.8,38
RC,0272,BONE VAC,949.64,522.31,284.89,821.44,38
RC,0272,BRACE KNEE POSTOP HINGED UNIV,445.74,245.16,133.72,385.57,38
RC,0272,BRACE KNEE TROM COOL XL,539.75,296.87,161.93,466.88,38
RC,0272,BRUSH CYTOLOGY 8FRX200CMX3MM,575.0,316.25,172.5,497.38,38
RC,0272,BTL STONE COLLECTION 140ML 8MM,242.08,133.15,72.62,209.4,38
RC,0272,BUR DIAMOND ELITE 9.2MMX10.4MM,575.0,316.25,172.5,497.38,38
RC,0272,BUR FINE DIAMOND ELITE 1.0MM,570.86,313.98,171.26,493.79,38
RC,0272,BUR FINE DIAMOND ELITE 1.5MM,570.86,313.98,171.26,493.79,38
RC,0272,BUR FINE DIAMOND ELITE RND 2.0,570.86,313.98,171.26,493.79,38
RC,0272,BUR FINE DIAMOND EXT 0.5MM,575.0,316.25,172.5,497.38,38
RC,0272,BUR MR8 ACORN FLUT 7.5MMC,575.0,316.25,172.5,497.38,38
RC,0272,BUR MR8 BALL FLUT 5.0MMC,575.0,316.25,172.5,497.38,38
RC,0272,BUR MR8 BALL FLUT LG 5MMC,575.0,316.25,172.5,497.38,38
RC,0272,BUR MR8 EXTRA COARSE 9CM 6MMC,588.69,323.78,176.61,509.22,38
RC,0272,BUR RND CARBIDE 3.0MM,964.75,530.62,289.43,834.51,38
RC,0272,BUR RND DIAMOND 3.0MM,575.0,316.25,172.5,497.38,38
RC,0272,BUR RND DIAMOND 5.0MM,575.0,316.25,172.5,497.38,38
RC,0272,BUR RND DIAMOND 6.0MM,575.0,316.25,172.5,497.38,38
RC,0272,BUR RND DIAMOND ELITE 4.0MM,575.0,316.25,172.5,497.38,38
RC,0272,BUR RND DIAMOND EXT 2.0MM,575.0,316.25,172.5,497.38,38
RC,0272,BUR RND MULTI-FLUT 5.0MM,575.0,316.25,172.5,497.38,38
RC,0272,BUR RND MULTI-FLUT EXT 3.0MM,567.99,312.4,170.4,491.31,38
RC,0272,BURR EXTRA COARSE 9CM 5MMC,588.69,323.78,176.61,509.22,38
RC,0272,CABLE COAXIAL UMBIL 72IN,500.71,275.4,150.21,433.11,38
RC,0272,CABLE ELEC UMBIL 48IN,763.11,419.72,228.93,660.09,38
RC,0272,CABLE EXT DOPPLER SCHWARTZ,661.5,363.83,198.45,572.2,38
RC,0272,CANN ART BLUNT 20FR 12IN,301.59,165.88,90.48,260.88,38
RC,0272,CANN ART BLUNT 22FR 12IN,301.59,165.88,90.48,260.88,38
RC,0272,CANN ART FEM 21FR 17IN,1407.15,773.94,422.15,1217.18,38
RC,0272,CANN BACKFLUSH HNDL 25GA,345.0,189.75,103.5,298.43,38
RC,0272,CANN DBL MERCEDES DISP 4X22X10,454.25,249.84,136.28,392.93,38
RC,0272,CANN DLP OSTIAL CORONARY 15FRC,279.74,153.86,83.92,241.98,38
RC,0272,CANN DLP OSTIAL CORONARY 17FRC,279.74,153.86,83.92,241.98,38
RC,0272,CANN DLP OSTIAL CORONARY 20FRC,279.74,153.86,83.92,241.98,38
RC,0272,CANN DUAL BORE PFC 23GA,299.0,164.45,89.7,258.64,38
RC,0272,CANN DUAL BORE PFC 25GA,299.0,164.45,89.7,258.64,38
RC,0272,CANN ENTRY VALVED 25GA+,387.9,213.35,116.37,335.53,38
RC,0272,CANN FLARED MERCEDES 3X30X9.7,483.0,265.65,144.9,417.8,38
RC,0272,CANN FLARED MERCEDES 4X22X10,483.0,265.65,144.9,417.8,38
RC,0272,CANN GRUNDY SIL 13FR LFC,533.89,293.64,160.17,461.81,38
RC,0272,CANN MERCEDES DISP 3X22 8MM,454.25,249.84,136.28,392.93,38
RC,0272,CANN NEXTGEN FEM JUG VENT 17FRC,1588.23,873.53,476.47,1373.82,38
RC,0272,CANN NEXTGEN FEM JUG VENT 21FRC,1588.23,873.53,476.47,1373.82,38
RC,0272,CANN NEXTGEN FEM VEN BICAV 21FRC,1844.37,1014.41,553.31,1595.38,38
RC,0272,CANN PROTEKDUO DUAL LUMEN 29FR,33000.0,18150.0,9900.0,28545.0,38
RC,0272,CANN PROTEKDUO DUAL LUMEN 31FR,33000.0,18150.0,9900.0,28545.0,38
RC,0272,CANN RETRO 14FRX20CM,575.0,316.25,172.5,497.38,38
RC,0272,CANN RETRO CARDIOPLEGA 15FR,501.86,276.03,150.56,434.11,38
RC,0272,CANN SPHINCTERTOME 3.9FR 20MM,924.12,508.27,277.24,799.36,38
RC,0272,CANN TRI PORT II DISP 3X22X8,454.25,249.84,136.28,392.93,38
RC,0272,CANN TRI PORT II DISP 4X22X10,454.25,249.84,136.28,392.93,38
RC,0272,CANN VEN FEM 76.2CM 23FRC,1844.37,1014.41,553.31,1595.38,38
RC,0272,CANN VEN FEM 76.2CM 25FRC,1844.37,1014.41,553.31,1595.38,38
RC,0272,CARTRIDGE C2 CRYOBALLOON,379.5,208.73,113.85,328.27,38
RC,0272,CASSETTE SONOPET IQ IRRIG/SUCT,1951.47,1073.31,585.44,1688.02,38
RC,0272,CATH ACCESS/DELIV SPYSCOPE DS,10142.1,5578.16,3042.63,8772.92,38
RC,0272,CATH BIOMEDICUS FLEX 55CM 19FRC,2362.5,1299.38,708.75,2043.56,38
RC,0272,CATH BIOMEDICUS FLEX 55CM 21FRC,2362.5,1299.38,708.75,2043.56,38
RC,0272,CATH BIOMEDICUS LUMEN 18CM 17FC,2025.0,1113.75,607.5,1751.63,38
RC,0272,CATH BIOMEDICUS LUMEN 18CM 19FC,2025.0,1113.75,607.5,1751.63,38
RC,0272,CATH BIOMEDICUS XL 61CM 23FRC,2520.0,1386.0,756.0,2179.8,38
RC,0272,CATH BIOMEDICUS XL 61CM 25FRC,2520.0,1386.0,756.0,2179.8,38
RC,0272,CATH GLIDECATH ANGL 5FR 65CM,324.88,178.69,97.46,281.02,38
RC,0272,CATH ION FULLY ARTICUL,4500.0,2475.0,1350.0,3892.5,38
RC,0272,CATH PA HEPARIN FREE 7FR,407.45,224.1,122.24,352.44,38
RC,0272,CATH SWAN BIPLR PACG FEMR 5FR,576.86,317.28,173.06,498.98,38
RC,0272,CATH SWAN GANZ 7FR 110CM,575.0,316.25,172.5,497.38,38
RC,0272,CATH SWAN GANZ MONITOR 7.5FR,575.0,316.25,172.5,497.38,38
RC,0272,CATH SWAN-GANZ 4LUM 7FR 110CM,1910.25,1050.64,573.08,1652.37,38
RC,0272,CATH TACTIFLEX F-CURVE 4X115,12540.0,6897.0,3762.0,10847.1,38
RC,0272,CAUTERY CUSA XL CEM NOSE CONE,725.94,399.27,217.78,627.94,38
RC,0272,CLIP CLOSURE MANTIS 235CM X2.8,1701.0,935.55,510.3,1471.37,38
RC,0272,CLIP RESOLUTION 360 235CM,938.16,515.99,281.45,811.51,38
RC,0272,CLIP RESOLUTION 360 ULTRA 235,983.03,540.67,294.91,850.32,38
RC,0272,CONN ENDO TUBE 60DEG 15X7MM,357.65,196.71,107.3,309.37,38
RC,0272,CONN MEDTRONIC ROTATABLE 3.66M,1440.0,792.0,432.0,1245.6,38
RC,0272,CONN PUDENZ STR,284.63,156.55,85.39,246.2,38
RC,0272,CPLR ANASTOMOTIC TI TIPPED 4MM,1571.27,864.2,471.38,1359.15,38
RC,0272,CTRL REGULATOR SUCT VACPAC,350.0,192.5,105.0,302.75,38
RC,0272,CUTTER IOL PACKER/CHANG 19GA,678.74,373.31,203.62,587.11,38
RC,0272,CUTTER VIT 25GA+,1116.9,614.3,335.07,966.12,38
RC,0272,DEVICE 3CM EPISENSE GUIDE 6130,33000.0,18150.0,9900.0,28545.0,38
RC,0272,DEVICE AERO AIRWAY SZR,900.0,495.0,270.0,778.5,38
RC,0272,DEVICE BEACON TRANSILLUMINATOR,345.0,189.75,103.5,298.43,38
RC,0272,DEVICE COMBINED OMNI 720,7395.3,4067.42,2218.59,6396.93,38
RC,0272,DEVICE CUSA CLARITY CEM,969.35,533.15,290.81,838.49,38
RC,0272,DEVICE DRIVER ROBOTIC PROBE,12450.0,6847.5,3735.0,10769.25,38
RC,0272,DEVICE FEED LP 20F 3.5CM,517.5,284.63,155.25,447.64,38
RC,0272,DEVICE FIX STRAP ABSORB 5MM,2526.08,1389.35,757.82,2185.06,38
RC,0272,DEVICE INFLATION SPHERE 60ML,258.75,142.32,77.63,223.82,38
RC,0272,DEVICE ONETRAC LX 135X30MM,1523.84,838.12,457.15,1318.12,38
RC,0272,DEVICE ONETRAC LX 135X60MM,1417.5,779.63,425.25,1226.14,38
RC,0272,DEVICE ONETRAC LX 175X30MM,1417.5,779.63,425.25,1226.14,38
RC,0272,DEVICE ONETRAC LX 90X30M,1417.5,779.63,425.25,1226.14,38
RC,0272,DEVICE ONETRAC LXD DUAL BLADE,1506.38,828.51,451.91,1303.02,38
RC,0272,DEVICE PASSER CATH SHUNT XLNG,575.0,316.25,172.5,497.38,38
RC,0272,DEVICE SUPERSETON CLOSURE,373.75,205.57,112.13,323.29,38
RC,0272,DEVICE WRENCH TORQUE SYS 36KHZ,337.18,185.45,101.15,291.66,38
RC,0272,DILAT CRE 10-12MM 8CM,740.66,407.37,222.2,640.67,38
RC,0272,DILAT SHEATH 8.5FR,1881.0,1034.55,564.3,1627.07,38
RC,0272,DILAT URET W/HYDROPLUS 10FX70CM,298.83,164.36,89.65,258.49,38
RC,0272,DILAT URET W/HYDROPLUS 8FX70CM,298.83,164.36,89.65,258.49,38
RC,0272,DRAPE C-ARM EXPANDABLE STL,287.5,158.13,86.25,248.69,38
RC,0272,DRAPE INST TRAY EYE ARTIC ARM,426.13,234.38,127.84,368.6,38
RC,0272,DRAPE MD MICROSCOPE LG,595.85,327.72,178.76,515.41,38
RC,0272,DRAPE PATIENT DBSC,4196.25,2307.94,1258.88,3629.76,38
RC,0272,DRAPE ROBOTIC NEUROMATE DISP,276.0,151.8,82.8,238.74,38
RC,0272,DRAPE SHOULDER ARTHROSCOPY,594.05,326.73,178.22,513.85,38
RC,0272,DRAPE SLUSH W/DISC 66INX44IN,236.73,130.21,71.02,204.77,38
RC,0272,DRILL 2.3X40MM,552.0,303.6,165.6,477.48,38
RC,0272,DRILL BIT 3.2X450MM,244.78,134.63,73.43,211.73,38
RC,0272,DRILL BIT 4X522 PIN,575.0,316.25,172.5,497.38,38
RC,0272,DRILL COUNTERSINK AO 2.7X2MM,778.5,428.18,233.55,673.4,38
RC,0272,DRILL SOLID CUTTING 2.5X40MM,465.75,256.17,139.73,402.87,38
RC,0272,DRILL SOLID CUTTING 2X40MM,454.25,249.84,136.28,392.93,38
RC,0272,DRILL TWIST CANN 3.5MM,787.5,433.13,236.25,681.19,38
RC,0272,DRN CHEST SAHARA PLEUR DRY SGL,290.38,159.71,87.11,251.18,38
RC,0272,DRSG DISSOLVABLE 2X6 POSISEP X,575.0,316.25,172.5,497.38,38
RC,0272,DYE ICG W/SOLVENT,916.88,504.29,275.06,793.1,38
RC,0272,DYE IOL VISION BLU,476.68,262.18,143.0,412.33,38
RC,0272,ELECTRODE CABLE STL,1102.5,606.38,330.75,953.66,38
RC,0272,ELECTRODE DEPTH 6 CONTACT,2497.5,1373.63,749.25,2160.34,38
RC,0272,ELECTRODE DUALKNIFE J LOWER,4045.5,2225.03,1213.65,3499.36,38
RC,0272,ELECTRODE DUALKNIFE J UPPER,4045.5,2225.03,1213.65,3499.36,38
RC,0272,ELECTRODE ITKNIFE NANO LOWER,2722.5,1497.38,816.75,2354.96,38
RC,0272,ELECTRODE MICROTARGETING,1183.5,650.93,355.05,1023.73,38
RC,0272,ELECTRODE ORISE PROKNIFE 1.5,3703.23,2036.78,1110.97,3203.29,38
RC,0272,ELECTRODE SB KNIFE JR LOWER,4050.0,2227.5,1215.0,3503.25,38
RC,0272,ELECTRODE SUBDURAL 8 SHT ST,1800.0,990.0,540.0,1557.0,38
RC,0272,EXTRAC PERC N-CIRC NITINOL,676.13,371.88,202.84,584.85,38
RC,0272,EXTRAC STONE TIPLESS 1.5FR,1190.07,654.54,357.02,1029.41,38
RC,0272,EXTRAC STONE TIPLESS 2.2FR,1040.99,572.55,312.3,900.46,38
RC,0272,EXTRAC STONE TIPLESS 3FR,664.2,365.31,199.26,574.53,38
RC,0272,EXTRAC STONE TIPLESS 4.5FR,664.2,365.31,199.26,574.53,38
RC,0272,FCP ACTU8 END-GRIP 23 GA DISP,575.0,316.25,172.5,497.38,38
RC,0272,FCP ACTU8 END-GRIP 25 GA DISP,575.0,316.25,172.5,497.38,38
RC,0272,FCP ACTU8 ILM 23 GA DISP,575.0,316.25,172.5,497.38,38
RC,0272,FCP ACTU8 ILM 25 GA DISP,575.0,316.25,172.5,497.38,38
RC,0272,FCP ACTU8 PRO-GRIP 23 GA DISP,575.0,316.25,172.5,497.38,38
RC,0272,FCP ACTU8 PRO-GRIP 25 GA DISP,575.0,316.25,172.5,497.38,38
RC,0272,FCP ACTU8 TALON ILM 25GA STL,575.0,316.25,172.5,497.38,38
RC,0272,FCP BIOP DISP 230CM,629.1,346.01,188.73,544.17,38
RC,0272,FCP BIOP JAWZ CRVD 6FRX50CM,787.5,433.13,236.25,681.19,38
RC,0272,FCP BIOP JAWZ STR FORM 6FRX105,787.5,433.13,236.25,681.19,38
RC,0272,FCP BIOP JAWZ STR FORM 6FRX50,787.5,433.13,236.25,681.19,38
RC,0272,FCP BIOPSY PRE MARK 1.7X110MM,592.2,325.71,177.66,512.25,38
RC,0272,FCP HOT BIOP DISP 165CM,909.14,500.03,272.74,786.41,38
RC,0272,FCP MICRO HOLDING CRVD 23GA,678.74,373.31,203.62,587.11,38
RC,0272,FCP MONOPOLAR 4MMX230CM,1125.0,618.75,337.5,973.13,38
RC,0272,FCP REVOLUTION DSP MAXGRIP 25+,683.42,375.89,205.03,591.16,38
RC,0272,FIBER LASER FLEXIVA PULSE 242,1941.3,1067.72,582.39,1679.22,38
RC,0272,FIBER LASER FLEXIVA PULSE ID 242,1941.3,1067.72,582.39,1679.22,38
RC,0272,FIBER LASER FLEXIVA PULSE ID 365,1611.63,886.4,483.49,1394.06,38
RC,0272,FIBER LASER FLEXIVA PULSE ID 550,2124.45,1168.45,637.34,1837.65,38
RC,0272,FIBER LASER FLEXIVA PULSE ID 910,3571.25,1964.19,1071.38,3089.13,38
RC,0272,GAS INTROCULAR SF6 20GM,4056.53,2231.1,1216.96,3508.9,38
RC,0272,GLIDEWIRE ANGL 3CM .035X260CM,293.25,161.29,87.98,253.66,38
RC,0272,GLIDEWIRE STIFF ANGL .035X260,330.63,181.85,99.19,285.99,38
RC,0272,GLIDEWIRE TERUMO .035X260,575.0,316.25,172.5,497.38,38
RC,0272,GRAFT ENDOVAS CONFORM 36X4.5,14447.4,7946.07,4334.22,12497.0,38
RC,0272,GRASP SURG AHMED MICRO 25GA,913.5,502.43,274.05,790.18,38
RC,0272,GUIDE CATH ION,230.0,126.5,69.0,198.95,38
RC,0272,GUIDE ENDONASAL ACCESS LG,2646.0,1455.3,793.8,2288.79,38
RC,0272,GUIDEWIRE ANGL .018/180,356.5,196.08,106.95,308.37,38
RC,0272,GUIDEWIRE ANGL TIP .035X180CM,261.63,143.9,78.49,226.31,38
RC,0272,GUIDEWIRE GI JAG .025X.260IN,517.5,284.63,155.25,447.64,38
RC,0272,GUIDEWIRE JAG ANGL .035X260,661.0,363.55,198.3,571.77,38
RC,0272,GUIDEWIRE JAGWIRE ANGL .025,763.11,419.72,228.93,660.09,38
RC,0272,GUIDEWIRE JAGWIRE STIFF .035,508.47,279.66,152.54,439.83,38
RC,0272,GUIDEWIRE ORTHO 150X1.4MM,575.0,316.25,172.5,497.38,38
RC,0272,GUIDEWIRE RUNTHROUGH 014X180C,575.0,316.25,172.5,497.38,38
RC,0272,GUIDEWIRE RUNTHROUGH EXT NS,575.0,316.25,172.5,497.38,38
RC,0272,GUIDEWIRE UNTHRD 3.2X230MM,322.0,177.1,96.6,278.53,38
RC,0272,GUIDEWIRE ZEBRA .038X260CM,508.47,279.66,152.54,439.83,38
RC,0272,GUIDEWIRE ZIP 0.035IN STIFF ST,318.84,175.37,95.65,275.8,38
RC,0272,HAND ALUM XL,268.81,147.85,80.64,232.52,38
RC,0272,HC 14-18FR LOW PROFILE G-JET FEEDING TUBE,2969.0,1632.95,890.7,2568.19,38
RC,0272,HC 14-22FR AMT TRADITIONAL G-JET FEEDING TUBE,1464.0,805.2,439.2,1266.36,38
RC,0272,HC 14FR LOW PROFILE G-J TUBE MIC-KEY,2396.5,1318.08,718.95,2072.97,38
RC,0272,HC 16FR LOW PROFILE G-J TUBE MIC-KEY,1577.5,867.63,473.25,1364.54,38
RC,0272,HC 18 - 22 R LOW PROFILE G-J TUBE MIC-KEY,1562.5,859.38,468.75,1351.56,38
RC,0272,HC ACHIEVE BIOPSY DEVICE,377.5,207.63,113.25,326.54,38
RC,0272,HC ACHIEVE MAPPING CATHETER,2514.0,1382.7,754.2,2174.61,38
RC,0272,HC ALTIUS COOLING CATH,1604.0,882.2,481.2,1387.46,38
RC,0272,HC AMBIT PRESET PAIN CONTROL SYSTEM,1195.5,657.53,358.65,1034.11,38
RC,0272,HC ANGIOJET CATH,554.5,304.98,166.35,479.64,38
RC,0272,HC ARTERIAL CANNULA 15-17 FR,1709.5,940.23,512.85,1478.72,38
RC,0272,HC ARTLINE SET-UP,105.0,57.75,31.5,90.83,38
RC,0272,HC ATEC 9-12 G BIOPSY DEVICE,942.75,518.515,242.4,932.04,76
RC,0272,HC BALLOON BAKRI POSTPARTUM 24 FR,987.5,543.13,296.25,854.19,38
RC,0272,HC BALLOON CERVICAL,289.0,158.95,86.7,249.99,38
RC,0272,HC BALLOON OCCLUSION BRIDGE,3097.5,1703.63,929.25,2679.34,38
RC,0272,HC BARD MARQUEE BIOPSY SYSTEM,575.0,316.25,172.5,497.38,76
RC,0272,HC BAYLISS TRANSEPTAL NEEDLE,2540.0,1397.0,762.0,2197.1,38
RC,0272,HC BELMONT 3-SPIKE DISPOSABLE SET,575.0,316.25,172.5,497.38,38
RC,0272,HC BELMONT RAPID INFUSER KITHC BELMONT RAPID INFUSER KIT,1600.5,880.28,480.15,1384.43,38
RC,0272,HC BERMAN ANGIOGRAPHIC 7 FR CATH,254.0,139.7,76.2,219.71,38
RC,0272,HC BI BARD US BIOPSY DEVICE,818.5,450.18,245.55,708.0,38
RC,0272,HC BI BIOPSY NEEDLE 14 G,1524.0,838.2,457.2,1318.26,38
RC,0272,HC BI BIOPSY NEEDLE ACHIEVE 14 G COAXIAL,293.0,161.15,87.9,253.45,38
RC,0272,HC BI BIOPSY NEEDLE ACHIEVE 18 G,250.5,137.78,75.15,216.68,38
RC,0272,HC BI BIOPSY SUROS NEEDLE 12 G,1156.0,635.8,346.8,999.94,38
RC,0272,HC BI BIPOSY SUROS NEEDLE 9 G OR 14 G,1454.5,799.98,436.35,1258.14,38
RC,0272,HC BI CATHETER SKATER APD,322.0,177.1,96.6,278.53,38
RC,0272,HC BI CLIP GELMARK ULTRACOR SUP,292.0,160.6,87.6,252.58,38
RC,0272,HC BI CLIP TRI-MARK TD 13-12 SUP,271.5,149.33,81.45,234.85,38
RC,0272,HC BI EVIVA STEREO NEEDLE,1065.0,585.75,319.5,921.23,38
RC,0272,HC BI EVIVA STEREO TRIMARK MARKER,400.0,220.0,120.0,346.0,38
RC,0272,HC BI US SUROS MARKER,418.5,230.18,125.55,362.0,38
RC,0272,HC BIOPSY NEEDLE,276.0,151.8,82.8,238.74,152
RC,0272,HC BONE LESION BX KIT 10G X 10CM  / 12G X 14.8CM,2672.0,1469.6,801.6,2311.28,38
RC,0272,HC BONE LESION BX KIT 11G X 6CM / 13G X 10.8CM,2672.0,1469.6,801.6,2311.28,38
RC,0272,HC BONE MARROW BX KIT 11G X 10CM,1001.5,550.83,300.45,866.3,38
RC,0272,HC BONE MARROW BX KIT 11G X 15CM,658.5,362.18,197.55,569.6,38
RC,0272,HC BOVIE CAUTERY PAD,32.0,17.6,9.6,27.68,38
RC,0272,HC BOVIE PENCIL HAND TOOL,50.0,27.5,15.0,43.25,38
RC,0272,HC BREAST LOCALIZATION KIT,890.0,489.5,267.0,769.85,38
RC,0272,HC BRONCHOCATH,575.0,316.25,172.5,497.38,38
RC,0272,"HC BSN, TOTAL CONTACT CAST",442.5,243.38,132.75,382.76,38
RC,0272,HC BX FORCEPS 1.8,780.0,429.0,234.0,674.7,38
RC,0272,HC C-SECTION CART,231.0,127.05,69.3,199.82,38
RC,0272,HC CARDIAC CATH PACK,342.5,188.38,102.75,296.26,38
RC,0272,HC CARTO REFERENCE PATCH,1719.5,945.73,515.85,1487.37,38
RC,0272,HC CASSETTE VAC VERALINK,316.0,173.8,94.8,273.34,38
RC,0272,HC CATH DRAIN 7-16 FR X 25-30-35 CM,575.0,316.25,172.5,497.38,38
RC,0272,HC CATH PLEUREX KIT,1633.5,898.43,490.05,1412.98,38
RC,0272,HC CATH SHEATH INTRO 11 CM,147.0,80.85,44.1,127.16,38
RC,0272,HC CATH SHEATH INTRO 24 CM,157.5,86.63,47.25,136.24,38
RC,0272,HC CATH SPG TX360,374.0,205.7,112.2,323.51,114
RC,0272,HC CERIBELL HEADBAND,2969.0,1632.95,890.7,2568.19,1558
RC,0272,HC CHEST TUBE INSERTION KIT,596.5,328.08,178.95,515.97,38
RC,0272,HC CIVCO DISPOSABLE GUIDE FOR US GUIDANCE,274.0,150.7,82.2,237.01,38
RC,0272,HC CLOSURE PAD,301.0,165.55,90.3,260.37,38
RC,0272,HC COPILOT,436.5,240.08,130.95,377.57,38
RC,0272,HC CORE BIOPSY GUN,278.0,152.9,83.4,240.47,152
RC,0272,HC CORONARY SINUS DELIVERY CATH,1353.5,744.43,406.05,1170.78,38
RC,0272,HC CORVOCET BIOPSY KIT,316.0,173.8,94.8,273.34,114
RC,0272,HC CORVOCET BIOPSY NEEDLE,274.0,150.7,82.2,237.01,114
RC,0272,HC CT ONCONTROL TRAY 10.2 CM,577.5,317.63,173.25,499.54,38
RC,0272,HC DECANTER,25.0,13.75,7.5,21.63,38
RC,0272,HC DEFLECTABLE LOCATOR STYLET,641.5,352.83,192.45,554.9,38
RC,0272,HC DEVICE BIOP NOVACORE BLNT 17X6,2672.0,1469.6,801.6,2311.28,76
RC,0272,HC DIAGNOSTIC WIRE,56.0,30.8,16.8,48.44,38
RC,0272,HC DISP PACING CABLES,234.5,128.98,70.35,202.84,38
RC,0272,HC DISPOSABLE ENDOSCOPE,1212.0,666.6,363.6,1048.38,38
RC,0272,HC DISPOSABLE PROSTATE ENDORECTAL PROBE,1177.5,647.63,353.25,1018.54,38
RC,0272,HC DISPOSABLE RHINOSCOPE,801.0,440.55,240.3,692.87,38
RC,0272,HC DISPOSABLE TOWEL,36.0,19.8,10.8,31.14,38
RC,0272,HC DOUBLE LUMEN PIGTAIL,423.5,232.93,127.05,366.33,38
RC,0272,HC DRAGONFLY DUO CATHETER,3238.0,1780.9,971.4,2800.87,38
RC,0272,HC DRAIN SEROMA CATH WOUND 14GA X 3.5,292.5,160.88,87.75,253.01,76
RC,0272,HC DRESSING ALTRAZEAL POD 10X10CM,673.5,370.43,202.05,582.58,38
RC,0272,HC DRSG DISSOLVABLE 2X6 POSISEP X,575.0,316.25,172.5,497.38,38
RC,0272,HC DRSG VAC PEEL AND PLACE LG,642.5,353.38,192.75,555.76,38
RC,0272,HC DRSG VAC PEEL AND PLACE MED,575.0,316.25,172.5,497.38,38
RC,0272,HC DRSG VAC PEEL AND PLACE SM,575.0,316.25,172.5,497.38,38
RC,0272,"HC DRSG VERAFLO CLEAN CHOICE, MED",613.0,337.15,183.9,530.25,38
RC,0272,"HC DRSG VERAFLO VAC, LG",960.0,528.0,288.0,830.4,38
RC,0272,"HC DRSG VERAFLO VAC, MED",575.0,316.25,172.5,497.38,38
RC,0272,HC DUAL LUMEN CENTRAL LINE KIT,256.0,140.8,76.8,221.44,38
RC,0272,HC ECLIPSE PUMP/INSERT,4555.0,2505.25,1366.5,3940.08,38
RC,0272,HC ELECTRODES,990.0,544.5,297.0,856.35,38
RC,0272,HC EMBRYO THAW KIT,394.5,216.98,118.35,341.24,38
RC,0272,HC EP PACK,218.0,119.9,65.4,188.57,38
RC,0272,HC EVIVA SMARK MARKER,425.0,233.75,127.5,367.63,38
RC,0272,HC EXPORT CATH,2319.5,1275.73,695.85,2006.37,38
RC,0272,HC EZ-10 SET ADULT AD NDL (BLUE),583.0,320.65,174.9,504.3,38
RC,0272,HC EZ-10 SET BARIATRIC LD NDL (YELLOW),612.5,336.88,183.75,529.81,38
RC,0272,HC EZ-10 SET RED PED AD NDL (PINK),606.5,333.58,181.95,524.62,38
RC,0272,HC EZ-IO INTRAOSSEOUS NDL,370.5,203.78,111.15,320.48,38
RC,0272,HC FALLOPIAN TUBE RECAN SET,399.5,219.73,119.85,345.57,38
RC,0272,HC FEEDING TUBE,575.0,316.25,172.5,497.38,76
RC,0272,HC FEM ART KITS,576.0,316.8,172.8,498.24,38
RC,0272,HC FEMSTOP,608.5,334.68,182.55,526.35,38
RC,0272,HC FIBEROPTIC BRONCHOSCOPE AIRWAY INTUB KIT,1482.5,815.38,444.75,1282.36,38
RC,0272,HC FIDUCIAL MARKER KIT,1312.5,721.88,393.75,1135.31,38
RC,0272,HC FL GASTRIC TUBE BARD SUP FH,245.5,135.03,73.65,212.36,38
RC,0272,HC FLEXCATH STEERABLE SHEATH CRYO,3232.0,1777.6,969.6,2795.68,38
RC,0272,HC FLEXIVA 365,1597.0,878.35,479.1,1381.41,38
RC,0272,HC FLEXIVA 550,2479.5,1363.73,743.85,2144.77,38
RC,0272,HC FLOSEAL HEMOSTATIC MATRIX 5 ML KIT,575.0,316.25,172.5,497.38,38
RC,0272,HC FUHRMAN PLEURAL DRAINAGE TRAY,583.0,320.65,174.9,504.3,38
RC,0272,HC GASTRIC TUBE 20 FR MONARCH,575.0,316.25,172.5,497.38,38
RC,0272,HC GASTRIC TUBE MIC LOW PROFILE,394.0,216.7,118.2,340.81,114
RC,0272,HC GLIDE WIRE,193.0,106.15,57.9,166.95,38
RC,0272,HC GUIDE CATH SLITTER,290.5,159.78,87.15,251.28,38
RC,0272,HC GUIDEWIRE AMPLATZ 145 CM,349.0,191.95,104.7,301.89,38
RC,0272,HC HOLMIUM LASER HIGH POWER,2969.0,1632.95,890.7,2568.19,38
RC,0272,HC HOLMIUM LASER SINGLE USE FIBER PER 200 MICRON,867.5,477.13,260.25,750.39,38
RC,0272,"HC HOLMIUM LASER SINGLE USE FIBER PER 272, 273 MICRON",867.5,477.13,260.25,750.39,38
RC,0272,HC HOLMIUM LASER SINGLE USE FIBER PER 365 MICRON,867.5,477.13,260.25,750.39,38
RC,0272,"HC HOVER MAT - MAT AIR PT TRANSFER 39"" DISPOSABLE",442.5,243.38,132.75,382.76,114
RC,0272,"HC HOVER MAT - MAT AIR PT TRANSFER 50"" DISPOSABLE",575.0,316.25,172.5,497.38,114
RC,0272,HC HOVER MATT SINGLE USE,494.5,271.98,148.35,427.74,38
RC,0272,HC IABP CATH,3637.0,2000.35,1091.1,3146.01,38
RC,0272,HC IMPEDENCE PROBE,2571.0,1414.05,771.3,2223.92,38
RC,0272,HC IMPELLA 2.5 A-C CATHETER,68826.5,37854.58,20647.95,59534.92,38
RC,0272,HC IMPELLA CP 3.5 CATHETER,68826.5,37854.58,20647.95,59534.92,38
RC,0272,HC IMPELLA RP CATHETER,62500.0,34375.0,18750.0,54062.5,38
RC,0272,HC IMPLANT PACK,279.5,153.73,83.85,241.77,38
RC,0272,HC INFLATION DEVICE,554.5,304.98,166.35,479.64,38
RC,0272,HC INJ IN-ROOM TEMP KIT,78.0,42.9,23.4,67.47,38
RC,0272,HC INJECTOR SYRINGE,49.0,26.95,14.7,42.39,38
RC,0272,HC INTRAOSSEOUS (IO) NDL ADULT PED,593.5,326.43,178.05,513.38,38
RC,0272,HC INTRAUTERINE BALLOON CATH,333.0,183.15,99.9,288.05,38
RC,0272,HC INTRAUTERINE VACCUM-INDUCED HEMORRHCONTROL DEVICE,5374.5,2955.98,1612.35,4648.94,38
RC,0272,HC IOBAN,13.0,7.15,3.9,11.25,38
RC,0272,HC IR  UR CATH URETT DL 6/10FR 50CM,274.0,150.7,82.2,237.01,38
RC,0272,HC IR  UR EXTRAC STONE TIPLESS,871.5,479.33,261.45,753.85,38
RC,0272,HC IR  UR SET NORMOTHERMIC IRRIGATION,274.0,150.7,82.2,237.01,38
RC,0272,HC IR AMBU ASCOPE 4 CYSTO,823.5,452.93,247.05,712.33,38
RC,0272,HC IR ANCILLARY DFINE,431.5,237.33,129.45,373.25,38
RC,0272,HC IR AUTOTOME GI,914.0,502.7,274.2,790.61,38
RC,0272,HC IR AVAMAX HANDLE STYLET,247.5,136.13,74.25,214.09,38
RC,0272,HC IR AVAMAX TRAY ADDL LEVEL,1165.5,641.03,349.65,1008.16,38
RC,0272,HC IR AVATEX BONE CEMENT RADIOPAQUE,400.0,220.0,120.0,346.0,38
RC,0272,HC IR AVATEX TRAY W CEMENT INTL LVL,1516.0,833.8,454.8,1311.34,38
RC,0272,HC IR AVATEX TRAY W CEMENT MULT LVL,2487.0,1367.85,746.1,2151.26,38
RC,0272,HC IR BALLOON CATH FOGARTY 6 FR,345.5,190.03,103.65,298.86,38
RC,0272,HC IR BALLOON CODA,916.5,504.08,274.95,792.77,38
RC,0272,HC IR BALLOON RELIANT,1382.5,760.38,414.75,1195.86,38
RC,0272,HC IR BALLOON SHOCKWAVE,11717.5,6444.63,3515.25,10135.64,38
RC,0272,"HC IR BALLOON SHOCKWAVE, E8",17237.5,9480.63,5171.25,14910.44,38
RC,0272,"HC IR BALLOON SHOCKWAVE, HIGH",12783.0,7030.65,3834.9,11057.3,38
RC,0272,HC IR BALLOON WEDGE CATH,690.0,379.5,207.0,596.85,38
RC,0272,HC IR BARD BIOPSY NEEDLE,289.5,159.23,86.85,250.42,38
RC,0272,HC IR BENVENUE BONE DRILL,1555.5,855.53,466.65,1345.51,38
RC,0272,HC IR BLAZER BONE CEMENT,1178.0,647.9,353.4,1018.97,38
RC,0272,HC IR BLUNT PIN IFUSE,575.0,316.25,172.5,497.38,38
RC,0272,HC IR BOTTLE DRAIN STARTER KIT,1178.0,647.9,353.4,1018.97,38
RC,0272,HC IR BRONCH ACCESS TOOL,1312.5,721.88,393.75,1135.31,38
RC,0272,HC IR BRONCH ADAPTER,454.0,249.7,136.2,392.71,38
RC,0272,HC IR BRONCH BIOPSY CORE,2529.5,1391.23,758.85,2188.02,38
RC,0272,HC IR BRONCH BRUSH CYTOLOGY,277.0,152.35,83.1,239.61,38
RC,0272,HC IR BRONCH KIT PROCEDURE,5423.0,2982.65,1626.9,4690.9,38
RC,0272,"HC IR BRONCH KNIFE, HYBRID",2903.5,1596.93,871.05,2511.53,38
RC,0272,HC IR BRONCH NEEDLE ASPIRATION,575.0,316.25,172.5,497.38,38
RC,0272,"HC IR BRONCH NEEDLE, PULMONARY",897.0,493.35,269.1,775.91,38
RC,0272,HC IR BRONCH PROBE CRYO,1312.5,721.88,393.75,1135.31,38
RC,0272,"HC IR BRONCH PROBE, PLASMA",924.5,508.48,277.35,799.69,38
RC,0272,HC IR BRONCH TRIPLE NEEDLE BRUSH CYTOLOGY,720.5,396.28,216.15,623.23,38
RC,0272,HC IR BX COOK BIOPSY FORCEPS,690.0,379.5,207.0,596.85,38
RC,0272,HC IR BX RADIAL JAW BX SET,621.5,341.83,186.45,537.6,38
RC,0272,HC IR CANN ANGIOVAC,33000.0,18150.0,9900.0,28545.0,38
RC,0272,HC IR CANN ANGIOVAC ANGLED,36250.0,19937.5,10875.0,31356.25,38
RC,0272,HC IR CANN ART FEM,1391.0,765.05,417.3,1203.22,38
RC,0272,HC IR CANNULA  SIDE PORT FLOW SCREW,1335.0,734.25,400.5,1154.78,38
RC,0272,HC IR CANNULA 31 F,33000.0,18150.0,9900.0,28545.0,38
RC,0272,HC IR CANNULA DUAL LUMEN PERFUSION,9736.0,5354.8,2920.8,8421.64,38
RC,0272,"HC IR CANNULA, SINGLE LUMEN 17F",2672.0,1469.6,801.6,2311.28,38
RC,0272,HC IR CATH ASPIRATION,2524.5,1388.48,757.35,2183.69,38
RC,0272,HC IR CATH DUODENAL ASPIRATION,1033.0,568.15,309.9,893.55,38
RC,0272,HC IR CATH GUIDE ENDOANCHOR,6691.5,3680.33,2007.45,5788.15,38
RC,0272,HC IR CATH INF EKOS LYSIS CATHETER,11400.0,6270.0,3420.0,9861.0,38
RC,0272,HC IR CATH INF SUREFIRE INFUSN CATH,11400.0,6270.0,3420.0,9861.0,38
RC,0272,HC IR CATH MICRO PENUMBRA MC,3412.0,1876.6,1023.6,2951.38,38
RC,0272,HC IR CATH SPHENOPALATINE CANNULA,575.0,316.25,172.5,497.38,38
RC,0272,HC IR CATH TORCON BEACON ADVANTAGE,149.0,81.95,44.7,128.89,38
RC,0272,HC IR CATH TORCON BEACON ADVANTAGE RBT,365.0,200.75,109.5,315.73,38
RC,0272,HC IR CATH TORCON BEACON ADVANTAGE VISCERAL CHG B,1741.5,957.83,522.45,1506.4,38
RC,0272,HC IR CATHETER RETRIVAL AVEIR,8760.0,4818.0,2628.0,7577.4,38
RC,0272,HC IR CEMENT THERMALFIX,1112.5,611.88,333.75,962.31,38
RC,0272,HC IR CIRCUIT ANGIOVAC,5700.0,3135.0,1710.0,4930.5,38
RC,0272,HC IR CLOSURE RF STYLET,2965.0,1630.75,889.5,2564.73,38
RC,0272,HC IR COIL DETACH AZURE DEVICE,392.5,215.88,117.75,339.51,38
RC,0272,HC IR COIL DETACH INZONE,575.0,316.25,172.5,497.38,38
RC,0272,HC IR COIL DETACH SWIFT,1111.5,611.33,333.45,961.45,38
RC,0272,HC IR COIL DETACH V-GRIP DEVICE,3421.0,1881.55,1026.3,2959.17,38
RC,0272,HC IR COIL MICROPLEX COMPLEX 18,3233.0,1778.15,969.9,2796.55,38
RC,0272,HC IR COIL PUSHER 0.016,575.0,316.25,172.5,497.38,38
RC,0272,HC IR COOK CURVED NEEDLE,275.5,151.53,82.65,238.31,38
RC,0272,HC IR CVC CATHETER REPAIR KIT,575.0,316.25,172.5,497.38,38
RC,0272,HC IR CVC EXTENDED IV,575.0,316.25,172.5,497.38,38
RC,0272,HC IR CVC MIDLINE,575.0,316.25,172.5,497.38,38
RC,0272,HC IR CYSTO STONE EXTRACTOR,917.0,504.35,275.1,793.21,38
RC,0272,HC IR DEVICE ANGIOVAC OBTURATOR,33000.0,18150.0,9900.0,28545.0,38
RC,0272,HC IR DEVICE DELIVERY CEMENT,2450.0,1347.5,735.0,2119.25,38
RC,0272,HC IR DEVICE DETACH WEB,864.0,475.2,259.2,747.36,38
RC,0272,HC IR DEVICE INFLATION ENCORE,272.0,149.6,81.6,235.28,38
RC,0272,HC IR DEVICE NEVA VS HUD # H210004,18338.0,10085.9,5501.4,15862.37,38
RC,0272,HC IR DEVICE OUTBACK RE-ENTRY CATH,7135.5,3924.53,2140.65,6172.21,38
RC,0272,HC IR DEVICE RETRIEVAL NET,575.0,316.25,172.5,497.38,38
RC,0272,HC IR DILATOR  SET,838.0,460.9,251.4,724.87,38
RC,0272,HC IR DRAIN COOK 20 FR,575.0,316.25,172.5,497.38,38
RC,0272,HC IR DRESSING PREVENA,2529.5,1391.23,758.85,2188.02,38
RC,0272,HC IR ELLIPSYS VASCULAR ACCESS CATHETER,20400.0,11220.0,6120.0,17646.0,38
RC,0272,HC IR EMB CONTOUR PVA,406.5,223.58,121.95,351.62,38
RC,0272,HC IR EMB ONCOZENE MICROSPHERES,6828.5,3755.68,2048.55,5906.65,38
RC,0272,HC IR ENT FORCEPS OLSEN JEWELERS,278.0,152.9,83.4,240.47,38
RC,0272,"HC IR ENT TRACHEOSTOMY TUBE, CUFFED",274.0,150.7,82.2,237.01,38
RC,0272,HC IR EPD ACCUNET CAROTID RECOVERY S,17089.5,9399.23,5126.85,14782.42,38
RC,0272,HC IR EPD GORE FILTER,6251.0,3438.05,1875.3,5407.12,38
RC,0272,HC IR EXCHANGE PIN,575.0,316.25,172.5,497.38,38
RC,0272,HC IR EXTRACTOR PRO GI,634.0,348.7,190.2,548.41,38
RC,0272,"HC IR EXTRACTOR PRO LOW, GI",575.0,316.25,172.5,497.38,38
RC,0272,HC IR FILTER OXYGENATOR,4974.5,2735.98,1492.35,4302.94,38
RC,0272,HC IR FORCEP MIN,2969.0,1632.95,890.7,2568.19,38
RC,0272,HC IR GASTRIC MIC TUBE,575.0,316.25,172.5,497.38,76
RC,0272,HC IR GASTRIC TUBE LOW PROFILE 18-20 FR,325.0,178.75,97.5,281.13,38
RC,0272,HC IR GASTRO G-J TUBE LOW PROFILE 16-22 FR,978.0,537.9,293.4,845.97,38
RC,0272,HC IR GUIDE PIN IFUSE,575.0,316.25,172.5,497.38,38
RC,0272,HC IR GUIDE TIP DELIVERY CEMENT,3114.5,1712.98,934.35,2694.04,38
RC,0272,HC IR GUIDEWIRE FLOW SCREW,575.0,316.25,172.5,497.38,38
RC,0272,HC IR GUIDEWIRE POWERWIRE RF,6214.5,3417.98,1864.35,5375.54,38
RC,0272,HC IR INSTRUMENT RFA BONE,12231.0,6727.05,3669.3,10579.82,38
RC,0272,HC IR INTRACRANIAL PRESSURE (ICP) BIN,3281.5,1804.83,984.45,2838.5,38
RC,0272,HC IR INTRO SET COAXIAL NDL,1555.5,855.53,466.65,1345.51,38
RC,0272,HC IR INTRO SET GASTRIC ANCHOR,1593.5,876.43,478.05,1378.38,38
RC,0272,HC IR INTRO SET PEDAL MICROPUNCTURE,255.5,140.53,76.65,221.01,38
RC,0272,HC IR IPG TEMPLATE KIT,437.5,240.63,131.25,378.44,38
RC,0272,HC IR JEJUNAL TUBE LOW PROFILE,743.5,408.93,223.05,643.13,38
RC,0272,HC IR KIT ACCESS PROTEK DUO,2672.0,1469.6,801.6,2311.28,38
RC,0272,HC IR KIT CENTRAL VENOUS DUAL LUMEN W/ VALVE MAC 7/8 F,434.0,238.7,130.2,375.41,38
RC,0272,HC IR KIT DELIVERY POWER PULSE,234.0,128.7,70.2,202.41,38
RC,0272,HC IR KIT LASER SHEATH GLIDE LIGHT,12314.5,6772.98,3694.35,10652.04,38
RC,0272,HC IR KIT NEEDLE CEMENT KIVA,666.5,366.58,199.95,576.52,38
RC,0272,HC IR KIT PREP STERILE,325.0,178.75,97.5,281.13,38
RC,0272,HC IR KIT PROTEK DUO,43750.0,24062.5,13125.0,37843.75,38
RC,0272,HC IR KIT VALVE REPAIR PLEURX,575.0,316.25,172.5,497.38,38
RC,0272,HC IR KIVA INTRODUCER KIT,6150.5,3382.78,1845.15,5320.18,38
RC,0272,HC IR KYPH BONE FILLER DIRECTIONAL,400.0,220.0,120.0,346.0,38
RC,0272,HC IR KYPH BONE FILLER EXPRESS SZ 2,400.0,220.0,120.0,346.0,38
RC,0272,HC IR KYPH CEMENT CARTRIDGE,337.0,185.35,101.1,291.51,38
RC,0272,HC IR KYPH CEMENT DELV GUN W FILL,4555.0,2505.25,1366.5,3940.08,38
RC,0272,HC IR KYPH CURETTE DEVICE,2969.0,1632.95,890.7,2568.19,38
RC,0272,HC IR KYPH INFLATION SYRINGE,380.5,209.28,114.15,329.13,38
RC,0272,HC IR KYPH INTRODUCER DRILL,4450.0,2447.5,1335.0,3849.25,38
RC,0272,HC IR KYPH OSTEO INTRODUCER,915.0,503.25,274.5,791.48,38
RC,0272,HC IR LIGASURE,2648.5,1456.68,794.55,2290.95,38
RC,0272,HC IR LUMBAR CATHETER LONG,969.0,532.95,290.7,838.19,38
RC,0272,HC IR MICROINTRODUCER SHEATH SHORT,575.0,316.25,172.5,497.38,38
RC,0272,HC IR MISC CANNULATED DRILL,920.0,506.0,276.0,795.8,38
RC,0272,HC IR MISC CORTOSS DELIVERY GUN,816.5,449.08,244.95,706.27,38
RC,0272,HC IR MISC CORTOSS MIXING TIP,575.0,316.25,172.5,497.38,38
RC,0272,HC IR MISC CORTOSS PLUNGER KIT,1062.0,584.1,318.6,918.63,38
RC,0272,HC IR MISC DFINE 1ST FX CEMENT KIT,12761.0,7018.55,3828.3,11038.27,38
RC,0272,HC IR MISC DFINE BONE DRILL,955.5,525.53,286.65,826.51,38
RC,0272,HC IR MISC DFINE CEMENT,2965.0,1630.75,889.5,2564.73,38
RC,0272,HC IR MISC DRILL BIT,390.0,214.5,117.0,337.35,38
RC,0272,HC IR MISC DRIVER,1052.0,578.6,315.6,909.98,38
RC,0272,HC IR MISC ETRAX NEEDLE,283.5,155.93,85.05,245.23,38
RC,0272,HC IR MISC HEX DRIVER,740.5,407.28,222.15,640.53,38
RC,0272,HC IR MISC IVAS CEMENT CAN,379.5,208.73,113.85,328.27,38
RC,0272,HC IR MISC LUBRICANT,575.0,316.25,172.5,497.38,38
RC,0272,HC IR MISC PROBE STRYKER RF,274.0,150.7,82.2,237.01,38
RC,0272,HC IR MISC SUP CRYO TEMPATURE MONITOR,1335.0,734.25,400.5,1154.78,38
RC,0272,HC IR MISC SUP DRAIN KIT,2965.0,1630.75,889.5,2564.73,38
RC,0272,HC IR MISC SUP IVUS RE ENTRY CATHETER,12335.5,6784.53,3700.65,10670.21,38
RC,0272,HC IR MISC SUP PV TUNNLER,826.5,454.58,247.95,714.92,38
RC,0272,HC IR MISC SUP STERILE TAPE MEASURE,374.0,205.7,112.2,323.51,38
RC,0272,HC IR MISC SUP TRAY ANGIO,403.5,221.93,121.05,349.03,38
RC,0272,HC IR MISC SUP Y ADAPTOR COPILOT,278.0,152.9,83.4,240.47,38
RC,0272,HC IR MRI GRID,2969.0,1632.95,890.7,2568.19,38
RC,0272,HC IR N300 LEAD ANCHOR KIT,575.0,316.25,172.5,497.38,38
RC,0272,HC IR NEEDLE BIOPSY BONOPTY,575.0,316.25,172.5,497.38,38
RC,0272,HC IR NEEDLE COLAPINTO,575.0,316.25,172.5,497.38,38
RC,0272,HC IR NEEDLE CONFIDENCE,575.0,316.25,172.5,497.38,38
RC,0272,HC IR NEEDLE DIAMOND TIP,304.5,167.48,91.35,263.39,38
RC,0272,HC IR NEEDLE ROSS MODIFIED,966.0,531.3,289.8,835.59,38
RC,0272,HC IR NEEDLE TEMNO BEVEL BX W INT,305.0,167.75,91.5,263.83,38
RC,0272,HC IR NEEDLE TEMNO BEVEL BX W SHT,305.0,167.75,91.5,263.83,38
RC,0272,HC IR NEEDLE TRANSVENOUS BX,1075.5,591.53,322.65,930.31,38
RC,0272,"HC IR NEEDLE, TRANSSEPTAL",2761.0,1518.55,828.3,2388.27,38
RC,0272,HC IR NEURO PACK,659.5,362.73,197.85,570.47,38
RC,0272,HC IR OSTEO VC ACCESS NEEDLE SET,575.0,316.25,172.5,497.38,38
RC,0272,HC IR OSTEO VC COAXIAL NDL SET,1666.5,916.58,499.95,1441.52,38
RC,0272,HC IR OSTEO VC POWER DRIVER,2965.0,1630.75,889.5,2564.73,38
RC,0272,HC IR OSTEO VC PROC TRAY & NEEDLE,607.0,333.85,182.1,525.06,38
RC,0272,HC IR OSTEO VC PROCEDURE TRAY,1333.0,733.15,399.9,1153.05,38
RC,0272,HC IR OSTEOCOOL BONE ACCESS,1000.0,550.0,300.0,865.0,38
RC,0272,"HC IR PACK, ENT BASIC",289.5,159.23,86.85,250.42,38
RC,0272,HC IR PATCH XENOSURE,930.0,511.5,279.0,804.45,38
RC,0272,HC IR PROBE MICROWAVE ABL,6698.5,3684.18,2009.55,5794.2,38
RC,0272,HC IR PROBE MICROWAVE ABL COVIDIEN,12335.5,6784.53,3700.65,10670.21,38
RC,0272,HC IR PROBE RFA BONE KIT,12761.0,7018.55,3828.3,11038.27,38
RC,0272,"HC IR PUMP, PERFUSION",33000.0,18150.0,9900.0,28545.0,38
RC,0272,HC IR RADIAL JAW FORCEPS,235.5,129.53,70.65,203.71,38
RC,0272,"HC IR RADIOPAQUE RULER, STERILE",345.0,189.75,103.5,298.43,38
RC,0272,HC IR RELOAD ESCHELON,437.0,240.35,131.1,378.01,38
RC,0272,"HC IR SCORER, DEEP TISSUE",583.0,320.65,174.9,504.3,38
RC,0272,HC IR SENZA CHARGER KIT,4555.0,2505.25,1366.5,3940.08,38
RC,0272,HC IR SENZA OMNIA PATIENT REMOTE KIT,4555.0,2505.25,1366.5,3940.08,38
RC,0272,HC IR SET RETRIEVAL DOTTER,985.0,541.75,295.5,852.03,38
RC,0272,HC IR SET RETRIEVAL STONE BASKET,1090.0,599.5,327.0,942.85,38
RC,0272,HC IR SHEATH DESTINATION CROSS-CUT,575.0,316.25,172.5,497.38,38
RC,0272,HC IR SHEATH GUIDING,645.0,354.75,193.5,557.93,38
RC,0272,HC IR SHEATH PEELAWAY 6-8 FR,575.0,316.25,172.5,497.38,38
RC,0272,HC IR SHEATH PEELAWAY < 15 CM,261.0,143.55,78.3,225.77,38
RC,0272,HC IR SHEATH PEELAWAY > 15 CM,277.0,152.35,83.1,239.61,38
RC,0272,HC IR SHEATH SUREFIRE,575.0,316.25,172.5,497.38,38
RC,0272,HC IR SPY KIT,2490.5,1369.78,747.15,2154.28,38
RC,0272,HC IR SPYGLASS BITE,2939.0,1616.45,881.7,2542.24,38
RC,0272,HC IR SPYGLASS DISCOVER,11717.5,6444.63,3515.25,10135.64,38
RC,0272,HC IR STAPLER,1460.0,803.0,438.0,1262.9,38
RC,0272,HC IR STOPCOCK METAL,575.0,316.25,172.5,497.38,38
RC,0272,HC IR STRKR ELECTRODE,2965.0,1630.75,889.5,2564.73,38
RC,0272,HC IR STRYKER IVAS BONE TAMP,4971.5,2734.33,1491.45,4300.35,38
RC,0272,HC IR STRYKER VERTAPLEX HV KIT,3669.5,2018.23,1100.85,3174.12,38
RC,0272,HC IR STYLET PORTAL ACCESS,2969.0,1632.95,890.7,2568.19,38
RC,0272,HC IR SURGICEL,575.0,316.25,172.5,497.38,38
RC,0272,HC IR SWAN GANZ CATH,402.5,221.38,120.75,348.16,38
RC,0272,HC IR SYRINGE CADENCE ONYX 1 ML,353.5,194.43,106.05,305.78,38
RC,0272,HC IR SYRINGE PULSE SPRAY 1 ML,391.0,215.05,117.3,338.22,38
RC,0272,HC IR THERMAL SENSOR GALIL,1333.0,733.15,399.9,1153.05,38
RC,0272,HC IR THROMB PENUMBRA ASPR TUBING,2417.0,1329.35,725.1,2090.71,38
RC,0272,HC IR THROMB PENUMBRA CANISTER SET,1644.5,904.48,493.35,1422.49,38
RC,0272,HC IR THROMB PENUMBRA INDIGO SEPERATOR,3536.0,1944.8,1060.8,3058.64,38
RC,0272,HC IR THROMB PENUMBRA INDIGO SEPERATOR HIGH,7615.0,4188.25,2284.5,6586.98,38
RC,0272,HC IR THROMB PENUMBRA KIT,12060.0,6633.0,3618.0,10431.9,38
RC,0272,HC IR THROMB PENUMBRA SEPARATOR FLEX,12718.5,6995.18,3815.55,11001.5,38
RC,0272,HC IR THROMB TREROTOLA DRIVE UNIT,618.0,339.9,185.4,534.57,38
RC,0272,HC IR TRAY BIOPSY,669.0,367.95,200.7,578.69,38
RC,0272,HC IR TUNNELING TOOL KIT,431.5,237.33,129.45,373.25,38
RC,0272,HC IR UR CATCHER STONE LITHOCLAST,455.0,250.25,136.5,393.58,38
RC,0272,HC IR UR CATH KIT BALLOON NEPRHO XFORCE,961.0,528.55,288.3,831.27,38
RC,0272,HC IR UR EXTRAC PERC N CIRC NITINOL,575.0,316.25,172.5,497.38,38
RC,0272,HC IR UR PROBE LG U/S LITHOCLAST,2969.0,1632.95,890.7,2568.19,38
RC,0272,HC IR UR PROBE PNEUM LITHOCLAST,1203.5,661.93,361.05,1041.03,38
RC,0272,HC IR VCF BALLOON CURVED,8286.0,4557.3,2485.8,7167.39,38
RC,0272,HC IR VERT AUG BEVENUE CEMENT,2635.5,1449.53,790.65,2279.71,38
RC,0272,HC IR VERT AUG BLAZER DEVICE AND CEMENT KIT,11400.0,6270.0,3420.0,9861.0,38
RC,0272,HC IR VERT AUG BONE BIOPSY DEVICE,575.0,316.25,172.5,497.38,38
RC,0272,HC IR VERT AUG CONFIDENCE CEMENT,3335.5,1834.53,1000.65,2885.21,38
RC,0272,HC IR VERT AUG COOK OSTEO NDL,924.0,508.2,277.2,799.26,38
RC,0272,HC IR VERT AUG DIAMOND TIP NDL,1275.5,701.53,382.65,1103.31,38
RC,0272,HC IR VERT AUG DIAMOND TIP NEEDLE LONG,575.0,316.25,172.5,497.38,38
RC,0272,HC IR VERT AUG DIAMOND TIP NEEDLE ORTHO,1428.5,785.68,428.55,1235.65,38
RC,0272,HC IR VERT AUG IVAS STRK PED KIT,3668.5,2017.68,1100.55,3173.25,38
RC,0272,HC IR VERT AUG KIVA,6639.0,3651.45,1991.7,5742.74,38
RC,0272,HC IR VERT AUG KIVA PILOT,3540.5,1947.28,1062.15,3062.53,38
RC,0272,HC IR VERT AUG STRK CEMENT CANNULA,278.0,152.9,83.4,240.47,38
RC,0272,HC IR VERT AUG STRYKER BONE BX NDL,575.0,316.25,172.5,497.38,38
RC,0272,HC IR VERT AUG STRYKER DRILL HNDL,303.5,166.93,91.05,262.53,38
RC,0272,HC IR VERT AUG TROCAR NDL,275.5,151.53,82.65,238.31,38
RC,0272,"HC IR WIRE, BALL TIPPED, NON-VASC",587.5,323.13,176.25,508.19,38
RC,0272,HC KIT - ACCESSORY CATHETER LLD,583.0,320.65,174.9,504.3,38
RC,0272,HC KIT - ACCESSORY PREP LEAD EXTRACTION BRIDGE,1284.5,706.48,385.35,1111.09,38
RC,0272,HC KIT - LAZER SHEATH GLIDELIGHT,8745.5,4810.03,2623.65,7564.86,38
RC,0272,HC KIT CATH COOL-LINE SUBCLAVIAN,3113.0,1712.15,933.9,2692.75,38
RC,0272,HC KIT CATH ICY FEMORAL,3152.5,1733.88,945.75,2726.91,38
RC,0272,HC LASER TUBE,302.0,166.1,90.6,261.23,38
RC,0272,HC LATEX FREE SWAN CATH,1363.0,749.65,408.9,1179.0,38
RC,0272,HC LEAD EXTENDER BULLDOG,1499.0,824.45,449.7,1296.64,38
RC,0272,HC LEAD LOCKING DEVICE CUTTER,548.0,301.4,164.4,474.02,38
RC,0272,HC LEAD LOCKING DEVICE W/ STYLET,2335.0,1284.25,700.5,2019.78,38
RC,0272,HC LEFT HEART KIT,201.5,110.83,60.45,174.3,38
RC,0272,HC LOCK DOWN SHEATH,154.5,84.98,46.35,133.64,38
RC,0272,HC LONG SEROMA CATH 14G X 3.5 IN NEEDLES,274.0,150.7,82.2,237.01,76
RC,0272,HC LOW PROFILE J TUBE 18 FR 5.5,753.5,414.43,226.05,651.78,76
RC,0272,HC MAGIC TORQUE,240.0,132.0,72.0,207.6,38
RC,0272,HC MIC FEEDING TUBE,261.5,143.83,78.45,226.2,76
RC,0272,HC MIC GASTRIC TUBE,307.0,168.85,92.1,265.56,76
RC,0272,HC MIC GASTRONOMY FEEDING TUBE,261.5,143.83,78.45,226.2,38
RC,0272,HC MIC JEJ TUBE 16-22 FR,575.0,316.25,172.5,497.38,38
RC,0272,HC MIC TRANSGASTRIC JEJUNAL FEEDING KIT,984.0,541.2,295.2,851.16,76
RC,0272,HC MIC TRANSGASTRIC JEJUNAL TUBE,390.5,214.78,117.15,337.78,76
RC,0272,HC MICRO CATH,2160.5,1188.28,648.15,1868.83,38
RC,0272,HC MICROPUNCTURE WIRE,168.5,92.68,50.55,145.75,38
RC,0272,HC MISC SUP FLOSEAL,1339.5,736.73,401.85,1158.67,38
RC,0272,HC MITRACLIP SYSTEM KIT,75000.0,41250.0,22500.0,64875.0,38
RC,0272,HC MR CLIP APPL ATEC TD 13,300.0,165.0,90.0,259.5,38
RC,0272,HC MR CLIP APPL ATEC TD 2S 13,300.0,165.0,90.0,259.5,38
RC,0272,HC MR INTRODUCER 9 GA 12,636.0,349.8,190.8,550.14,38
RC,0272,HC MR INTRODUCER 9 GA 20,636.0,349.8,190.8,550.14,38
RC,0272,HC MR SUP INVIVO LELOC HOOK WIRE-NEEDLE,575.0,316.25,172.5,497.38,38
RC,0272,HC MR TISSUE MARKER MICROMRK 11 G,434.5,238.98,130.35,375.84,38
RC,0272,HC MR TRAY ATEC 12 MM 9 GA X 14 CM,1141.5,627.83,342.45,987.4,38
RC,0272,HC MR TRAY ATEC 20 MM 9 GA X 14 CM,1141.5,627.83,342.45,987.4,38
RC,0272,HC MRGFUS COUPLING GEL BOWL,575.0,316.25,172.5,497.38,38
RC,0272,HC MRGFUS GEL PAD,575.0,316.25,172.5,497.38,38
RC,0272,HC MRGFUS TREATMENT KIT - BONE,889.0,488.95,266.7,768.99,38
RC,0272,HC MRGFUS TREATMENT KIT - UTERINE,889.0,488.95,266.7,768.99,38
RC,0272,HC NASAL BRIDLE,283.0,155.65,84.9,244.8,76
RC,0272,HC NEG PRESSURE WOUND THREAPY TWO DRESSING KIT W/ PUMP,1046.0,575.3,313.8,904.79,38
RC,0272,HC ONCONTROL TRAY W INTRODUCER,1666.5,916.58,499.95,1441.52,38
RC,0272,HC OPTIFLOW / AEROSOL SETUP,287.5,158.13,86.25,248.69,38
RC,0272,"HC ORIGINAL SEROMA CATH, 2 IN",274.0,150.7,82.2,237.01,76
RC,0272,HC OXYGEN DAILY,285.5,157.03,85.65,246.96,38
RC,0272,HC PANNUS RETENTION STRAP,281.5,154.83,84.45,243.5,76
RC,0272,"HC PEEL AWAY INTRODUCER, 7-14 FR",620.5,341.28,186.15,536.73,38
RC,0272,HC PENETRATION SET BONOPTY,297.5,163.63,89.25,257.34,38
RC,0272,HC PERCUTANEOUS TRACH TRAYS,961.0,528.55,288.3,831.27,38
RC,0272,HC PERICARDIOCENTESIS KIT,559.0,307.45,167.7,483.54,38
RC,0272,HC PFO SIZING BALLOON,1056.0,580.8,316.8,913.44,38
RC,0272,HC PLEUREX DRN,296.0,162.8,88.8,256.04,38
RC,0272,"HC PLEURX DRAIN BOTTLE 1,000 ML",575.0,316.25,172.5,497.38,38
RC,0272,HC PNEUMOTHORAX KIT,575.0,316.25,172.5,497.38,38
RC,0272,HC POLYPVAC 4.0MM MICRODEBRIDER,1444.5,794.48,433.35,1249.49,38
RC,0272,HC POWER GLIDE NEEDLE,417.0,229.35,125.1,360.71,38
RC,0272,HC PRO-TEK DUO KIT DL31,48750.0,26812.5,14625.0,42168.75,38
RC,0272,HC PROBE CLARITEE HTEE ZURO EVO,4555.0,2505.25,1366.5,3940.08,38
RC,0272,HC PROCEDURE KIT 1,33000.0,18150.0,9900.0,28545.0,38
RC,0272,HC PROCEDURE PACK,296.0,162.8,88.8,256.04,38
RC,0272,HC PULM WEDGE PRESS CATH,356.0,195.8,106.8,307.94,38
RC,0272,HC PURGE CASSETTE,933.0,513.15,279.9,807.05,38
RC,0272,HC RADIAL ARTERIAL LINE KIT,329.0,180.95,98.7,284.59,38
RC,0272,HC RADIAL SHEATH,229.0,125.95,68.7,198.09,38
RC,0272,"HC RAIATION ATTENUATION GLOVES, SZ 7.5-8",322.5,177.38,96.75,278.96,38
RC,0272,HC RAPID RHINO NASAL PAK,274.0,150.7,82.2,237.01,38
RC,0272,HC REAGENTS AND SUPPLIES FOR FACTOR VIII TRANSDUCED AUTOLOGOUS CD34+ PREP,1290.5,709.78,387.15,1116.28,38
RC,0272,HC REAGENTS AND SUPPLIES FOR VIRAL-SPECIFIC CTL PREP USING CYTOKINE CAP SYS,6460.0,3553.0,1938.0,5587.9,38
RC,0272,HC REPOSITIONING SLEEVE,55.5,30.53,16.65,48.01,38
RC,0272,HC RIGHT HEART KIT,128.0,70.4,38.4,110.72,38
RC,0272,HC ROADRUNNER GUIDE WIRE 0.035 X 145 - 180 CM,232.0,127.6,69.6,200.68,38
RC,0272,HC ROADRUNNER GUIDE WIRE 0.035 X 260 CM,274.0,150.7,82.2,237.01,38
RC,0272,HC ROTOBLATOR ROTO GLIDE SOLUTION,361.0,198.55,108.3,312.27,38
RC,0272,HC SAFE-T CENTSIS 6 FR TRAY,391.5,215.33,117.45,338.65,38
RC,0272,HC SALINE CONTRAST,278.0,152.9,83.4,240.47,76
RC,0272,HC SCALPEL,13.0,7.15,3.9,11.25,38
RC,0272,HC SEALING ADAPTER,161.5,88.83,48.45,139.7,38
RC,0272,HC SECURMARK MRI BIOPSY MARKER,391.0,215.05,117.3,338.22,38
RC,0272,HC SENSOMARK BIOPSY MARKER,402.5,221.38,120.75,348.16,38
RC,0272,HC SEROMA CATH WOUND DRAINAGE SYSTEM,2236.5,1230.08,670.95,1934.57,76
RC,0272,HC SET DILATOR SHEATH BYRD X-LONG,1513.0,832.15,453.9,1308.75,38
RC,0272,HC SET TUBE DUO VAC VERATRAC,431.5,237.33,129.45,373.25,38
RC,0272,HC SHEATH 45 CM,357.0,196.35,107.1,308.81,38
RC,0272,HC SHEATH DILATOR VISI SHEATH,1191.0,655.05,357.3,1030.22,38
RC,0272,HC SHEATH MINI ROTATING TIGHTRAIL,6351.0,3493.05,1905.3,5493.62,38
RC,0272,HC SHEATH ROTATING DILATOR TIGHTRAIL,5154.0,2834.7,1546.2,4458.21,38
RC,0272,HC SNAP ADVANCED DRESSING KIT,275.5,151.53,82.65,238.31,38
RC,0272,HC SNAP BRIDGE DRESSING KIT 14 X 11 CM,339.5,186.73,101.85,293.67,38
RC,0272,HC SPINAL NDL,272.0,149.6,81.6,235.28,38
RC,0272,HC STEERING DEVICE,85.5,47.03,25.65,73.96,38
RC,0272,HC STEINMAN PIN,312.0,171.6,93.6,269.88,38
RC,0272,HC STEREO BX CLIP,457.0,251.35,137.1,395.31,38
RC,0272,HC STEREO BX PROBE,1142.0,628.1,342.6,987.83,38
RC,0272,HC STERILE PROGRAMMER SLEEVE,127.0,69.85,38.1,109.86,38
RC,0272,HC STIMULATOR LEAD,393.0,216.15,117.9,339.95,76
RC,0272,HC STYLET KIT,639.0,351.45,191.7,552.74,38
RC,0272,HC SUP CT ONCONTROL TRAY 15.2 CM,577.5,317.63,173.25,499.54,38
RC,0272,HC SUTURE,25.0,13.75,7.5,21.63,38
RC,0272,HC SWAN GANZ CATH,296.0,162.8,88.8,256.04,38
RC,0272,HC TEMNO BX SYSTEM WO INTRO,235.0,129.25,70.5,203.28,38
RC,0272,HC THERMOCOOL IRRIGATION SET,481.5,264.83,144.45,416.5,38
RC,0272,HC THULIUM/MOSES LASER,5087.5,2798.13,1526.25,4400.69,38
RC,0272,HC TORAY INOVE BALLOON,6763.5,3719.93,2029.05,5850.43,38
RC,0272,HC TR BAND (RADIAL),159.0,87.45,47.7,137.54,38
RC,0272,HC TRACKER,1160.5,638.28,348.15,1003.83,38
RC,0272,HC TRANSFER BOARD W/SLOTS 30 INCHES,253.0,139.15,75.9,218.85,38
RC,0272,HC TRAY PNEUMOTHORAX,896.0,492.8,268.8,775.04,38
RC,0272,HC TUBE MIC-KEY G LP 16FR 3.0CM,575.0,316.25,172.5,497.38,38
RC,0272,HC TUNNELED CATH REPAIR KIT,431.5,237.33,129.45,373.25,38
RC,0272,HC TWIN PASS CATH,1062.5,584.38,318.75,919.06,38
RC,0272,HC URETH DILATOR SET BLUE SLT LAS,684.0,376.2,205.2,591.66,76
RC,0272,HC UROMAX WITH ENCORE,1120.5,616.28,336.15,969.23,38
RC,0272,HC VENOUS CANNULA 21-23 FR,1997.5,1098.63,599.25,1727.84,38
RC,0272,HC VERT AUG CURVED NEEDLE,1305.0,717.75,391.5,1128.83,38
RC,0272,"HC VICRYL SUTURE, 27-30 IN",285.5,157.03,85.65,246.96,38
RC,0272,HC WAFFLE/HEEL PROTECTOR BOOT,260.0,143.0,78.0,224.9,38
RC,0272,HC WAND ELECTROSURGICAL REFLEX ULTRA PTR COBLATION,1353.0,744.15,405.9,1170.35,38
RC,0272,HC WHOOLEY WIRE,340.0,187.0,102.0,294.1,38
RC,0272,HC WIRE INSERTION TOOL,55.5,30.53,16.65,48.01,38
RC,0272,HC WOUND VAC,401.5,220.83,120.45,347.3,38
RC,0272,HC WRENCH KIT,186.5,102.58,55.95,161.32,38
RC,0272,HC Z-MED DILATION BALLOON,2335.0,1284.25,700.5,2019.78,38
RC,0272,HC ZIP LINE STRIPS,350.0,192.5,105.0,302.75,38
RC,0272,HLDR KNEE ALVARADO,242.13,133.18,72.64,209.44,38
RC,0272,HNDL COIL DETACHMENT,1071.0,589.05,321.3,926.42,38
RC,0272,HNDPC ENDO ABLAT MINERVA DISP,4050.0,2227.5,1215.0,3503.25,38
RC,0272,HNDPC ENSEAL X1 360D CRVD 5X37,1771.43,974.29,531.43,1532.29,38
RC,0272,HNDPC LAPSC 36CM 5MM ARGON,833.09,458.2,249.93,720.62,38
RC,0272,HNDPC LIGASURE EXACT FINE 21CM,3216.33,1768.99,964.9,2782.13,38
RC,0272,IMPL STIM LIBERTA RC IPG,62000.0,34100.0,18600.0,53630.0,38
RC,0272,INST APPROX 3.5MM,1571.27,864.2,471.38,1359.15,38
RC,0272,INST BONE TAP STD THRD 3.5MM,839.34,461.64,251.8,726.03,38
RC,0272,INST COUNTERSINK CANN W/AO FIT,589.5,324.23,176.85,509.92,38
RC,0272,INST HARMONIC 700 SHEAR 23CM,1792.67,985.97,537.8,1550.66,38
RC,0272,INST HARMONIC SHEAR 1100 20CM,2138.94,1176.42,641.68,1850.18,38
RC,0272,INST HNDPC ENSEAL 5MM 35CM,1773.36,975.35,532.01,1533.96,38
RC,0272,INST POINTER NAVIGATION AXIEM,2871.0,1579.05,861.3,2483.42,38
RC,0272,INST REAMER SHAFT 885MM,1332.0,732.6,399.6,1152.18,38
RC,0272,INST REAMER SHAFT 8X510MM,1188.0,653.4,356.4,1027.62,38
RC,0272,INST SURG ROUTER TPR BUR 1.5MM,575.0,316.25,172.5,497.38,38
RC,0272,INST TRACKER PT SKULL MOUNT,1453.5,799.43,436.05,1257.28,38
RC,0272,INST VISION PROBE ION,1710.0,940.5,513.0,1479.15,38
RC,0272,INTRO CATH SHEATH 7FRX85CM,575.0,316.25,172.5,497.38,38
RC,0272,INTRO MINOPA 26FR DISP,1242.27,683.25,372.68,1074.56,38
RC,0272,INTRO SET HEMOSTASIS 7F 40,639.0,351.45,191.7,552.74,38
RC,0272,INTRO SET HEMOSTASIS STD 12F,304.75,167.62,91.43,263.61,38
RC,0272,INTRO SHEATH 30DEG 45CM LGTH,488.75,268.82,146.63,422.77,38
RC,0272,INTRO SHEATH RAMP 8.5FR,585.0,321.75,175.5,506.03,38
RC,0272,INTRO SHEATH RAMP-1 8.5FX60CM,738.0,405.9,221.4,638.37,38
RC,0272,KIT ACCESSORY FOR AMS 700 INFLATABLE PENILE PROSTHESIS TENAC,4668.75,2567.82,1400.63,4038.47,38
RC,0272,KIT ADV LAPSC CARE NEW WAVE,257.89,141.84,77.37,223.07,38
RC,0272,KIT ASPIRATION NDL,533.6,293.48,160.08,461.56,38
RC,0272,KIT BLD PROCESSING  PLASMA SYS,967.5,532.13,290.25,836.89,38
RC,0272,KIT BONE DOWEL REV 13MM,2250.0,1237.5,675.0,1946.25,38
RC,0272,KIT CATH PROGREAT 2.8FRX150CM,2664.0,1465.2,799.2,2304.36,38
RC,0272,KIT CATH VALVULOTOME COMPL,12450.0,6847.5,3735.0,10769.25,38
RC,0272,KIT CENTRAL VENOUS TWO LUM,543.95,299.18,163.19,470.52,38
RC,0272,KIT CYSVIEW 100MG,5602.5,3081.38,1680.75,4846.16,38
RC,0272,KIT DEFENDO EUS VALVE 3 PC,244.38,134.41,73.31,211.39,38
RC,0272,KIT DILA VASC NDL18G 11 BLADE,1035.0,569.25,310.5,895.28,38
RC,0272,KIT DRILL VARIOGUIDE .075IN,3375.0,1856.25,1012.5,2919.38,38
RC,0272,KIT HIPEC BELMONT,5287.1,2907.91,1586.13,4573.34,38
RC,0272,KIT ILLUMISITE PROC 180 DEG,7154.6,3935.03,2146.38,6188.73,38
RC,0272,KIT ILLUMISITE PROC 45 DEG,7154.6,3935.03,2146.38,6188.73,38
RC,0272,KIT ILLUMISITE PROC 90 DEG,7154.6,3935.03,2146.38,6188.73,38
RC,0272,KIT LEVINE IRRIG SUCT ENT,263.24,144.79,78.97,227.7,38
RC,0272,KIT MARROW COLLECTION,1353.11,744.22,405.93,1170.44,38
RC,0272,KIT PICO14 DRSG W/PUMP 10X20CM,1480.5,814.28,444.15,1280.63,38
RC,0272,KIT PICO14 DRSG W/PUMP 10X30CM,1480.5,814.28,444.15,1280.63,38
RC,0272,KIT PICO14 DRSG W/PUMP 10X40CM,1480.5,814.28,444.15,1280.63,38
RC,0272,KIT PREP BRIDGE BALLOON,1305.0,717.75,391.5,1128.83,38
RC,0272,KIT PROGRAMMING HANDSET AND COMMUNICATOR INCEPTIV,3608.55,1984.71,1082.57,3121.4,38
RC,0272,KIT RECELL GO PREP,24750.0,13612.5,7425.0,21408.75,38
RC,0272,KIT ROSA WALTER ACTIVATION STL,2758.5,1517.18,827.55,2386.1,38
RC,0272,KIT SIGMOID BULB/SCOPE DISP,404.11,222.27,121.23,349.56,38
RC,0272,KIT SMARTFRAME BUR SKULL BASE,16318.5,8975.18,4895.55,14115.5,38
RC,0272,KIT SUT SOFT TISSUE REPAIR LG,4117.5,2264.63,1235.25,3561.64,38
RC,0272,KIT TRANSDUCER TRIFURCATE,233.97,128.69,70.19,202.38,38
RC,0272,KIT TRILOGY PROBE DISP 3.9X350,4565.0,2510.75,1369.5,3948.73,38
RC,0272,KIT TRILOGY PROBE DISP 3.9X440,3795.71,2087.65,1138.71,3283.29,38
RC,0272,KIT VEN INSERT BIOMEDIUSC,506.63,278.65,151.99,438.23,38
RC,0272,LASER FIBER TIP MOSES 200 MIC,3370.91,1854.01,1011.27,2915.84,38
RC,0272,LASER FIBER TIP MOSES 365 MIC,1916.77,1054.23,575.03,1658.01,38
RC,0272,LASER FIBER TIP MOSES 550 MIC,2643.84,1454.12,793.15,2286.92,38
RC,0272,LEAD PACER BIPOLAR VALVE (HV),402.5,221.38,120.75,348.16,38
RC,0272,LEGION HK 11MM BOLT - SLEEVE,3477.38,1912.56,1043.21,3007.93,38
RC,0272,LENS CONTACT AIR OPTIX 8.6,416.3,228.97,124.89,360.1,38
RC,0272,LIGHT PIPE 23GA DORC PHOTON,1012.5,556.88,303.75,875.81,38
RC,0272,MANIPUL UTERINE CLEARVIEW 7CM,431.25,237.19,129.38,373.03,38
RC,0272,MARKER MARGIN INK 6 COLOR KIT,824.13,453.28,247.24,712.87,38
RC,0272,MAT AIR PT TRANSFER 50IN DISP,575.0,316.25,172.5,497.38,38
RC,0272,MATRIX BONE PEARLMATRIX 10.0CC,19305.0,10617.75,5791.5,16698.83,38
RC,0272,NDL ACUJECT INJ FLEX 25G,230.0,126.5,69.0,198.95,38
RC,0272,NDL ACUJET FLEX INJ 23GAX5MM,230.0,126.5,69.0,198.95,38
RC,0272,NDL ASPIRATION 21GA 152X130CM,474.55,261.01,142.37,410.49,38
RC,0272,NDL BIOP 1.8X235MM,2565.0,1410.75,769.5,2218.73,38
RC,0272,NDL BIOP ECHOTIP ACUCORE 22GA,1912.5,1051.88,573.75,1654.31,38
RC,0272,NDL BIOPSY 2.1MM X 257MM DISP,2970.0,1633.5,891.0,2569.05,38
RC,0272,NDL EBUS PULM ACQUIRE 22GA,1593.5,876.43,478.05,1378.38,38
RC,0272,NDL ECHOTIP 5.3FR 22GA 0-8CM,1912.5,1051.88,573.75,1654.31,38
RC,0272,NDL ENDO L40MM 22GA,1028.7,565.79,308.61,889.83,38
RC,0272,NDL ENDO U/S ECHOTIP 19GA,1062.0,584.1,318.6,918.63,38
RC,0272,NDL ENDO U/S ECHOTIP BALL 22GA,1062.0,584.1,318.6,918.63,38
RC,0272,NDL ENDO U/S SLIM 22GA,965.66,531.12,289.7,835.3,38
RC,0272,NDL ENDO U/S SLIM 25GA,965.66,531.12,289.7,835.3,38
RC,0272,NDL ENDO U/S SLIM FLEX 19GA,1963.49,1079.92,589.05,1698.42,38
RC,0272,NDL GUIDE TP PIVOT PRO,810.0,445.5,243.0,700.65,38
RC,0272,NDL INJ DBL BEVEL 16GA X 9.8IN,373.75,205.57,112.13,323.29,38
RC,0272,NDL PULM ARCPOINT 21G X 137CM,1071.0,589.05,321.3,926.42,38
RC,0272,NDL STELLARIS FRAG 30DEG 23GA,575.0,316.25,172.5,497.38,38
RC,0272,NDL TRANSBRONCHIAL 19GA,474.55,261.01,142.37,410.49,38
RC,0272,NET RETRIEVAL ROTH MINI 1.8,575.0,316.25,172.5,497.38,38
RC,0272,OSCIL SAW BLDE 1.35MM FAN HALL 3/4 IN,279.91,153.96,83.97,242.12,38
RC,0272,OSCILLATING SAW BLADE 1.35MM FAN 3M,279.91,153.96,83.97,242.12,38
RC,0272,PACK ACCESSORY CARDIOGEN-82,578.25,318.04,173.48,500.19,38
RC,0272,PACK CANISTER LIPO FILTER  ASP,1080.0,594.0,324.0,934.2,38
RC,0272,PACK COMBO PROC A/P CONST 25GA,2917.67,1604.72,875.3,2523.78,38
RC,0272,PACK CONSTELLATION VIT 25GA,3251.03,1788.07,975.31,2812.14,38
RC,0272,PACK CUSTOM ABD AOR ANRSM,575.0,316.25,172.5,497.38,38
RC,0272,PACK CUSTOM AMPUTATION,768.47,422.66,230.54,664.73,38
RC,0272,PACK CUSTOM AV FISTULA,534.23,293.83,160.27,462.11,38
RC,0272,PACK CUSTOM BASIC ARTHROSCOPY,323.84,178.12,97.15,280.12,38
RC,0272,PACK CUSTOM BASIC PLASTIC,364.38,200.41,109.31,315.19,38
RC,0272,PACK CUSTOM BREAST,575.69,316.63,172.71,497.97,38
RC,0272,PACK CUSTOM C SECTION,464.49,255.47,139.35,401.78,38
RC,0272,PACK CUSTOM CABG SUPPLEMENT,668.03,367.42,200.41,577.85,38
RC,0272,PACK CUSTOM CHEST,659.7950000000001,362.89,75.21,924.59,76
RC,0272,PACK CUSTOM CP PRIME,1183.5,650.93,355.05,1023.73,38
RC,0272,PACK CUSTOM DRAPE ANGIO S P,299.17,164.55,89.75,258.78,38
RC,0272,PACK CUSTOM EAR SUPPLEMENT,575.0,316.25,172.5,497.38,38
RC,0272,PACK CUSTOM ECMO,646.06,355.34,193.82,558.84,38
RC,0272,PACK CUSTOM ENT BASIC- ASC,283.13,155.73,84.94,244.91,38
RC,0272,PACK CUSTOM ENT SCOPE,314.07,172.74,94.22,271.67,38
RC,0272,PACK CUSTOM EP FMLH,378.98,208.44,113.69,327.82,38
RC,0272,PACK CUSTOM FREE FLAP DONOR,1131.5700000000002,622.37,261.82,1202.7,76
RC,0272,PACK CUSTOM FREE FLAP RECIPENT,1861.79,1023.99,558.54,1610.45,38
RC,0272,PACK CUSTOM GENERAL ENDOSCOPY,575.0,316.25,172.5,497.38,38
RC,0272,PACK CUSTOM GYN LAPAROSCOPY,1257.8,691.79,377.34,1088.0,38
RC,0272,PACK CUSTOM GYN LITHOTOMY MAJOR,807.03,443.87,242.11,698.08,38
RC,0272,PACK CUSTOM GYN MINOR,575.0,316.25,172.5,497.38,38
RC,0272,PACK CUSTOM GYN ROBOTIC,1867.95,1027.38,560.39,1615.78,38
RC,0272,PACK CUSTOM HEART,1760.645,968.36,312.16,2145.86,76
RC,0272,PACK CUSTOM IMPLANT EP CATH,271.63,149.4,81.49,234.96,38
RC,0272,PACK CUSTOM KIDNEY TRANSPLANT,1356.08,745.85,406.82,1173.01,38
RC,0272,PACK CUSTOM L SUPPORT,2934.0,1613.7,880.2,2537.91,38
RC,0272,PACK CUSTOM LIVER TRANSPLNT,928.44,510.65,278.53,803.1,38
RC,0272,PACK CUSTOM LIVER TRNSPLNT,2410.7,1325.89,723.21,2085.26,38
RC,0272,PACK CUSTOM LOWER EXTREM HFM,524.75,288.62,157.43,453.91,38
RC,0272,PACK CUSTOM LOWER EXTREMITY,488.52,268.69,146.56,422.57,38
RC,0272,PACK CUSTOM MAJOR GEN,575.0,316.25,172.5,497.38,38
RC,0272,PACK CUSTOM MEDIPORT INSERTION,575.0,316.25,172.5,497.38,38
RC,0272,PACK CUSTOM MINOR GEN,312.74,172.01,93.82,270.52,38
RC,0272,PACK CUSTOM MINOR NEURO,412.995,227.15,83.6,473.45,76
RC,0272,PACK CUSTOM MINOR VASC,506.06,278.34,151.82,437.74,38
RC,0272,PACK CUSTOM MINOR VASCULAR,1377.9,757.85,413.37,1191.88,38
RC,0272,PACK CUSTOM NEURO CRANI,699.98,384.99,209.99,605.48,38
RC,0272,PACK CUSTOM NEURO CRANIOTOMY,397.56,218.66,119.27,343.89,38
RC,0272,PACK CUSTOM NEURO SPINE,491.195,270.15999999999997,122.22,497.38,76
RC,0272,PACK CUSTOM OR CYSTO,275.14,151.33,82.54,238.0,38
RC,0272,PACK CUSTOM ORTHO SPINE,574.94,316.22,172.48,497.32,38
RC,0272,PACK CUSTOM PROSTATECTMY ROBOT,1367.42,752.09,410.23,1182.82,38
RC,0272,PACK CUSTOM PROSTATECTOMY ROBOTIC,2937.38,1615.56,881.21,2540.83,38
RC,0272,PACK CUSTOM ROBOTIC CHEST,2714.22,1492.83,814.27,2347.8,38
RC,0272,PACK CUSTOM ROBOTIC KIDNEY,2779.25,1528.59,833.78,2404.05,38
RC,0272,PACK CUSTOM THYROID,630.36,346.7,189.11,545.26,38
RC,0272,PACK CUSTOM TRANSPHENOIDAL,650.7,357.89,195.21,562.86,38
RC,0272,PACK CUSTOM TRAUMA,1494.81,822.15,448.44,1293.01,38
RC,0272,PACK CUSTOM UPPER EXTREMITY,345.42999999999995,189.995,98.65,313.15,76
RC,0272,PACK CUSTOM VASCULAR PERC,1028.3,565.57,308.49,889.48,38
RC,0272,PACK CUSTOM VP SHUNT,833.36,458.35,250.01,720.86,38
RC,0272,PACK CUSTOM WO PLEG,3784.5,2081.48,1135.35,3273.59,38
RC,0272,PACK HEMOCONCENTRATOR DHFO.6,540.5,297.28,162.15,467.53,38
RC,0272,PACK I/O GAS CONSTELLATION,575.0,316.25,172.5,497.38,38
RC,0272,PACK NEXUS VITRECTOMY 23GA,2126.25,1169.44,637.88,1839.21,38
RC,0272,PACK NEXUS VITRECTOMY 25GA,2126.25,1169.44,637.88,1839.21,38
RC,0272,PACK ORTHALIGN KNEE PIN 65MM,575.0,316.25,172.5,497.38,38
RC,0272,PACK VITRECTOMY ANT 23G,1018.22,560.03,305.47,880.76,38
RC,0272,PAD CARD INSULATION ADULT,657.0,361.35,197.1,568.31,38
RC,0272,PAD SPLIT ARTIC SUN VEST LG,1262.16,694.19,378.65,1091.77,38
RC,0272,PASSER CATH 60CM,506.0,278.3,151.8,437.69,38
RC,0272,PERF DISP CRANIAL 0.14MM,1795.5,987.53,538.65,1553.11,38
RC,0272,PIN DORO LUCENT SKULL STL DISP,963.0,529.65,288.9,833.0,38
RC,0272,PLATE SPRING 2H,1148.81,631.85,344.64,993.72,38
RC,0272,PLATE SPRING 3H,1230.39,676.72,369.12,1064.29,38
RC,0272,PORT ACCESS AIRSEAL 8MMX120MM,534.64,294.06,160.39,462.46,38
RC,0272,PROBE COAG FLEX CONCEAL 6.9F,1141.65,627.91,342.5,987.53,38
RC,0272,PROBE COAG ST 1.5MM X 150CM,1107.0,608.85,332.1,957.56,38
RC,0272,PROBE CORT STIM BIPOLAR,3298.5,1814.18,989.55,2853.2,38
RC,0272,PROBE CRYOSPHERE MAX 11IN,11620.0,6391.0,3486.0,10051.3,38
RC,0272,PROBE CRYOSPHERE MAX LNG 17IN,12035.0,6619.25,3610.5,10410.28,38
RC,0272,PROBE DIATHERMY 25GA,282.15,155.19,84.65,244.06,38
RC,0272,PROBE DOPPLER NEURO DISP,1743.75,959.07,523.13,1508.34,38
RC,0272,PROBE FLEX CRYO 1.7X1150MM,1518.3,835.07,455.49,1313.33,38
RC,0272,PROBE FLEX CRYO 2.4X1150MM,1518.3,835.07,455.49,1313.33,38
RC,0272,PROBE FLEX SHEATH 1.1X1150X817,2106.9,1158.8,632.07,1822.47,38
RC,0272,PROBE FULLFIRE SZ 000 3.3MM,32610.6,17935.83,9783.18,28208.17,38
RC,0272,PROBE GLD INJ BIPOLAR 7FR,2365.83,1301.21,709.75,2046.44,38
RC,0272,PROBE LASER CRVD 25GA 0.5MM,998.06,548.94,299.42,863.32,38
RC,0272,PROBE LASER G TRANCLERAL STD,1237.5,680.63,371.25,1070.44,38
RC,0272,PROBE LASER ILLUMINATED 23 GA,932.13,512.68,279.64,806.29,38
RC,0272,PROBE LASER ILLUMINATED 25 GA,1530.68,841.88,459.2,1324.04,38
RC,0272,PROBE LASER MAS REACH 23GA,575.0,316.25,172.5,497.38,38
RC,0272,PROBE LASER MAS REACH 25GA,575.0,316.25,172.5,497.38,38
RC,0272,PROBE MEDISTIM 4MM,11599.25,6379.59,3479.78,10033.35,38
RC,0272,PROBE SERFAS SWEEP 50-S XL,1575.0,866.25,472.5,1362.38,38
RC,0272,PROBE SIDEFIRE SZ 00 3.3MM,32610.6,17935.83,9783.18,28208.17,38
RC,0272,PROBE SIDEFIRE SZ 000 3.3MM,32610.6,17935.83,9783.18,28208.17,38
RC,0272,PROBE SIDEFIRE SZ 1 3.3MM,32610.6,17935.83,9783.18,28208.17,38
RC,0272,PROBE TEMP ESOPH 10 FR CIRCA,2880.0,1584.0,864.0,2491.2,38
RC,0272,PROBE VASCUCHEK SURG STL,670.5,368.78,201.15,579.98,38
RC,0272,PUNCH AOR VEIN 2X4MM,603.0,331.65,180.9,521.6,38
RC,0272,PUNCH AOR VEIN 2X6MM,603.0,331.65,180.9,521.6,38
RC,0272,RELOAD ECHELON CONTOUR GST GRN,1275.66,701.62,382.7,1103.45,38
RC,0272,RELOAD ECHELON GST 45MM BLU,676.67,372.17,203.0,585.32,38
RC,0272,RELOAD ECHELON GST 45MM GRN,676.67,372.17,203.0,585.32,38
RC,0272,RELOAD ECHELON GST 45MM WHT,676.67,372.17,203.0,585.32,38
RC,0272,RELOAD ECHELON GST 60MM BLK,731.66,402.42,219.5,632.89,38
RC,0272,RELOAD ECHELON GST 60MM BLU,731.66,402.42,219.5,632.89,38
RC,0272,RELOAD ECHELON GST 60MM GLD,731.66,402.42,219.5,632.89,38
RC,0272,RELOAD ECHELON GST 60MM GRN,731.66,402.42,219.5,632.89,38
RC,0272,RELOAD ECHELON GST 60MM WHT,731.66,402.42,219.5,632.89,38
RC,0272,RELOAD ENDO ECHELON VASC 35 WH,691.02,380.07,207.31,597.73,38
RC,0272,RELOAD STAPLER ECHELON 80MM,513.25,282.29,153.98,443.96,38
RC,0272,RELOAD STAPLER THICK 4.2MM BLK,676.67,372.17,203.0,585.32,38
RC,0272,RELOAD SUREFORM 30 3.5MM BLU,945.0,519.75,283.5,817.43,38
RC,0272,RELOAD SUREFORM 45 2.5 WH,630.0,346.5,189.0,544.95,38
RC,0272,REPRO CATH EP CRISTA D TYPE,1517.27,834.5,455.18,1312.44,38
RC,0272,REPRO TIP CUSA XL CRVD EXT,371.45,204.3,111.44,321.3,38
RC,0272,RESERVOIR CELL SAVER W/FILTER,302.62,166.45,90.79,261.77,38
RC,0272,RETAINER VISCERA RADIOPAQUE LG,274.79,151.14,82.44,237.69,38
RC,0272,RETR ALEXIS ORTH PROTECT SM/MD,1102.5,606.38,330.75,953.66,38
RC,0272,RETR ASSISTANT 3S,1802.52,991.39,540.76,1559.18,38
RC,0272,RETR ASSISTANT HERCULES 2S,1802.52,991.39,540.76,1559.18,38
RC,0272,RETR CAPSULE EYE DISP,592.52,325.89,177.76,512.53,38
RC,0272,RETRIEVER RESCUE NET 5.5X3CM,487.54,268.15,146.26,421.72,38
RC,0272,RETRIEVER SUT HOFFEE,346.67,190.67,104.0,299.87,38
RC,0272,RING MALYUGIN 6.25MM,674.24,370.84,202.27,583.22,38
RC,0272,RING MALYUGIN 7MM,674.24,370.84,202.27,583.22,38
RC,0272,ROD EXFIX MOD HOFFMAN 11X150MM,1089.0,598.95,326.7,941.99,38
RC,0272,ROD MOD CONN EXFIX 11X450MM,1309.5,720.23,392.85,1132.72,38
RC,0272,ROD VECTRAN MOD CONN 11X500MM,1494.0,821.7,448.2,1292.31,38
RC,0272,SCOPE RECTO MAXI 25CM DISP,319.18,175.55,95.75,276.09,38
RC,0272,SCRAPER MEMBRANE CVD 25GA,644.49,354.47,193.35,557.48,38
RC,0272,SCRUB SOL SURG POVIDONE IODINE,257.6,141.68,77.28,222.82,38
RC,0272,SCRUB SURG DURAPREP 26ML,453.85,249.62,136.16,392.58,38
RC,0272,SET FMS INTREPID BALANCED 30D,500.83,275.46,150.25,433.22,38
RC,0272,SET FOREIGN BODY RETRIEVAL FBR,740.25,407.14,222.08,640.32,38
RC,0272,SET INTRODUCER STOPLOSS,652.5,358.88,195.75,564.41,38
RC,0272,SET OTSC STENTFIX SYS,3145.5,1730.03,943.65,2720.86,38
RC,0272,SET SUCT IRRI FLOW II W/TIP,366.04,201.33,109.81,316.62,38
RC,0272,SET TUBE INSERT TANDEM STL,1264.5,695.48,379.35,1093.79,38
RC,0272,SET TUBING I/A PHACO CONST,239.78,131.88,71.93,207.41,38
RC,0272,SET UROLOGY TUBING DISP,719.28,395.61,215.78,622.18,38
RC,0272,SHEATH CSTA 8.5FR,666.0,366.3,199.8,576.09,38
RC,0272,SHEATH DILAT SUB-C 11FR,7698.25,4234.04,2309.48,6658.99,38
RC,0272,SHEATH DILAT SUB-C 13FR,7698.25,4234.04,2309.48,6658.99,38
RC,0272,SHEATH DILAT TIGHTRAIL 11FR,9482.75,5215.52,2844.83,8202.58,38
RC,0272,SHEATH DILAT TIGHTRAIL 13FR,9482.75,5215.52,2844.83,8202.58,38
RC,0272,SHEATH DILAT VISI LG 16F 43,1215.0,668.25,364.5,1050.98,38
RC,0272,SHEATH DRYSEAL FLEX 14FX33CM,2362.5,1299.38,708.75,2043.56,38
RC,0272,SHEATH DRYSEAL FLEX 16FX33CM,2362.5,1299.38,708.75,2043.56,38
RC,0272,SHEATH DRYSEAL FLEX 18FX33CM,3213.0,1767.15,963.9,2779.25,38
RC,0272,SHEATH DRYSEAL FLEX 24FX33CM,3213.0,1767.15,963.9,2779.25,38
RC,0272,SHEATH HYDROPHILIC 5F 25 21G,316.25,173.94,94.88,273.56,38
RC,0272,SHEATH HYDROPHILIC 6F 25 21G,316.25,173.94,94.88,273.56,38
RC,0272,SHEATH INTRO PERC 7FR 24,419.75,230.87,125.93,363.08,38
RC,0272,SHEATH INTRO SENTRANT 18FR28CMC,841.5,462.83,252.45,727.9,38
RC,0272,SHEATH PINNACLE STR 6FR 45CM,575.0,316.25,172.5,497.38,38
RC,0272,SHEATH PINNACLE STR 6FR 65CM,575.0,316.25,172.5,497.38,38
RC,0272,SHEATH PINNACLE STR 7FR 45CM,575.0,316.25,172.5,497.38,38
RC,0272,SHEATH PINNACLE STR 7FR 65CM,575.0,316.25,172.5,497.38,38
RC,0272,SHEATH SL2 8.5FR,711.0,391.05,213.3,615.02,38
RC,0272,SHEATH SLENDER 5FR 10MM,316.25,173.94,94.88,273.56,38
RC,0272,SHEATH SLENDER 6FR 10MM,316.25,173.94,94.88,273.56,38
RC,0272,SHEATH SLENDER 6FR 16MM,316.25,173.94,94.88,273.56,38
RC,0272,SHEATH SLENDER 7FR 10MM,316.25,173.94,94.88,273.56,38
RC,0272,SHEATH SPLITABLE LNG 7FRX25CM,259.04,142.48,77.71,224.07,38
RC,0272,SHEATH SPLITABLE LNG 9FRX25CM,259.04,142.48,77.71,224.07,38
RC,0272,SHEATH SRO 8.5FR,738.0,405.9,221.4,638.37,38
RC,0272,SLEEVE INSERT ELASTIC 8-11MM,431.25,237.19,129.38,373.03,38
RC,0272,SOL ASCENDO LIFTING AGENT 5ML,230.0,126.5,69.0,198.95,38
RC,0272,SOL WOUND BACTISURE 1L,3356.01,1845.81,1006.8,2902.95,38
RC,0272,SPG BIO SENTREX 10X10CM X 1CM,1912.5,1051.88,573.75,1654.31,38
RC,0272,SPLINT ROLL 4IN,385.19,211.86,115.56,333.19,38
RC,0272,STAPLE PRECISE 2.5MM,1571.27,864.2,471.38,1359.15,38
RC,0272,STAPLE PRECISE 2MM,1571.27,864.2,471.38,1359.15,38
RC,0272,STAPLE PRECISE 3MM,1571.27,864.2,471.38,1359.15,38
RC,0272,STAPLER 30 VASC,472.19,259.71,141.66,408.44,38
RC,0272,STAPLER ECHELON 60X440MM LONG,1952.15,1073.69,585.65,1688.61,38
RC,0272,STAPLER ECHELON CONTOUR CVD GRN,2267.24,1246.99,680.17,1961.16,38
RC,0272,STAPLER ECHELON LINEAR 80MM,382.78,210.53,114.83,331.1,38
RC,0272,STAPLER ECHELON POWR CIRC 25MM,1635.66,899.62,490.7,1414.85,38
RC,0272,STAPLER ECHELON POWR CIRC 29MM,1635.66,899.62,490.7,1414.85,38
RC,0272,STAPLER ECHLN 60X280MM COMPCT,1952.15,1073.69,585.65,1688.61,38
RC,0272,STAPLER ENDO LINEAR CUTTER 75,575.0,316.25,172.5,497.38,38
RC,0272,STAPLER POWR COMPACT 45,1252.85,689.07,375.86,1083.72,38
RC,0272,STAPLER POWR ECHELON FLEX VASC,1262.3,694.27,378.69,1091.89,38
RC,0272,STAPLER POWR LNG 45,1252.85,689.07,375.86,1083.72,38
RC,0272,STAPLER POWR+ 340MM 60MM,1503.41,826.88,451.02,1300.45,38
RC,0272,STAPLER POWR+ 400MM 60MM,1503.41,826.88,451.02,1300.45,38
RC,0272,STAPLER POWR+ STD 45,1252.85,689.07,375.86,1083.72,38
RC,0272,STAPLER PROX LINEAR 30,435.39,239.47,130.62,376.61,38
RC,0272,STAPLER PROX LINEAR 60,439.59000000000003,241.77999999999997,131.26,382.04,76
RC,0272,STENT URET SILIC 6X22 BLK,637.88,350.84,191.36,551.77,38
RC,0272,STENT URET SILIC 6X26 BLK,637.88,350.84,191.36,551.77,38
RC,0272,STENT VBX BALLOON 11X39X135,12450.0,6847.5,3735.0,10769.25,38
RC,0272,STIMULATOR NERVE HEAD/NECK,2677.5,1472.63,803.25,2316.04,38
RC,0272,STIMULATOR NERVE INTRAOPERATVE,3303.0,1816.65,990.9,2857.1,38
RC,0272,STRAP ANKLE ARTHRO DISTRAC,339.6,186.78,101.88,293.75,38
RC,0272,STYLET 2 COIL SGL,2871.0,1579.05,861.3,2483.42,38
RC,0272,STYLET PRE CALIB,3690.0,2029.5,1107.0,3191.85,38
RC,0272,SUCT COAG BIPOLAR 11FR 11IN,506.0,278.3,151.8,437.69,38
RC,0272,SUPPORT ABUTMENT OPRA F,6536.25,3594.94,1960.88,5653.86,38
RC,0272,SUPPORT SURG BRA 2XL,437.75,240.77,131.33,378.65,38
RC,0272,SUPPORT SURG BRA 3XL,437.75,240.77,131.33,378.65,38
RC,0272,SUPPORT SURG BRA XL,416.88,229.29,125.06,360.6,38
RC,0272,SUT ETHIBOND 2 30IN GRNWH V37,575.0,316.25,172.5,497.38,38
RC,0272,SUT ETHIBOND 5 MO-4 18IN GRN,284.57,156.52,85.37,246.15,38
RC,0272,SUT LOOP 5 NON ABSORB GRN,430.85,236.97,129.26,372.69,38
RC,0272,SUT PDS 2-0 VIOL 60IN CT-1,303.03,166.67,90.91,262.12,38
RC,0272,SUT PDS II 4-0 RB-1 36IN VIOL,295.84,162.72,88.75,255.9,38
RC,0272,SUT PDS II 5-0 RB-1 27IN CLR,359.03,197.47,107.71,310.56,38
RC,0272,SUT VLOC 0 GS-22 9IN BLU,323.61,177.99,97.08,279.92,38
RC,0272,SUT VLOC 0 GS21 18IN,272.95,150.13,81.89,236.1,38
RC,0272,SUT VLOC PBT 2-0 V-20 12IN BLU,239.26,131.6,71.78,206.96,38
RC,0272,SUT VLOCM 90 VIO 3-0 CV23 6IN,235.64,129.61,70.69,203.83,38
RC,0272,SYR DEFLUX GEL 1ML,12450.0,6847.5,3735.0,10769.25,38
RC,0272,SYS ACCESS TRUSTEER DBL CRVD,6225.0,3423.75,1867.5,5384.63,38
RC,0272,SYS AERA EUSTACHAIN BALLOON,7882.72,4335.5,2364.82,6818.55,38
RC,0272,SYS CARDIOPLEGIA TUBE PK,1107.0,608.85,332.1,957.56,38
RC,0272,SYS DETACHMENT ACTUATOR,312.8,172.04,93.84,270.57,38
RC,0272,SYS DURA SEALANT,3045.6,1675.08,913.68,2634.44,38
RC,0272,SYS DURA SEALANT SPINE 5ML,3045.6,1675.08,913.68,2634.44,38
RC,0272,SYS FTRD COLONIC SET,6511.35,3581.25,1953.41,5632.32,38
RC,0272,SYS NAV ROD SPINE UNID TECH,5913.75,3252.57,1774.13,5115.39,38
RC,0272,SYS PORT CLOSE CARTER THOM XL,1025.1,563.81,307.53,886.71,38
RC,0272,SYS PUMPING SGL ACTION,266.51,146.59,79.95,230.53,38
RC,0272,SYS SKIN CLOSURE DERMABOND 42,575.0,316.25,172.5,497.38,38
RC,0272,SYS STEREOTACTIC TRACER POINTC,2871.0,1579.05,861.3,2483.42,38
RC,0272,SYS VASCADE MVP VEN CLOS 10-12,1147.5,631.13,344.25,992.59,38
RC,0272,SYS VASOVIEW 6 PRO STL,575.0,316.25,172.5,497.38,38
RC,0272,SYS XTACK ENDO HELIX TACK,3906.0,2148.3,1171.8,3378.69,38
RC,0272,TAP 2 LEAD XPDM 5MM SPINE SURG,1022.76,562.52,306.83,884.69,38
RC,0272,TAPE RETRACT-O-TAPE BLUNT NDL,335.22,184.38,100.57,289.97,38
RC,0272,TEMPLATE SURGICAL FOR 2/2.3MM 4 HOLE BAR MANDIBULAR FRACTURE,366.28,201.46,109.88,316.83,38
RC,0272,TEMPLATE SURGICAL FOR 2/2.3MM 6 HOLE BAR MANDIBULAR FRACTURE,351.33,193.24,105.4,303.9,38
RC,0272,TIP ABLATION 2.8X2MM 23KHZ,2390.99,1315.05,717.3,2068.21,38
RC,0272,TIP CUSA XL CRVD EXT STD,1313.55,722.46,394.07,1136.22,38
RC,0272,TIP HANDPIECE CRVD 1.6MM 36KHZ,2390.99,1315.05,717.3,2068.21,38
RC,0272,TIP LAP CUSA 23 STD LENGTH,5762.61,3169.44,1728.78,4984.66,38
RC,0272,TIP SONOPET BROAD KNIFE 10CM,4217.26,2319.5,1265.18,3647.93,38
RC,0272,TIP SONOPET IQ APEX 360 12CM,4500.0,2475.0,1350.0,3892.5,38
RC,0272,TIP SONOPET IQ APEX 360 20CM,4940.7,2717.39,1482.21,4273.71,38
RC,0272,TIP SONOPET IQ APEX KNIFE 11CM,4345.11,2389.82,1303.53,3758.52,38
RC,0272,TIP SONOPET IQ BARRACUDA 12CM,3862.53,2124.4,1158.76,3341.09,38
RC,0272,TIP SONOPET IQ MICRO CLAW 12CM,4287.38,2358.06,1286.21,3708.58,38
RC,0272,TIP SONOPET IQ SURG CLAW 12CM,4287.38,2358.06,1286.21,3708.58,38
RC,0272,TIP SONOPET IQ SURG MICRO 12CM,3782.75,2080.52,1134.83,3272.08,38
RC,0272,TIP SONOPET IQ SURG STD 12CM,3530.43,1941.74,1059.13,3053.82,38
RC,0272,TOOL CUSA XL WRENCH 36KHZ DISP,530.21,291.62,159.06,458.63,38
RC,0272,TOOL STERNAL TUNNEL 9FR 35.5CM,2700.0,1485.0,810.0,2335.5,38
RC,0272,TOOL TRANSVERSE TUNNEL 36.1CM,2700.0,1485.0,810.0,2335.5,38
RC,0272,TOOL TUNNEL DBS SUBCUTANEOUS,1350.0,742.5,405.0,1167.75,38
RC,0272,TRAY CUSTOM CHEST TUBE INSERT,261.74,143.96,78.52,226.41,38
RC,0272,TRAY MAHUR ELITE 12.5FRX24CM,575.0,316.25,172.5,497.38,38
RC,0272,TRAY PNEUMOTHORAX 14FRX29CM,1278.9,703.4,383.67,1106.25,38
RC,0272,TRIALTIS SPINE SYSTEM TAPLONG 4.0MM 3-5CM  1%,1022.76,562.52,306.83,884.69,38
RC,0272,TRIALTIS SPINE SYSTEM TAPLONG 5.0MM 3-5CM  1%,1022.76,562.52,306.83,884.69,38
RC,0272,TRIALTIS SPINE SYSTEM TAPLONG 6.0MM 3-7CM  1%,1022.76,562.52,306.83,884.69,38
RC,0272,TRIALTIS SPINE SYSTEM TAPLONG 7.0MM 3-10CM  1%,1022.76,562.52,306.83,884.69,38
RC,0272,TROCAR VERSASTEP 5MM,575.0,316.25,172.5,497.38,38
RC,0272,TUBE ENDOLUMIK GASTRIC 36FR,1350.0,742.5,405.0,1167.75,38
RC,0272,TUBE FEED ENFIT JEJUNAL 16FR,643.68,354.03,193.1,556.78,38
RC,0272,TUBE MIC JEJUNAL 18FR,643.68,354.03,193.1,556.78,38
RC,0272,TUBE NASAL BRIDLE 12-14F NAVY,575.0,316.25,172.5,497.38,38
RC,0272,TUBE NASAL BRIDLE 16-18F YEL,575.0,316.25,172.5,497.38,38
RC,0272,TUBE NG NASOINTESTINAL KIT 12,451.38,248.26,135.41,390.44,38
RC,0272,TUBE OCTOPUS STARFISH,3563.73,1960.06,1069.12,3082.63,38
RC,0272,TUBE SGL INSERT,1201.5,660.83,360.45,1039.3,38
RC,0272,TUBE ST CARDIOPLEGIA,436.89,240.29,131.07,377.91,38
RC,0272,TUBE STOPLOSS JONES 4.0X15MM,1102.5,606.38,330.75,953.66,38
RC,0272,TUBING CASSETTE CROSS PUMP SYS,440.74,242.41,132.22,381.24,38
RC,0272,VALVE ENDOSPY UROSEAL ADJ,230.0,126.5,69.0,198.95,38
RC,0272,VISERA RETAINER MCNEALY GLASS,234.66,129.07,70.4,202.98,38
RC,0272,WIRE JAG STIFF SHAFT 035 260CM,508.47,279.66,152.54,439.83,38
RC,0272,WIRE STR TIP 0.025INX260CM,940.5,517.28,282.15,813.53,38
RC,0272,WIRE WATCHMAN PIGTAIL RF 230CM,4544.25,2499.34,1363.28,3930.78,38
RC,0272,elastomeric (ON-Q) pump 120 mL Device 120 mL Package,1500.0,825.0,450.0,1297.5,38
RC,0272,elastomeric (ON-Q) pump 270 mL Device 270 mL Package,2310.0,1270.5,693.0,1998.15,38
RC,0274,HC HEARTWARE CONTROLLER 1420,19975.0,10986.25,5992.5,17578.0,140
RC,0274,SPLINT ANKLE SEATTLE MED 16-18,523.25,287.79,156.98,460.46,35
RC,0275,HC TRANSVEN PACING KIT-ARROW,8528.0,4690.4,2558.4,7504.64,35
RC,0276,IOL PC AR40E 14.5D,575.0,316.25,172.5,506.0,35
RC,0278,ALLOG TIB PROX W/WHOLE BTB L,32214.6,17718.03,9664.38,28348.85,35
RC,0278,AMS 700 CX TENACIO PROSTHESIS PENILE PUMP 18CM,41925.0,23058.75,12577.5,36894.0,35
RC,0278,BLOCK SILIC STL 7X4X1.5CM,1260.0,693.0,378.0,1108.8,35
RC,0278,BONE CANC CHIPS 90CC 0.1-4.0MM,5389.61,2964.29,1616.88,4742.86,35
RC,0278,BONE CEMENT SIMPLEX P SPEEDSET,323.72,178.05,97.12,284.87,35
RC,0278,CABLE CIRCLAGE CC 1.8 635MM,1800.0,990.0,540.0,1584.0,35
RC,0278,CATH IMPELLA SMARTASSIST 5.5,110000.0,60500.0,33000.0,96800.0,35
RC,0278,CEMENT BONE HOWMEDICA,323.72,178.05,97.12,284.87,35
RC,0278,CEMENT PROCEM OTOLOGIC,2070.0,1138.5,621.0,1821.6,35
RC,0278,CLIP ANEU AVM 2MM,1683.0,925.65,504.9,1481.04,35
RC,0278,CLIP ANEU L 90DEG ANGL 5MM,2165.31,1190.93,649.59,1905.47,35
RC,0278,CLIP ANEU L MINI STRONG CRVD 5,2165.31,1190.93,649.59,1905.47,35
RC,0278,CLIP ANEU L PERM 45DEG ANGL 5,2165.31,1190.93,649.59,1905.47,35
RC,0278,CLIP ANEU L PERM 45DEG ANGL 7.5,2165.31,1190.93,649.59,1905.47,35
RC,0278,CLIP ANEU L PERM CRVD 4MM,2165.31,1190.93,649.59,1905.47,35
RC,0278,CLIP ANEU L PERM CRVD 5MM,2165.31,1190.93,649.59,1905.47,35
RC,0278,CLIP ANEU L PERM CRVD SIDE 9MM,2165.31,1190.93,649.59,1905.47,35
RC,0278,CLIP ANEU L PERM LIGHT CRVD 11,2165.31,1190.93,649.59,1905.47,35
RC,0278,CLIP ANEU L PERM STR 15MM,2165.31,1190.93,649.59,1905.47,35
RC,0278,CLIP ANEU L TEMP BAYONET 7MM,2165.31,1190.93,649.59,1905.47,35
RC,0278,CLIP ANEU L TEMP BAYONET LT 5,2165.31,1190.93,649.59,1905.47,35
RC,0278,CLIP ANEU L TEMP CRVD 5MM,2165.31,1190.93,649.59,1905.47,35
RC,0278,CLIP ANEU L TEMP CRVD SIDE 9MM,2165.31,1190.93,649.59,1905.47,35
RC,0278,CLIP ANEU L TEMP LIGHT CRVD 5,2165.31,1190.93,649.59,1905.47,35
RC,0278,CLIP ANEU L TEMP LIGHT CRVD 9,2165.31,1190.93,649.59,1905.47,35
RC,0278,CLIP ANEU L TEMP MINI STR 5MM,2165.31,1190.93,649.59,1905.47,35
RC,0278,CLIP ANEU L TEMP STR 12MM,2165.31,1190.93,649.59,1905.47,35
RC,0278,CLIP ENDOSCOPIC 7FR 16MMX230CM,810.0,445.5,243.0,712.8,35
RC,0278,CLIP MICRO AVM 4MM,1683.0,925.65,504.9,1481.04,35
RC,0278,COMP FEM DIAPHYSEAL LF 150MM,21671.1,11919.11,6501.33,19070.57,35
RC,0278,COMP FEM FINN LT PROX 70,22295.46,12262.51,6688.64,19620.0,35
RC,0278,COMP TIB POLY BEARING 20MM,4519.35,2485.65,1355.81,3977.03,35
RC,0278,CYLINDER HEALING OPRA -12,8279.25,4553.59,2483.78,7285.74,35
RC,0278,DEVICE ATRICLIP PRO MINI 45MM,19800.0,10890.0,5940.0,17424.0,35
RC,0278,DEVICE EYEJET PRELOAD 14A RT,810.0,445.5,243.0,712.8,35
RC,0278,DEVICE HERO ART GRAFT COMP,5021.5,2761.83,1506.45,4418.92,35
RC,0278,ENV TYRX ABSORB CARDIAC LG,4027.5,2215.13,1208.25,3544.2,35
RC,0278,ENV TYRX ABSORB CARDIAC MED,4027.5,2215.13,1208.25,3544.2,35
RC,0278,GRAFT DURAGEN 4X5,4500.0,2475.0,1350.0,3960.0,35
RC,0278,GRAFT DURAGEN NON SUT 5X7,6134.49,3373.97,1840.35,5398.35,35
RC,0278,GRAFT FIBERFUSE BONE SUB 10CC,7158.75,3937.32,2147.63,6299.7,35
RC,0278,GRAFT FIBERFUSE BONE SUB 5CC,3982.5,2190.38,1194.75,3504.6,35
RC,0278,HC ATLAS GOLD DILATION BALLOON CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER,2335.0,1284.25,700.5,2054.8,35
RC,0278,HC EDWARDS SAPIEN 3 THV 20 MM,81250.0,44687.5,24375.0,71500.0,35
RC,0278,HC EDWARDS SAPIEN 3 THV 23 MM,81250.0,44687.5,24375.0,71500.0,35
RC,0278,HC EDWARDS SAPIEN 3 THV 26 MM,81250.0,44687.5,24375.0,71500.0,35
RC,0278,HC EDWARDS SAPIEN 3 THV 29 MM,81250.0,44687.5,24375.0,71500.0,35
RC,0278,HC EVOLUT TRANSCATHETER AORTIC VALVE REPLACEMENT,75000.0,41250.0,22500.0,66000.0,35
RC,0278,HC IMPELLA 5.0 A-C CATHETER,70000.0,38500.0,21000.0,61600.0,35
RC,0278,"HC IR BONE STABLIZATION, PHOTODYNAMIC",17888.5,9838.68,5366.55,15741.88,35
RC,0278,HC IR CAREFUSION VENOUS CATH,635.5,349.53,190.65,559.24,35
RC,0278,HC IR CLOSURE DEVICE EXOSEAL,800.0,440.0,240.0,704.0,35
RC,0278,HC IR COIL AXIUM BARE 3D,3141.5,1727.83,942.45,2764.52,35
RC,0278,HC IR COIL AXIUM BARE HELIX,1356.0,745.8,406.8,1193.28,35
RC,0278,HC IR COIL AXIUM NYLON HELIX,3377.5,1857.63,1013.25,2972.2,35
RC,0278,HC IR COIL AXIUM PGLA 3D,3632.0,1997.6,1089.6,3196.16,35
RC,0278,HC IR COIL AXIUM X SOFT 3D,6940.0,3817.0,2082.0,6107.2,35
RC,0278,HC IR COIL AXIUM X SOFT HELIX,4971.5,2734.33,1491.45,4374.92,35
RC,0278,HC IR COIL AZUR 0.018 DETACHABLE,5417.0,2979.35,1625.1,4766.96,35
RC,0278,HC IR COIL AZUR 0.018 PUSHABLE,4450.0,2447.5,1335.0,3916.0,35
RC,0278,HC IR COIL AZUR 0.035 DETACHABLE,3668.5,2017.68,1100.55,3228.28,35
RC,0278,HC IR COIL AZUR 0.035 PUSHABLE,5177.0,2847.35,1553.1,4555.76,35
RC,0278,HC IR COIL CONCERTO,2965.0,1630.75,889.5,2609.2,35
RC,0278,HC IR COIL DELTAPLUSH 10,3415.0,1878.25,1024.5,3005.2,35
RC,0278,HC IR COIL DETACH EV3,287.5,158.13,86.25,253.0,35
RC,0278,HC IR COIL DETACH PENUMBRA SYS,1111.0,611.05,333.3,977.68,35
RC,0278,HC IR COIL EMBOLD 10-20 CM,3500.0,1925.0,1050.0,3080.0,35
RC,0278,HC IR COIL EMBOLD 30-60 CM,4102.5,2256.38,1230.75,3610.2,35
RC,0278,HC IR COIL EMBOLD 4-8CM,3500.0,1925.0,1050.0,3080.0,35
RC,0278,HC IR COIL EMBOLD PACKING 15 CM,3720.0,2046.0,1116.0,3273.6,35
RC,0278,HC IR COIL FIBERED PLATINUM,345.0,189.75,103.5,303.6,35
RC,0278,HC IR COIL HILAL,402.5,221.38,120.75,354.2,35
RC,0278,HC IR COIL HYDROFILL,5546.5,3050.58,1663.95,4880.92,35
RC,0278,HC IR COIL HYDROFRAME 10,6889.5,3789.23,2066.85,6062.76,35
RC,0278,HC IR COIL HYDROFRAME 18,8619.0,4740.45,2585.7,7584.72,35
RC,0278,HC IR COIL HYDROSOFT 10,4801.5,2640.83,1440.45,4225.32,35
RC,0278,HC IR COIL HYPERSOFT 3D COMPLEX,4450.0,2447.5,1335.0,3916.0,35
RC,0278,HC IR COIL IDC INTERLOCK 0.018 2D,1403.0,771.65,420.9,1234.64,35
RC,0278,HC IR COIL IDC INTERLOCK 0.035 2D,2718.5,1495.18,815.55,2392.28,35
RC,0278,HC IR COIL MICROPLEX COMPLEX 10,2902.5,1596.38,870.75,2554.2,35
RC,0278,HC IR COIL MICROPLEX COSMOS 10,5259.5,2892.73,1577.85,4628.36,35
RC,0278,HC IR COIL MICROPLEX COSMOS 18,5220.0,2871.0,1566.0,4593.6,35
RC,0278,HC IR COIL MICROPLEX HYPSOFT,5690.0,3129.5,1707.0,5007.2,35
RC,0278,HC IR COIL MICROPLEX REG HELICAL 18,1500.5,825.28,450.15,1320.44,35
RC,0278,HC IR COIL MICROPLEX SOFT HELICAL 18,1283.5,705.93,385.05,1129.48,35
RC,0278,HC IR COIL NESTER,402.5,221.38,120.75,354.2,35
RC,0278,HC IR COIL PENUMBRA COMP SOFT,8401.5,4620.83,2520.45,7393.32,35
RC,0278,HC IR COIL PENUMBRA COMP STD,7866.0,4326.3,2359.8,6922.08,35
RC,0278,HC IR COIL PENUMBRA COMP XSOFT,7205.5,3963.03,2161.65,6340.84,35
RC,0278,HC IR COIL PENUMBRA CURVE X SFT,7014.0,3857.7,2104.2,6172.32,35
RC,0278,HC IR COIL PENUMBRA J SHAPE,8769.5,4823.23,2630.85,7717.16,35
RC,0278,HC IR COIL PENUMBRA J SOFT RUBY,5034.0,2768.7,1510.2,4429.92,35
RC,0278,HC IR COIL PENUMBRA POD,7429.0,4085.95,2228.7,6537.52,35
RC,0278,HC IR COIL PENUMBRA RUBY,3335.5,1834.53,1000.65,2935.24,35
RC,0278,HC IR COIL PENUMBRA SMART HELICAL,4971.5,2734.33,1491.45,4374.92,35
RC,0278,HC IR COIL PENUMBRA SMART X SFT,6790.5,3734.78,2037.15,5975.64,35
RC,0278,HC IR COIL RMBOLD PACKING 30-60CM,4540.5,2497.28,1362.15,3995.64,35
RC,0278,HC IR COIL STAINLESS STEEL 0.035,345.0,189.75,103.5,303.6,35
RC,0278,HC IR COIL SWIFTPAC 10/15 CM,4935.0,2714.25,1480.5,4342.8,35
RC,0278,HC IR COIL SWIFTPAC 30 CM,5723.0,3147.65,1716.9,5036.24,35
RC,0278,HC IR COIL SWIFTPAC 6 CM,4059.0,2232.45,1217.7,3571.92,35
RC,0278,HC IR COIL TARGET 360 SOFT,8647.0,4755.85,2594.1,7609.36,35
RC,0278,HC IR COIL TARGET 360 STANDARD,7917.5,4354.63,2375.25,6967.4,35
RC,0278,HC IR COIL TARGET 360 ULTRA,8647.0,4755.85,2594.1,7609.36,35
RC,0278,HC IR COIL TARGET 3D,7917.5,4354.63,2375.25,6967.4,35
RC,0278,HC IR COIL TARGET HELICAL ULTRA,5602.5,3081.38,1680.75,4930.2,35
RC,0278,HC IR COIL TARGET XL SOFT,12176.0,6696.8,3652.8,10714.88,35
RC,0278,HC IR COIL TARGET XL STANDARD,12176.0,6696.8,3652.8,10714.88,35
RC,0278,HC IR COIL TORNADO,408.5,224.68,122.55,359.48,35
RC,0278,HC IR COIL TORNADO LEF,823.0,452.65,246.9,724.24,35
RC,0278,HC IR COIL ULTIPAQ 10,4450.0,2447.5,1335.0,3916.0,35
RC,0278,HC IR DENVER SHUNT KIT,11400.0,6270.0,3420.0,10032.0,35
RC,0278,HC IR DETACHABLE COIL 0.035,2869.5,1578.23,860.85,2525.16,35
RC,0278,HC IR DEVICE EMBOLIZATION WEB,37375.0,20556.25,11212.5,32890.0,35
RC,0278,HC IR DRAIN CAREFUSION PERITONEAL CATH,575.0,316.25,172.5,506.0,35
RC,0278,HC IR EMB AMPLAZTER VASCULAR PLUG,4450.0,2447.5,1335.0,3916.0,35
RC,0278,HC IR EMB CATEPILLAR,4555.0,2505.25,1366.5,4008.4,70
RC,0278,HC IR EMB EMBOSPHERES PARTICLES,1080.0,594.0,324.0,950.4,35
RC,0278,HC IR EMB LAVA  KIT 6 ML,18338.0,10085.9,5501.4,16137.44,35
RC,0278,HC IR EMB LAVA KIT 2ML,7262.5,3994.38,2178.75,6391.0,35
RC,0278,HC IR EMB LC BEAD,6242.0,3433.1,1872.6,5492.96,35
RC,0278,HC IR EMB LIQUID EMBOLIC (N-BCA) GLUE,13175.5,7246.53,3952.65,11594.44,35
RC,0278,HC IR EMB MEDTRONIC VASCULAR PLUG,6193.5,3406.43,1858.05,5450.28,35
RC,0278,HC IR EMB ONYX EMBOLIC LIQUID,8319.0,4575.45,2495.7,7320.72,35
RC,0278,HC IR EMB PIPELINE DEVICE,33000.0,18150.0,9900.0,29040.0,35
RC,0278,HC IR EMB PIPELINE DEVICE- HIGH,35437.5,19490.63,10631.25,31185.0,35
RC,0278,HC IR EMB SEPTAL OCCLUDER,23823.5,13102.93,7147.05,20964.68,35
RC,0278,HC IR ENDOANCHOR,17421.0,9581.55,5226.3,15330.48,35
RC,0278,HC IR FIBRIN GLUE,693.0,381.15,207.9,609.84,35
RC,0278,HC IR KIT VENASEAL,5671.5,3119.33,1701.45,4990.92,35
RC,0278,HC IR KYPH BONE CEMENT,1000.0,550.0,300.0,880.0,35
RC,0278,HC IR KYPH BONE TAMP,3308.5,1819.68,992.55,2911.48,35
RC,0278,HC IR MISC BIO-BONE GRAFT,15473.0,8510.15,4641.9,13616.24,35
RC,0278,HC IR MISC CORTOSS BONE CEMENT,4450.0,2447.5,1335.0,3916.0,35
RC,0278,HC IR MISC DFINE 2ND FX CEMENT KIT,7750.5,4262.78,2325.15,6820.44,35
RC,0278,"HC IR SCREW, FENESTRATED",13074.0,7190.7,3922.2,11505.12,35
RC,0278,HC IR VERT AUG KIVA KIT,12761.0,7018.55,3828.3,11229.68,35
RC,0278,HC LOTUS EDGE VALVE (23-27 MM),81250.0,44687.5,24375.0,71500.0,35
RC,0278,HC TRANSCATHETER MELODY PULMONIC VALVE,63750.0,35062.5,19125.0,56100.0,35
RC,0278,IMPL BIOHELIX 16X80 -12,64575.0,35516.25,19372.5,56826.0,35
RC,0278,IMPL BODY 15MM 135DEG AEQUALIS,14975.4,8236.47,4492.62,13178.35,35
RC,0278,IMPL SILIC BTN 22,350.75,192.92,105.23,308.66,35
RC,0278,IMPL TUBE MONO-CANALICU CRAWFO,498.35,274.1,149.51,438.55,35
RC,0278,IMPL VALVE MTRL MASTER 27MM,16830.0,9256.5,5049.0,14810.4,35
RC,0278,IMPL WILDCAT PRO ALTO TOTAL,2003.49,1101.92,601.05,1763.07,35
RC,0278,IMPL WT EYE PLATINUM SLIM 1.0G,2106.0,1158.3,631.8,1853.28,35
RC,0278,INST ABUTMENT 12X78,33000.0,18150.0,9900.0,29040.0,35
RC,0278,KIT ENFIT PEG MIC PULL 20FR,548.95,301.93,164.69,483.08,35
RC,0278,KIT ENFIT PEG PULL METHOD 20FR,587.61,323.19,176.28,517.1,35
RC,0278,KIT HERO ACCESSORY COMP,2722.5,1497.38,816.75,2395.8,35
RC,0278,LEGION FEM CONE ID 18MM LEFT,11205.0,6162.75,3361.5,9860.4,35
RC,0278,LEGION FINNED TIB WEDGE SZ5 10MM RIGHT,4755.9,2615.75,1426.77,4185.19,35
RC,0278,LEGION SCW LWDG S7 5D X 5P,3403.8,1872.09,1021.14,2995.34,35
RC,0278,LGN HK DIS FEM WDG SZ6 15MM,4195.13,2307.33,1258.54,3691.71,35
RC,0278,PATCH PERICARD XENOSURE 0.8X8,940.5,517.28,282.15,827.64,35
RC,0278,PROBE DOPPLER SCHWARTZ,2946.06,1620.34,883.82,2592.53,35
RC,0278,PRSTH AOR W/GRAFT 25MM,20295.0,11162.25,6088.5,17859.6,35
RC,0278,PRSTH AOR W/GRAFT 27/29MM,16496.7,9073.19,4949.01,14517.1,35
RC,0278,PUMP CARD IMPELLA CP,67500.0,37125.0,20250.0,59400.0,35
RC,0278,RESERVOIR TITAN 75CC,12450.0,6847.5,3735.0,10956.0,35
RC,0278,RING CAPSULAR TENSION 12-14.5,1229.36,676.15,368.81,1081.84,35
RC,0278,RING SEGUIN ANNULOPLASTY 32MM,9939.25,5466.59,2981.78,8746.54,35
RC,0278,RING SEGUIN ANNULOPLASTY 36MM,9939.25,5466.59,2981.78,8746.54,35
RC,0278,ROD UNID PERCUTAN TI 4+LVL 5.5C,5913.75,3252.57,1774.13,5204.1,35
RC,0278,SEGMENT CAPSULAR TENSION 9.61,967.5,532.13,290.25,851.4,35
RC,0278,SET INTUBATION CRAWFORD,563.5,309.93,169.05,495.88,35
RC,0278,SLING PTOSIS W/FRONTALIS 300MM,364.15,200.29,109.25,320.45,35
RC,0278,SPACER FORTIF-R 20 CORE 61-82,19800.0,10890.0,5940.0,17424.0,35
RC,0278,SPACER FORTIF-R 20 LO 25X30 4D,4500.0,2475.0,1350.0,3960.0,35
RC,0278,STEM HIP SZ 3 LT BOW 240MM,12450.0,6847.5,3735.0,10956.0,35
RC,0278,STENT AERO TRACH 14MMX20MM,10375.0,5706.25,3112.5,9130.0,35
RC,0278,STENT TRACH Y T18X60 12X30/15,16483.5,9065.93,4945.05,14505.48,35
RC,0278,STENT URET POLARIS 6FRX24CM,651.74,358.46,195.52,573.53,35
RC,0278,TRANSITION ROD Ã5.5 TITANIUM L600MM,4050.0,2227.5,1215.0,3564.0,35
RC,0278,TRANSITION TITANIUM ROD DIAM 3.5-5.4 L300MM,2700.0,1485.0,810.0,2376.0,35
RC,0278,TUBE FEED ENFIT JEJUNAL 12FR,643.68,354.03,193.1,566.44,35
RC,0278,TUBE FEED ENFIT JEJUNAL 20FR,643.68,354.03,193.1,566.44,35
RC,0278,VALVE AOR CONFORM-X 19MM,16496.7,9073.19,4949.01,14517.1,35
RC,0278,VALVE AOR CONFORM-X 21MM,16496.7,9073.19,4949.01,14517.1,35
RC,0278,VALVE AOR CONFORM-X 23MM,16496.7,9073.19,4949.01,14517.1,35
RC,0278,VALVE AOR CONFORM-X 25MM,16496.7,9073.19,4949.01,14517.1,35
RC,0278,VALVE AOR FREESTYLE 19MM,28743.0,15808.65,8622.9,25293.84,35
RC,0278,VALVE AOR FREESTYLE 25MM,28743.0,15808.65,8622.9,25293.84,35
RC,0278,VALVE AOR MAGNA EASE 21MM,24750.0,13612.5,7425.0,21780.0,35
RC,0278,VALVE AOR MAGNA EASE 25MM,24750.0,13612.5,7425.0,21780.0,35
RC,0278,VALVE AOR MAGNA EASE 27MM,24750.0,13612.5,7425.0,21780.0,35
RC,0278,VALVE AOR REGENT FLEX 29MM,16830.0,9256.5,5049.0,14810.4,35
RC,0278,VALVE AOR W/GRAFT 23MM,20295.0,11162.25,6088.5,17859.6,35
RC,0278,VALVE EPIC PLUS AORTIC 29MM,16407.6,9024.18,4922.28,14438.69,35
RC,0278,VALVE EPIC PLUS SUPRA 19MM,16407.6,9024.18,4922.28,14438.69,35
RC,0278,VALVE EPIC PLUS SUPRA 21MM,16407.6,9024.18,4922.28,14438.69,35
RC,0278,VALVE EPIC PLUS SUPRA 25MM,16407.6,9024.18,4922.28,14438.69,35
RC,0278,VALVE EPIC PLUS SUPRA 27MM,16407.6,9024.18,4922.28,14438.69,35
RC,0278,VALVE MTRL 25MM,16496.7,9073.19,4949.01,14517.1,35
RC,0278,VALVE MTRL 27/29MM,16496.7,9073.19,4949.01,14517.1,35
RC,0278,VALVE MTRL EPIC+ PORCINE 27MM,17490.0,9619.5,5247.0,15391.2,35
RC,0278,VALVE MTRL EPIC+ PORCINE 29MM,17490.0,9619.5,5247.0,15391.2,35
RC,0278,VALVE MTRL EPIC+ PORCINE 31MM,17490.0,9619.5,5247.0,15391.2,35
RC,0278,VALVE MTRL EPIC+ PORCINE 33MM,17490.0,9619.5,5247.0,15391.2,35
RC,0278,WASHER HEALING 21X0.5 -12,2173.5,1195.43,652.05,1912.68,35
RC,0278,WASHER HEALING 21X5 -12,2173.5,1195.43,652.05,1912.68,35
RC,0343,potassium perchlorate 200 mg Cap 1 capsule Package,9.94,5.47,2.98,8.75,38
RC,0360,HC COMPLEX VAGINAL DELIVERY,7578.0,4167.9,2273.4,24494.0,76
RC,0360,HC CX IN OR PRE PROCEDURE,3069.0,1687.95,920.7,24494.0,190
RC,0360,"HC CYSTO LEVEL 1 BASE, FIRST 15 MIN",728.0,400.4,218.4,24494.0,38
RC,0360,HC CYSTO LEVEL 1 PER MIN,28.0,15.4,8.4,24494.0,38
RC,0360,"HC CYSTO LEVEL 2 BASE, FIRST 15 MIN",2547.0,1400.85,764.1,24494.0,38
RC,0360,HC CYSTO LEVEL 2 PER MIN,37.0,20.35,11.1,24494.0,38
RC,0360,"HC CYSTO LEVEL 3 BASE, FIRST 15 MIN",4147.0,2280.85,1244.1,24494.0,38
RC,0360,HC CYSTO LEVEL 3 PER MIN,45.0,24.75,13.5,24494.0,38
RC,0360,"HC CYSTO LEVEL 4 BASE, FIRST 15 MIN",5750.0,3162.5,1725.0,24494.0,38
RC,0360,HC CYSTO LEVEL 4 PER MIN,54.0,29.7,16.2,24494.0,38
RC,0360,"HC CYSTO LEVEL 5 BASE, FIRST 15 MIN",7278.0,4002.9,2183.4,24494.0,38
RC,0360,HC CYSTO LEVEL 5 PER MIN,111.0,61.05,33.3,24494.0,38
RC,0360,"HC CYSTO LEVEL 6 BASE, FIRST 15 MIN",11741.0,6457.55,3219.0,24494.0,38
RC,0360,HC CYSTO LEVEL 6 PER MIN,138.0,75.9,41.4,24494.0,38
RC,0360,HC FL SG PAIN INJ SPINE FH,1811.0,996.05,543.3,24494.0,152
RC,0360,HC OR ADDL CASE RESOURCES EMERGENCY,1611.0,886.05,483.3,24494.0,190
RC,0360,HC OR ADDL CASE RESOURCES EQUIPMENT,1538.0,845.9,461.4,24494.0,190
RC,0360,HC OR ADDL CASE RESOURCES STAFF,1597.0,878.35,479.1,24494.0,190
RC,0360,"HC OR LEVEL 1 BASE, FIRST 15 MIN",5769.0,3172.95,1215.9,24494.0,152
RC,0360,"HC OR LEVEL 1, EA ADDL MIN",63.0,34.65,16.5,24494.0,152
RC,0360,"HC OR LEVEL 2 BASE, FIRST 15 MIN",6429.0,3535.95,1377.6,24494.0,152
RC,0360,"HC OR LEVEL 2, EA ADDL MIN",63.0,34.65,16.5,24494.0,152
RC,0360,"HC OR LEVEL 3 BASE, FIRST 15 MIN",8059.0,4432.45,1509.9,24494.0,152
RC,0360,"HC OR LEVEL 3, EA ADDL MIN",65.5,36.025,16.5,24494.0,152
RC,0360,"HC OR LEVEL 4 BASE, FIRST 15 MIN",10085.0,5546.75,1689.3,24494.0,152
RC,0360,"HC OR LEVEL 4, EA ADDL MIN",79.0,43.45,17.1,24494.0,152
RC,0360,"HC OR LEVEL 5 BASE, FIRST 15 MIN",10031.0,5517.05,1696.2,24494.0,114
RC,0360,"HC OR LEVEL 5, EA ADDL MIN",135.0,74.25,18.9,24494.0,114
RC,0360,"HC OR LEVEL 6 BASE, FIRST 15 MIN",11857.0,6521.35,1769.1,24494.0,114
RC,0360,"HC OR LEVEL 6, EA ADDL MIN",162.0,89.1,19.5,24494.0,114
RC,0360,"HC OR LEVEL 7 BASE, FIRST 15 MIN",25876.0,14231.8,3219.0,24494.0,38
RC,0360,"HC OR LEVEL 7, EA ADDL MIN",191.0,105.05,57.3,24494.0,38
RC,0360,HC ROUTINE VAGINAL DELIVERY,7189.0,3953.95,2156.7,24494.0,76
RC,0360,"HC URETHROPLASTY, W/ TUBULARIZATION",12915.0,7103.25,3219.0,24494.0,38
RC,0370,HC ANE LEVEL 1 GEN HLTHY ADDL 15 MIN,642.0,353.1,192.6,555.33,38
RC,0370,"HC ANE LEVEL 1 GEN HLTHY BASE, FIRST 15 MIN",2184.0,1201.2,655.2,1889.16,38
RC,0370,HC ANE LEVEL 2 GEN MILD ADDL 15 MIN,675.0,371.25,202.5,583.88,38
RC,0370,"HC ANE LEVEL 2 GEN MILD BASE, FIRST 15 MIN",2441.0,1342.55,732.3,2111.47,38
RC,0370,HC ANE LEVEL 3 GEN SEVERE ADDL 15 MIN,707.0,388.85,212.1,611.56,38
RC,0370,"HC ANE LEVEL 3 GEN SEVERE BASE, FIRST 15 MIN",2698.0,1483.9,809.4,2333.77,38
RC,0370,HC ANE LEVEL 4 GEN INCAP ADDL 15 MIN,739.0,406.45,221.7,639.24,38
RC,0370,"HC ANE LEVEL 4 GEN INCAP BASE, FIRST 15 MIN",2955.0,1625.25,886.5,2556.08,38
RC,0370,HC ANE LEVEL 5 GEN MORIB ADDL 15 MIN,771.0,424.05,231.3,666.92,38
RC,0370,"HC ANE LEVEL 5 GEN MORIB BASE, FIRST 15 MIN",3212.0,1766.6,963.6,2778.38,38
RC,0370,HC ANE LEVEL 6 GEN DONOR ADDL 15 MIN,804.5,442.48,241.35,695.89,38
RC,0370,"HC ANE LEVEL 6 GEN DONOR BASE, FIRST 15 MIN",3491.5,1920.33,1047.45,3020.15,38
RC,0370,HC ANE MONITORED ADDL 15 MIN,193.0,106.15,57.9,166.95,76
RC,0370,"HC ANE MONITORED BASE, FIRST 15 MIN",616.0,338.79999999999995,173.4,565.71,114
RC,0370,HC ANE OB GENERAL ADDL 15 MIN,590.0,324.5,177.0,510.35,38
RC,0370,"HC ANE OB GENERAL BASE, FIRST 15 MIN",2109.0,1159.95,632.7,1824.29,38
RC,0370,"HC CT MODERATE SEDATION SAME PHYSICIAN/QHP, EA ADDL 15 MIN (ADD ON CODE)",39.0,21.45,11.7,33.74,38
RC,0370,"HC CT MODERATE SEDATION SAME PHYSICIAN/QHP, INIT 15 MIN, PAT 5 YRS AND OLDR",155.0,85.25,46.5,134.08,38
RC,0370,"HC DX MODERATE SEDATION SAME PHYSICIAN/QHP, EA ADDL 15 MIN (ADD ON CODE)",39.0,21.45,11.7,33.74,38
RC,0370,"HC DX MODERATE SEDATION SAME PHYSICIAN/QHP, INIT 15 MIN, PAT 5 YRS AND OLDR",155.0,85.25,46.5,134.08,38
RC,0370,HC EYE ANE LEVEL 1 GEN HLTHY ADDL 15 MIN,331.0,182.05,99.3,286.32,38
RC,0370,"HC EYE ANE LEVEL 1 GEN HLTHY BASE, FIRST 15 MIN",1653.0,909.15,495.9,1429.85,38
RC,0370,HC EYE ANE LEVEL 2 GEN MILD ADDL 15 MIN,401.0,220.55,120.3,346.87,38
RC,0370,"HC EYE ANE LEVEL 2 GEN MILD BASE, FIRST 15 MIN",2011.0,1106.05,603.3,1739.52,38
RC,0370,HC EYE ANE LEVEL 3 GEN SEVERE ADDL 15MIN,547.0,300.85,164.1,473.16,38
RC,0370,"HC EYE ANE LEVEL 3 GEN SEVERE BASE, FIRST 15 MIN",2734.0,1503.7,820.2,2364.91,38
RC,0370,HC EYE ANE LEVEL 4 GEN INCAP ADDL 15MIN,835.0,459.25,250.5,722.28,38
RC,0370,"HC EYE ANE LEVEL 4 GEN INCAP BASE, FIRST 15 MIN",4183.0,2300.65,1254.9,3618.3,38
RC,0370,HC EYE ANE LEVEL 5 GEN MORIB ADDL 15MIN,1025.0,563.75,307.5,886.63,38
RC,0370,"HC EYE ANE LEVEL 5 GEN MORIB BASE, FIRST 15 MIN",5127.0,2819.85,1538.1,4434.86,38
RC,0370,HC EYE ANE LEVEL 6 GEN DONOR ADDL 15MIN,1197.0,658.35,359.1,1035.41,38
RC,0370,"HC EYE ANE LEVEL 6 GEN DONOR BASE, FIRST 15 MIN",5988.0,3293.4,1796.4,5179.62,38
RC,0370,HC EYE ANE MONITORED ADDL 15MIN,126.0,69.3,37.8,108.99,38
RC,0370,"HC EYE ANE MONITORED BASE, FIRST 15 MIN",625.0,343.75,187.5,540.63,38
RC,0370,HC EYE ANE REGIONAL ADDL 15MIN,161.0,88.55,48.3,139.27,38
RC,0370,"HC EYE ANE REGIONAL BASE, FIRST 15 MIN",806.0,443.3,241.8,697.19,38
RC,0370,"HC MODERATE SEDATION SAME PHYSICIAN/QHP, EA ADDL 15 MIN (ADD ON CODE)",47.0,25.85,11.7,47.58,342
RC,0370,"HC MODERATE SEDATION SAME PHYSICIAN/QHP, INIT 15 MIN, PAT 5 YRS AND OLDER",186.5,102.575,46.5,188.57,342
RC,0370,"HC MR MODERATE SEDATION SAME PHYSICIAN/QHP, EA ADDL 15 MIN (ADD ON CODE)",39.0,21.45,11.7,33.74,38
RC,0370,"HC MR MODERATE SEDATION SAME PHYSICIAN/QHP, INIT 15 MIN, PAT 5 YRS AND OLDR",155.0,85.25,46.5,134.08,38
RC,0370,"HC NM MODERATE SEDATION SAME PHYSICIAN/QHP, EA ADDL 15 MIN (ADD ON CODE)",39.0,21.45,11.7,33.74,38
RC,0370,"HC NM MODERATE SEDATION SAME PHYSICIAN/QHP, INIT 15 MIN, PAT 5 YRS AND OLDR",155.0,85.25,46.5,134.08,38
RC,0370,"HC OB REGIONAL BLOCK BASE, FIRST 15 MIN",2313.0,1272.15,693.9,2000.75,38
RC,0370,HC REGIONAL BLOCK ADDL 15 MIN,585.0,321.75,175.5,506.03,38
RC,0370,"HC REGIONAL BLOCK BASE, FIRST 15 MIN",1824.0,1003.2,547.2,1577.76,38
RC,0370,"HC US MODERATE SEDATION SAME PHYSICIAN/QHP, EA ADDL 15 MIN (ADD ON CODE)",39.0,21.45,11.7,33.74,38
RC,0370,"HC US MODERATE SEDATION SAME PHYSICIAN/QHP, INIT 15 MIN, PAT 5 YRS AND OLDR",155.0,85.25,46.5,134.08,38
RC,0410,HC RT BRONCH ASSIST W/ DISPOSABLE SCOPE (IP ONLY),1002.0,551.1,300.6,866.73,38
RC,0471,HC MISC MINOR CONSULT,25.0,13.75,7.5,471.0,38
RC,0471,"HC SP ONLY, AUDITORY CONSULT-COUNSELING MINOR",60.0,33.0,18.0,471.0,38
RC,0519,HC FACILITY STAFF FOR RESEARCH 15 MIN,28.0,15.4,17.36,46.0,375
RC,0519,HC LASIK ASSESSMENT VISIT,150.0,82.5,46.0,129.75,50
RC,0519,HC MR PROSTATE DTI,102.0,56.1,46.0,88.23,25
RC,0519,HC MRI SCANNER AND STAFF FOR RESEARCH 15 MIN,53.5,29.43,33.17,46.28,25
RC,0519,HC ROOM USAGE FEE FOR RESEARCH,74.5,40.98,46.0,64.44,350
RC,0519,HC SHIPPING SELF-PAY FEDEX UPS NON-TAXABLE,25.0,13.75,15.5,46.0,25
RC,0519,HC SHIPPING SELF-PAY FEDEX UPS TAXABLE,25.0,13.75,15.5,46.0,25
RC,0519,HC SHIPPING SELF-PAY US MAIL 3+ NON-TAXABLE,5.0,2.75,3.1,46.0,25
RC,0519,HC SHIPPING SELF-PAY US MAIL 3+ TAXABLE,5.0,2.75,3.1,46.0,25
RC,0519,"HC SP ONLY, AUDITORY CONSULT-COUNSELING",180.0,99.0,46.0,155.7,25
RC,0519,"HC SP ONLY, DRIVING EVALUATION",200.0,110.0,46.0,173.0,25
RC,0519,"HC SP ONLY, LASIK POST OP",150.0,82.5,46.0,129.75,50
RC,0519,"HC SP ONLY, TINNITUS GROUP",80.0,44.0,46.0,69.2,25
RC,0519,"HC ZEST SP ONLY, SEVERE DRY EYE LID AND LASH TREATMENT",90.0,49.5,46.0,77.85,50
RC,0550,SNF,,,530.0,962.0,10
RC,0624,HC ACURATE NEO2 TAVR AORTIC VALVE SYSTEM. IDE G190051,73430.5,40386.78,22029.15,63517.38,38
RC,0624,"HC CVC-ASAP-TOO, WATCHMAN DEVICE, IDE G160171",93466.0,51406.3,28039.8,80848.09,38
RC,0624,HC HOPE-2 PROTOCOL,313.5,172.43,94.05,271.18,38
RC,0624,HC PASCAL TRANSCATHETER VALVE REPAIR SYSTEM IDE G180266,91788.0,50483.4,27536.4,79396.62,38
RC,0624,"HC REPRISE IV TRIAL, LOTUS EDGE VALVE 23MM-27MM IDE G160209",73377.5,40357.63,22013.25,63471.54,38
RC,0624,"HC SAPIEN 3 THV VALVE, EARLY TAVR, IDE G160259",78675.5,43271.53,23602.65,68054.31,38
RC,0624,"HC UNLOAD TRIAL, SAPIEN 3 THV VALVE IDE G150252",85231.0,46877.05,25569.3,73724.82,38
RC,0636,Antihemophilic Factor-VWF 1000 units Recon Soln 1 Each Vial,30.38,16.71,9.11,26.73,38
RC,0655,Hospice,,,431.0,680.0,9
RC,0656,Hospice,,,431.0,680.0,9
RC,0681,HC TRAUMA ACTIVATION,11330.0,6231.5,3399.0,34016.0,51
RC,0710,HC C-SECTION RECOVERY 1ST 2 HRS,2144.0,1179.2,643.2,1854.56,38
RC,0710,"HC EYE PACU LEVEL 1 BASE, FIRST 15 MIN",1062.0,584.1,318.6,918.63,38
RC,0710,"HC EYE PACU LEVEL 1, EA ADDL MIN",57.0,31.35,17.1,49.31,38
RC,0710,"HC EYE PACU LEVEL 2 BASE, FIRST 15 MIN",1596.0,877.8,478.8,1380.54,38
RC,0710,"HC EYE PACU LEVEL 2, EA ADDL MIN",60.0,33.0,18.0,51.9,38
RC,0710,"HC EYE PACU LEVEL 3 BASE, FIRST 15 MIN",2128.0,1170.4,638.4,1840.72,38
RC,0710,"HC EYE PACU LEVEL 3, EA ADDL MIN",64.0,35.2,19.2,55.36,38
RC,0710,"HC EYE PACU LEVEL 4 BASE, FIRST 15 MIN",2657.0,1461.35,797.1,2298.31,38
RC,0710,"HC EYE PACU LEVEL 4, EA ADDL MIN",67.0,36.85,20.1,57.96,38
RC,0710,"HC EYE PACU LEVEL 5 BASE, FIRST 15 MIN",3191.0,1755.05,957.3,2760.22,38
RC,0710,"HC EYE PACU LEVEL 5, EA ADDL MIN",69.0,37.95,20.7,59.69,38
RC,0710,HC EYE PHASE 2 LEVEL 1,1419.0,780.45,425.7,1227.44,38
RC,0710,HC EYE PHASE 2 LEVEL 2,2128.0,1170.4,638.4,1840.72,38
RC,0710,HC EYE PHASE 2 LEVEL 3,2835.0,1559.25,850.5,2452.28,38
RC,0710,HC EYE PHASE 2 LEVEL 4,3545.0,1949.75,1063.5,3066.43,38
RC,0710,HC LEVEL 1 RECOVERY,1947.0,1070.85,584.1,1684.16,38
RC,0710,HC LEVEL 2 RECOVERY,2593.0,1426.15,777.9,2242.95,38
RC,0710,HC LEVEL 3 RECOVERY,3242.0,1783.1,972.6,2804.33,38
RC,0710,HC LEVEL 4 RECOVERY,3888.0,2138.4,1166.4,3363.12,38
RC,0710,HC OR PACU RECOVERY HOLD PER MIN,68.0,37.4,20.4,58.82,38
RC,0710,"HC PACU LEVEL 1 BASE, FIRST 15 MIN",1668.0,917.4000000000001,312.9,1983.45,190
RC,0710,"HC PACU LEVEL 1, EA ADDL MIN",54.0,29.7,14.1,52.77,190
RC,0710,"HC PACU LEVEL 2 BASE, FIRST 15 MIN",1938.0,1065.9,581.4,1676.37,152
RC,0710,"HC PACU LEVEL 2, EA ADDL MIN",50.5,27.78,15.15,43.68,152
RC,0710,"HC PACU LEVEL 3 BASE, FIRST 15 MIN",2834.0,1558.7,850.2,2451.41,152
RC,0710,"HC PACU LEVEL 3, EA ADDL MIN",56.0,30.8,16.8,48.44,152
RC,0710,"HC PACU LEVEL 4 BASE, FIRST 15 MIN",3728.0,2050.4,1118.4,3224.72,152
RC,0710,"HC PACU LEVEL 4, EA ADDL MIN",63.5,34.93,19.05,54.93,152
RC,0710,"HC PACU LEVEL 5 BASE, FIRST 15 MIN",4920.0,2706.0,1476.0,4255.8,152
RC,0710,"HC PACU LEVEL 5, EA ADDL MIN",68.0,37.4,20.4,58.82,152
RC,0710,HC PHASE 2 LEVEL 1,2020.0,1111.0,606.0,1747.3,152
RC,0710,HC PHASE 2 LEVEL 2,2695.0,1482.25,808.5,2331.18,152
RC,0710,HC PHASE 2 LEVEL 3,3370.0,1853.5,1011.0,2915.05,152
RC,0710,HC PHASE 2 LEVEL 4,4037.0,2220.35,1211.1,3492.01,152
RC,0710,HC PHASE 2 LEVEL 5,6062.0,3334.1,1818.6,5243.63,152
RC,0710,HC RECOVERY VAGINAL DELIVERY,1121.0,616.55,336.3,969.67,76
RC,0721,HC FETAL PROCEDURE CARE,1241.0,682.55,372.3,1904.0,76
RC,0721,HC LABOR CARE,1106.0,608.3,331.8,1904.0,76
RC,0740,HC EEG MONITORING PER HOUR,163.0,89.65,48.9,936.0,38
RC,0811,HC KIDNEY ACQUISITION LIVE,173000.0,95150.0,51900.0,149645.0,38
RC,0812,HC DOUBLE LUNG ACQUISITION,233000.0,128150.0,69900.0,201545.0,38
RC,0812,HC DOUBLE LUNG ACQUISITION - EXPAND II TRIAL - IDE G130019,270000.0,148500.0,81000.0,233550.0,38
RC,0812,HC HEART ACQUISITION,235000.0,129250.0,70500.0,203275.0,38
RC,0812,"HC HEART ACQUISITION, DCD HEART TRIAL- IDE G180272",229000.0,125950.0,68700.0,198085.0,38
RC,0812,HC KIDNEY ACQUISITION CADAVER,143000.0,78650.0,42900.0,123695.0,38
RC,0812,HC KIDNEY ACQUISITION EN BLOC,173000.0,95150.0,51900.0,149645.0,38
RC,0812,HC LIVER ACQUISITION,197000.0,108350.0,59100.0,170405.0,38
RC,0812,HC LIVER ACQUISITION LIVE,197000.0,108350.0,59100.0,170405.0,38
RC,0812,HC PANCREAS ACQUISITION,133000.0,73150.0,39900.0,115045.0,38
RC,0812,HC SINGLE LUNG ACQUISITION,233000.0,128150.0,69900.0,201545.0,38
RC,0815,HC BM ACTIVATN NMPD DNR SEAR,1801.0,990.55,540.3,1557.87,38
RC,0815,HC BM INFECTIOUS DISEASE TST,506.0,278.3,151.8,437.69,38
RC,0815,HC BM TRANSPLANT ACQ-NMDP,69325.0,38128.75,20797.5,59966.13,38
RC,0815,HC NMDP BM TRANS ACQ - PBSC,70389.0,38713.95,21116.7,60886.49,38
RC,0815,HC NMDP INFECTIOUS DS TYP INTL,859.0,472.45,257.7,743.04,38
RC,0815,HC NMDP MARROW CANCELLATION,4775.0,2626.25,1432.5,4130.38,38
RC,0815,HC NMDP MARROW PBSC INFO SES,1553.0,854.15,465.9,1343.35,38
RC,0815,HC NMDP MARROW PBSC PHY EXAM,5147.0,2830.85,1544.1,4452.16,38
RC,0815,HC NMDP PBSC CANCELLATION,4934.0,2713.7,1480.2,4267.91,38
RC,0815,HC NMDP PRE-COLLECTION SAMPLE,1071.0,589.05,321.3,926.42,38
RC,0815,HC NMDP SAMPLE COLLECTION & CENTRAL LAB RESULTS,2077.0,1142.35,623.1,1796.61,38
RC,0815,HC NMDP TUBE OF BLOOD (BLOOD SAMPLE),1071.0,589.05,321.3,926.42,38
RC,0942,HC DIAB OUTPT SELF-MGMT EDUC INDIV PER 15 MIN,80.0,44.0,24.0,266.0,38